I have medical insurance, why do I have to pay back medical expenses out of my auto accident settlement?

In: Automotive Insurance

24 Apr 2010




A drunk driver rear-ended me in 2006, I have medical insurance that I pay for through my job. When my attorney told me the driver didn’t have insurance I knew I was in trouble. My auto insurance paid part of my medical, I paid my co-pays and continued to go to the doctor/surgeons. When the attorney came to me and told me that I should settle because there was no more money I felt that I should so that I would not have to pay the firm anymore than was needed. But to my suprise he told me that I was going to have to pay the doctors for the amount that my insurance company had paid out. I thought what am I paying insurance premiums for? Is there anyone that can give me an answer to this? I don’t think it’s fair as I still have to go for medical care for this accident and my insurance pays it now.





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3 Responses to I have medical insurance, why do I have to pay back medical expenses out of my auto accident settlement?

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mbrcatz

April 24th, 2010 at 4:16 pm

So, you got paid by your health insurance, and now you want to get paid for the same bills, from a car insurance policy.

That’s called “double dipping” and is illegal. Your health insurance is entitled to reimbursement – otherwise, you come out AHEAD of the game! You cannot collect from two different insurance companies for the SAME thing. I’m sure you misunderstood – the settlement isn’t going to pay the doctor a second time, it’s paying back the insurance that’s already paid for your medical bills.

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lucy

April 24th, 2010 at 5:05 pm

Say you did not have medical coverage on your auto policy and you had no health insurance so you had to pay for all of your medical treatment yourself.

When you settle you injury claim, the money you would receive would reimburse you for your medical bills you paid for out of pocket. Then any money left over would be yours.

It is the same principle; Since they paid for your medical bills, they are allowed to be reimbursed what they paid so that you could get treatment.

good luck

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Chrissy

April 24th, 2010 at 5:47 pm

I’m not entirely clear, but this is what I think you’re saying: Your medical insurance paid for medical expenses related to this auto accident. Now you’ve received a settlement and you are being asked to pay back the medical insurance for what they’ve paid. Correct?

The reason for this is because your medical plan is not responsible for charges that should be covered under another insurance plan. Medical expenses related to an auto accident should be covered by your auto insurance. Your auto carrier is responsible for payment of those charges – your medical plan is not. Your medical plan went ahead and paid those charges, as a courtesy to you. But now that you’ve gotten a settlement from the insurance company, the medical plan has the right to ask for its money back.

It’s called third party subrogation.

It would be the same if you got injured at work. Ultimately worker’s compensation most likely would be responsible for paying those bills, but oftentimes your medical plan will go ahead and pay them. They do that because while you’re waiting on a settlement from the work comp carrier (or in your case, your auto carrier), you could potentially be turned over to a collection agency for non-payment of medical bills. But your medical carrier goes ahead and pays them, with the understanding that when the case is settled, they’ll get their money back. It’s actually very simple.

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