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Do I Have to Re-Pay My Medical Insurance Provider, such as Highmark, UPMC?
The answer is, it depends.
Are you interested to learn how medical bills get paid regarding a dog bite claim in Pennsylvania? Below, is how our Pittsburgh Dog Bite Lawyers explain it.
Primary and Secondary Coverage
Certain entities are primarily responsible — or first in line — to make payment for medical bills. For example, in an automobile accident case, this would be your “no fault” medical coverage.
Similarly, with an injury involving a premises — including a dog bite on the the owner’s property — the premises owner’s “no fault” medical coverage is first in line to make payment. This type of “no fault” coverage need not be repaid out of any settlement.
Sorting Out Secondary Medical Coverage
The next in line for payment is secondary coverage. For example, this could be your own health insurance, such as Highmark, or UPMC, or Medicare, or CHIP or other Coverage through the Commonwealth of Pennsylvania.
Paying Back Health Insurance Carriers: Subrogation
The entity paying for your medicals bills may have a right to be paid back out of your settlement. This right to be re-paid (from your settlement) is called subrogation.
You have to wait and see if the health insurer makes a claim for a “lien” against your recovery (which they are free to do). However, we can get those negotiated down. Importantly, if the insurer doesn’t hear from you and you don’t sue, they can also sue the dog owner in your name, literally.
For example, if your name is Sally Struthers, your insurance company can file suit: Sally Struthers v. Dog Owner. In fact, this is called a subrogation claim. However, each Pittsburgh lawyer at our firm will jump in and get things straightened out long before that happens. That said, in most instances, the insurer will ask you questions upfront. Did your treatment concern a dog bite or other responsible party who can re-pay us? Are you making a claim? Do you have a lawyer?
Medicare “Super Liens”
If Medicare (CMS) or some other governmental entity paid your medical bills in whole or in part, you have to make extra sure to set aside money from the settlement to satisfy the lien. First, understand: this money needs to be protected without them asking. That said, our advocates are very skilled at dealing with insurance companies and we negotiate down how much they can seek from your settlement.
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Contact a Pittsburgh lawyer about health insurance liens involving Highmark, UPMC, or Medicare, damages, disfigurement, scars, and a free initial consultation for dog bite law cases in Western Pennsylvania. We handle cases in Beaver County, Butler County, Greene County, Butler County, Washington County, and Westmoreland County. Plus, there is no fee unless we recover. In fact, our Pittsburgh dog bite lawyers also handle claims on behalf of parents or other guardians for claims involving a child or children.