When receiving a personal injury settlement in what cases, if ever, do you have to pay back your insurance company? - Injury Law Questions and Answers- LawQA.com

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When receiving a personal injury settlement in what cases, if ever, do you have to pay back your insurance company?

I am receiving a settlement in a personal injury lawsuit. I have no due medical bills as my insurance company paid them all when the injury happened. In what case, if ever, do I have to pay back my insurance company for paying those bills?


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If you received the responsible party's Policy limits as part of your settlement, your own carrier has no subrogation rights against your settlement for any medical they paid. They are also required by statute to waive any subrogation claim for any money paid to you from an Underinsured Motorist claim where policy limits were tendered by the responsible party's carrier. However, if policy limits were not paid, they do have a right to recover any medical paid to you out of the settlement. As a general rule, the responsible party's carrier will reimburse your Insurance Company directly.

Answer Applies to: Utah
Replied: 5/14/2013

Answer By Gary Montgomery
Montgomery Law Offices
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Most insurance policies contain a subrogation clause. This means that if you collect any money against the at fault party in your accident claim, then you are obligated to repay your own insurance company for any payments they have made on your behalf for medical bills. So you have check your insurance policy or call your insurance agent and ask them if there is a subrogation clause in the policy.

Answer Applies to: Idaho
Replied: 5/14/2013

Answer By J. Michael End

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The answer to your question depends on the type of health insurance paid the bills. There are different rules that apply to different kinds of insurance. If your employer paid the bills through an ERISA plan, your employer is entitled to be paid back for everything it spent. On the other hand, you have a better chance to negotiate if the health insurer was simply a standard insurer. Handling subrogation interests of health insurers is something that lawyers know how to deal with.

Answer Applies to: Wisconsin
Replied: 5/13/2013

Answer By Gregory M Janks
Gregory M Janks, PC
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If you are talking your No Fault car insurance company the answer is usually "no" you do not have to pay them back (there are a couple of circumstances re: out of state insurers where you may have to pay them back, but I presume those don't apply to you - but to know for sure, ask your lawyer or get a consultation with a lawyer handling these cases). If you are talking workers compensation insurance, then typically they do have a right of reimbursement. Again, ask your lawyer and/or consult with a lawyer with all your specific facts vs. the general ones stated hereon.

Answer Applies to: Michigan
Replied: 5/13/2013

Answer By Jim Hasser
James E. Hasser, Jr. P.C.
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Almost all medical insurance policies have "subrogation" provisions which allows the insurance company to get its money back out of any settlement or judgment. Good luck.

Answer Applies to: Alabama
Replied: 5/13/2013

Gini Lynn Jenkins Attorney, LLC of counsel with Kelly & Kelly, LLP
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It depends on whether your health insurance contract falls under Georgia law or a federal law scheme known as ERISA. Even if an ERISA plan, you may not have to pay the plan back. It depends on a few factors and the language of the plan. It can be quite complicated. If your plan is subject to GA law, then the insurer is only entitled to reimbursement if you have been completely compensated by the settlement which you were likely not. I recommend you hire an attorney for a couple of hours to review your documents and advise you.

Answer Applies to: Georgia
Replied: 5/13/2013


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It depends on which insurance company paid the medical bills. If it was your health insurance company, then you have to pay back up to the complete amount that they paid, depending on how much money you recovered. If it is your auto company that paid, then you don't have to pay them back.

Answer Applies to: Michigan
Replied: 5/13/2013

Peters Law, PLLC
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Yes, your insurance company is subrogated to the rights of the providers and is entitled to be reimbursed. Your attorney may be able to get them to take less than full values on the basis that the attorney's work helped the insurance company get its money back.

Answer Applies to: Idaho
Replied: 5/13/2013

Answer By Derek L. Hall

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If you are represented by an attorney, please ask them. Generally, if an insurance company pays your medical bills, they will want to be reimbursed. Whether you are required to or not depends on the specific language of your insurance policy.

Answer Applies to: Mississippi
Replied: 5/13/2013

Answer By John S. Hone
Hone Law Firm
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In any case in which your medical insurer has a lien or subrogation right per the contract, or statute.

Answer Applies to: Michigan
Replied: 5/13/2013

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