How Your Health Insurance Can Affect Your Personal Injury Claim


Being involved in a serious auto accident can be a life-altering experience. Many people walk away feeling thankful that they survived, and with an entirely new perspective on life. Those who have health insurance may have some peace of mind in the knowledge that at least some of their medical bills will be paid. When the negligence of another driver was the cause of the crash, the injured party has the right to seek legal recourse in the matter. It is important for Greenville residents to understand the interplay between health insurance and a personal injury case.

Who is Going to Pay the Bills?

In many cases, a considerable length of time will pass between the date of an accident and the final outcome of a personal injury claim. The medical bills, however, will continue to roll in, and must be dealt with. The manner in which those bills will be paid varies, and depends on the type of coverage (if any) that both drivers have at the time of the incident. Some policies include "med pay" coverage, which means that the insurer will cover medical bills for a driver or passenger involved in an accident with the person who is insured. However, there are limits to the amount that med pay will cover, and the individuals who were injured will be required to cover the rest. For those who have their own health insurance policy, that coverage will likely cover the cost of some medical services.

But a Successful Lawsuit Will Cover Everything in the End, Right?

Not so fast. When a lawsuit results in a settlement or award, the injured party's health insurer may be able to make a claim on those funds. Most people believe that the purpose of health insurance is to pay the medical bills of the insured party. They feel that any money that is gained as a result of a personal injury suit should go to the injured party. In reality, however, some insurers have the right to ask for a portion of those funds. This is known as subrogation, which can be understood as the right of the insurance company to be reimbursed the money that was spent to pay your medical bills. Taken from that perspective, the only reason why the insurer had to write any checks at all was due to the negligence of the other party. Why would they forego any right to demand repayment if a lawsuit ends favorably for the injured party? In Vegas terms, the house always wins, and they may be able file a lien to make sure that they are paid before you are.

How Much Will I Get to Keep?

Once they learn of the interplay between health insurance and personal injury cases, the vast majority of our clients ask this very question. The answer is frustratingly vague: it depends. In general, North Carolinians will not have to reimburse their health insurance. However, as with any general rule there are many exceptions. In North Carolina, people covered under the North Carolina State Health plan, Medicaid, Medicare, and self-funded ERISA plans will have to reimburse their insurance companies for amounts that were paid to their medical providers if they recover from a liable 3rd party. In these situations, it is vitally important for you to have an attorney to help negotiate these liens to make sure that you take home more money in your pocket. An experience personal injury attorney can work with you to make sure that when you are injured in an accident that your case results in the best possible financial outcome for you.

Greenville, NC Personal Injury Attorneys

I’m Brian Ricci, a Personal Injury Lawyer in Greenville, NC. If you have suffered a personal injury, please call me anytime at (252) 752-7785 or (888) 484-6881 for free, friendly advice. Let’s go over the details of your accident case over the phone and see how best to proceed. The call is free and there is no obligation to you.

I am a longtime member of the Million Dollar Advocates Forum. We are a group of top rated US trial lawyers with multi-million dollar settlements and case verdicts for the injured clients we have served.

Take a look at the excellent results our Greenville, NC injury attorneys have obtained on our Past Verdicts and Settlements page and our many Testimonials.

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Founder of the leading personal injury website: www.riccilawnc.com/Personal-Injury-Lawyer.
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