ACCIDENT RELATED SUBROGATION- HOW TO MINIMIZE IT
In Pennsylvania, accident related medical bills, other than car accidents covered by first party benefits, will be paid by your own health insurance. If you have Medicare, Medicaid, Workers’ Compensation, Veterans Administration benefits, an HMO or any other private health insurance plan, there will almost always be subrogation claims in the event of a settlement. Non-ERISA health plans may be barred from subrogation in Pennsylvania car accident cases.
There are a number of legal and medical issues that can be raised in order to try to reduce the subrogation lien. The legal issues require the collection and review of the underlying documents of the client’s health care plan. Health care plans differ in the language they use and it must be determined if they are legally entitled to claim what they have claimed.
A recent legal issue involved the collection of Heart & Lung Act benefits in motor vehicle accidents. This office filed a Declaratory Judgment action that went to the Pennsylvania Supreme Court which ruled that Heart and Lung Act benefits were not subject to subrogation in car accidents.
The medical issues require research of the client’s medical history. Not every medical bill is related to the accident in question.
Producing evidence of hardship on the part of the client may serve to reduce or even eliminate a substantial subrogation claim.
In many cases, this office has secured substantial reductions or waivers of subrogation claims for the benefit of the client.