Health Insurance Claims
Even the most minor car, truck or motorcycle accident – or dog bite – can result in injuries that require expensive medical treatment. Because personal injury victims may require this medical assistance right away – from surgery to casts to prescription medication – but lack the money to pay for it, they usually turn to their health insurance plan, i.e., Medicaid, Medicare, Tri-Care or other government health plan for help. Your health insurance company, however, may ask to be repaid when your lawsuit against the person who injured you results in a verdict or settlement.
At Glover Law Firm, in addition to working to collect as much money as we can, an increasingly important part of our job is to deal with and negotiate health insurance repayments from your settlement. Although North Carolina law generally prohibits health insurance carriers from being repaid from your automobile or third-party settlement or recovery, that law does not apply to all types of health insurance, such as Medicaid, Medicare, Tri-Care, ERISA health plans and certain government health plans. Further, more and more companies, organizations and insurance plans are attempting to claim the right to repayment, despite North Carolina’s general prohibition against such.
At Glover Law Firm, we work hard to determine the rights of various plans, and to reduce the amount that you have to pay back, so that you keep as much of your verdict or settlement as possible.
For more than 50 combined years, our attorneys have handled medical / healthcare liens for personal injury victims throughout the state, especially the Outer Banks of North Carolina, including those in Elizabeth City, Edenton, Hertford, Camden, Manteo, Nags Head, Kill Devil Hills, Duck, Corolla and surrounding areas in Pasquotank, Camden, Dare, Currituck, Perquimans, Chowan and Gates counties.Health Insurance Repayment Information
Although North Carolina law generally bars health insurance carriers from being repaid – or asserting a lien — from a “third-party recovery,” that law does not apply to all health insurance plans, like Medicaid, Medicare and certain state, county and government health plans. Also, more and more health insurance providers are attempting to claim the right to repayment despite North Carolina’s prohibition against it.
Here’s an example of what might happen. Personal injury victims who file civil lawsuits often turn to Medicaid for help paying their medical bills while waiting on a verdict or settlement. The agency that administers North Carolina’s Medicaid program is the Division of Medical Assistance. When you receive funds from DMA, the agency will assert a lien on your recovery from the party who caused your injury.
Calculating the amount owed under Medicaid, Medicare or Tri-Care can be highly complex, and the negotiations over the final dollar figure may be disputed. An experienced personal injury lawyer may be able to help you negotiate a favorable settlement.
As your personal injury attorneys, we will make sure that the DMA does not take more from your recovery than the agency is entitled, by law, to receive. The amount of DMA’s Medicaid lien is strictly limited to the amount it paid on your behalf for medical care. This means that DMA cannot touch any portion of your settlement that went toward property damage, lost wages or pain and suffering. DMA can never claim more than one-third of your recovery.Contact Our Northeastern North Carolina Attorneys Today
Danny Glover Jr. is a seasoned negotiator, accomplished trial lawyers and passionate advocates for the rights and interests of their clients. They have earned recognition from North Carolina Super Lawyers, The Million Dollar Advocates Forum and N.C. Advocates for Justice, among others.