Health Insurance Lien on Personal Injury Payment...

by Gary
(Glen Cove, NY USA)

We recently won an amount of money for a slip and fall. Payment has not arrived yet, however, the health insurance carrier has put a lien on the award in order to get reimbursed for the surgery which was not directly caused by the accident. The surgery was, however done sooner then expected because the accident accelerated a pre-exisiting condition.

In New York, a self insured carrier still has the right to put a lien on an award, we have been told this. Is this true? If the surgery was needed before the accident, does the hospital still have the right to reimbursement?

Does the reimbursement have to be paid from the total before the lawyer takes his share, or after the lawyer takes his share? Is there any way to stop the hospital lien at all? The lien came one week before the mediation agreement. Thanks for the help.

Visitor Question:
Disclaimer: Information provided in our response is NOT formal legal advice. It is generic legal information based on the very limited information provided. Under no circumstances should the information in our response, or anywhere else on this site be relied upon when deciding the proper course of a legal matter. Our response does NOT create an attorney-client relationship. Always get a formal case review from a licensed attorney in your area.

ANSWER for "Health Insurance Lien on Personal Injury Payment...":

Yes, the information you have received is correct regarding the lien. What happens is that the attorney is entitled to 1/3(typically) of the total aggregate settlement BEFORE reimbursements and payments are made. From there, any medical bills that you have will be paid.

Though you cannot get rid of the lien, what you may be able to do is compromise it, or have it reduced. Either the attorney that represented you or you personally can contact the lien holder and request that they reduce the total amount. Insurance companies have been known to reduce them by up to 70% so it definitely is beneficial to ask.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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