Visitor Question

Conflict between Auto Insurance and Medical Insurance over Hospital Bills…

Submitted By: Anonymous (Phoenix, AZ)

My daughter has her permit and I was taking her out driving. She was going too fast while making a right turn and ran us into a brick wall. She only had minor injuries since the airbag deployed. I had minor bruising and two broken ribs.

I have full coverage auto insurance and also I have medical insurance. I got a lien on my settlement because the insurance is refusing to pay, saying the accident was caused by a “3rd party”. Since it was caused by my daughter, and she is a minor, wouldn’t that make me the responsible party?

My medical insurance paid their portion and I paid my co-pays, however now the hospital has put a lien on my personal injury settlement.

My health insurance company says, based on their contract with the hospital and my “explanation of benefits”, the hospital is to consider the bill paid in full once they receive the portion from the health insurance and my copays?

Who is correct?

Disclaimer: Our response is not formal legal advice and does not create an attorney-client relationship. It is generic legal information based on the very limited information provided. Do not rely upon the information in our response, or anywhere else on this site, when deciding the proper course of a legal matter. Always get a personalized case review from a local attorney.

Answer

Dear Anonymous,

The hospital is correct. The State of Arizona does permit health care providers to place a lien on their patients’ insurance settlements. The State of Arizona Title 33 is an Arizona State statute designed to protect the interest of medical providers. It reads in part:

“A Medical Provider is entitled to a lien for the care and treatment …… of an injured person. The lien shall be for the claimant’s customary charges for care and treatment… of an injured person.”

A lien pursuant to this section extends to all claims of liability or indemnity.

The rationale for institution of medical liens is this:

Hospitals admit and treat injured people without first having them sign a written contract. Unlike other companies who have their customers sign written “express” contracts before rendering service, hospitals normally can’t do that.

When a hospital treats someone before having that person sign a contract, the hospital has an “implied” contract.

When considering the enactment of Title 33, Sections 931 – 936 the legislators had to decide to either allow hospitals to turn people away if they couldn’t pay, or make sure the hospitals do treat them without requiring them to sign a written contract.

The Legislature compromised. The compromise included Title 33. The hospitals can’t turn people away, but they have a right to place a lien on any insurance proceeds resulting from automobile collision settlements.

In your case it appears the hospital was following the law.

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

Best of luck,

Published: November 16, 2017

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