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How Will Medicare Or Other Health Insurance Reduce Your Recovery From An Auto Accident Claim?

Matt Troutman Nov. 28, 2023

Medicare has a right to be reimbursed from your settlement with a third-party (called “subrogation”) in an auto accident that caused your injuries. Medicare’s subrogation rights are very strong under federal law, but they should not prevent you from pursuing your claim against the third-party causing your accident. Your car accident attorney needs to be experienced at resolving Medicare subrogation claims in order to maximize your recovery. The Troutman Law Office handled a case where the Medicare lien more than doubled the amount of liability insurance available to the person causing the accident and the client had her case turned down by a previous injury attorney due to the amount of the Medicare lien. Despite the amount of the lien, the Troutman Law Office was able to obtain a substantial recovery for the client. The Medicare representatives can be difficult to deal with in some case, but if your auto accident injury attorney is knowledgeable about the Medicare laws, you can negotiate with them successfully to make the claim worthwhile.

The Troutman Law Office uses PIP benefits, available to motorists in Kentucky, to reduce or even eliminate the Medicare subrogation claim or the subrogation claim of any health insurance company. Every driver in Kentucky that has paid for insurance on their vehicle (including liability only policies) has $10,000.00 of PIP (Personal injury Protection) insurance and they have the right to direct the insurance company on how to pay these benefits. If the Troutman Law Office is hired soon after the auto accident, then we will have the opportunity to protect the PIP benefits so that the client’s recovery is maximized. Normally, I will advise the client to submit his medical bills to the health insurance company and then I will use the PIP benefits to satisfy the health lien so that the amount paid out of their settlement to the health insurance company is reduced or eliminated.

Here is how this process works. Let’s assume the settlement is for $30,000.00 and the medical bills are $25,000.00. If you submit your bills to the health insurance company, they will pay a fraction of the actual charge to satisfy the entire bill. I would estimate that the health insurance company would pay $7,000.00 to satisfy the $25,000.00 in bills. If we fail to protect the PIP benefits, the $25,000.00 will be first submitted to PIP and PIP will pay $10,000.00 leaving a balance of $15,000.00. The health insurance will then satisfy the remaining $15.000.00 by paying an estimated amount of $4,500.00. That $4,500.00 will come out of the client’s settlement. If the PIP is protected, the client pays nothing to the health insurance and receives a net recovery of $20,000.00 after paying the 1/3 legal fee. If the PIP is not protected, then the client will receive $15,500.00 after paying the 1/3 legal fee and paying $4,500.00 to their health insurance.

Contact Kentucky Auto Accident Lawyer

If you are involved in an auto accident, you will require the services of an experienced Kentucky auto accident attorney to investigate the cause of the accident and maximize all benefits available to the victims and their families. Matthew Troutman, a Kentucky auto accident lawyer, of the Troutman Law Office has been handling auto accident claims, almost exclusively, since 1986 and has the experience and talent to obtain the best result for the victim in the above accident.

If you need legal assistance due to an auto accident, contact Kentucky auto accident attorney Matthew Troutman directly at 502-648-9507 or 859-696-0001 and he will meet with you in the hospital, your home or wherever is convenient for you. He will give you direct access through his cell phone and guide you through the difficult process necessary to obtain the best result possible for you in your motorcycle accident claim. To learn more about Kentucky auto accident attorney Matthew Troutman and the Troutman Law Office, click here.