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Can My Health Insurer File a Lien Against My Case?

health insurance injury claim

It has been a hotly contested issue in New York over the years. Can a health insurer file a lien against a person’s personal injury claim in order to seek reimbursement for expenses paid for that person’s treatment after an accident? A lien is an entity asserting a legal right to a portion of a person’s monetary recovery in a claim. Generally speaking, health insurance companies, as well as Medicaid and Medicare require an insured to report any personal injury claims. Failure to report can result in loss of insurance coverage. So, can your health insurer file a lien against your case? Well, the unsatisfying answer is “maybe.”

Can My Health Insurer File a Lien Against My Case?

In 2009, the General Obligations Law Section 5-335 was passed by the New York State legislature. The law was intended to protect plaintiff’s settlement proceeds from being the subject of subrogation claims and liens established by health insurance providers. The subrogation claims had historically made it much more difficult to resolve personal injury claims because they stood to take substantial chunks out of an injured party’s monetary recovery. Furthermore, payment of such liens was seen as an unjust windfall to the health insurance providers as the injured party had paid premiums in exchange for the coverage provided and reimbursement from a personal injury settlement would be extra payment on top of those premium payments.

The General Obligations Law Section 5-335, the legislative embodiment of New York’s anti-subrogation rule, means that, most of the time, a private insurance company will not be able to file a lien against an insured’s personal injury case. There are, however, a few important exceptions. Insurance benefit providers may, in some cases, have the right to impose a lien against an award or settlement if it paid for the individual’s medical treatment related to the accident injuries. Liens may be filed by Medicare and Medicaid agencies, as well as certain disability insurance providers and private health insurers. Prior to the settling of your personal injury case, your attorney is obligated to investigate whether any liens filed against your claim are valid. Even in the event that a lien is found to be valid, your attorney should be able to negotiate the lien amount down. Oftentimes, the lien can be reduced by at least one-third. This is due, in part to the fact that the one-third reduction reflects the portion of the settlement that is generally paid to cover attorney’s fees.

Westchester Personal Injury Attorney

Were you confused by this discussion of health insurer liens filed against personal injury claims? Do not worry. This is complicated legal red tape. Unfortunately, it needs to be addressed before your personal injury claim can be resolved. Leave the legal headaches to knowledgeable personal injury attorney, Michael LoGiudice. He is well versed and experienced in this type of law. He will fight for your monetary award and preserve it from unsubstantiated and unjust claims. Contact us today.

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