Thursday, August 25, 2011

Who Do You Have to Pay From Your Settlement?


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Personal injury settlements have become the lifeblood for a number of related industries. Auto body repair locations, chiropractors, rehabilitation facilities, physical therapy, litigation lending institutions, subrogation attorneys and yours truly are just a few.


Obtaining an acceptable offer from the at -fault party, or their corresponding insurance company, is only part of the battle. The next major hurdle is which outstretched hands have a right to funds, and then how much goes to which hand?


When an entity files paperwork with the County alleging an interest in your settlement, what they have done is filed a lien. Sometimes, a lien exists whether paperwork is filed or not; this situation arises when the Arizona State Legislature decides that an entity’s interest is clearly valid, thus creating what is called a “statutory lien.” Week-long seminars are prepared for lawyers helping them understand the ins and outs of lien management and in the end it can still remain very cloudy.

Don’t Get Swindled


If you have health insurance, use it. You pay your health insurance just in case you happen to get injured or sick. If I buy two life insurance policies and I die, I expect my family to recover the fund from EACH policy, not from one or the other. The same is with health insurance. Generally, you pay premiums just in case you have need of a physicians. Just because your injuries came as a result of a car accident should not impact your health insurance’s decision to cover your bills.

I recently had a scenario occur where I had clients that decided to visit a chiropractor they had met at an event. This chiropractor was a preferred provider on the clients’ health insurance. The clients asked the chiropractor whether he accepted their insurance and instructed him to bill the insurance. He agreed. The clients, however, were never asked for a co-pay. Upon release from treatment, we submitted a demand with all their bills and records, the chiropractor included. Unfortunately, we determined that the at-fault party only had state minimum policy and we were able to recover $15,000.00 for each client. About half of that was claimed by the chiropractor. He never billed the clients’ health insurance, improperly filed his County lien, and did not have a statutory right to a lien. However, the clients did sign one of those standard forms that indicates that they are responsible for the fees that are accrued; the same ones that you sign at any doctor’s office.


Because of the limited funds available from the settlement, I asked all the physicians and other lien holders to accept a reduction in order to allow for the clients to walk away at the end with the lions share. All agreed, except the chiropractor. Ultimately, the chiropractor sued my clients for the full funds he believed were owed him.


This chiropractor is the exception. Most reasonable human beings, can look at a situation and agree to reduction of their fees in the interest of expediency and fairness. To avoid this catastrophe from occurring to you, you should remember that if you are not paying your co-pays, there is a good chance they are not billing your insurance. You should stay current with how much your physicians are charging. If you reach a point in your treatment where you are not improving to any recognizable degree, you should seek another opinion.

Adam W. Barlow, Esq.
Adam Barlow Law, P.C.
www.adambarlowlaw.com
www.facebook.com/adambarlowlaw
602-688-4529
480-835-5553
480-461-0533 (fax)

7 comments:

  1. The clients asked the chiropractor whether he accepted their insurance and instructed him to bill the insurance. Compass Claims is a huge name which is providing insurance services in all sectors.

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  2. Money awarded through a lawsuit can be paid out as a single lump sum or as periodic payments through a structured settlement. Structured settlement annuities can be tailored to meet individual needs, but once agreed upon, the terms cannot be changed.

    Porter & Malouf P.A.

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  3. Sometimes we have to dig our own pockets. click

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