When people get seriously injured, medical costs are always an issue. Fortunately, for many residents of the Bronx and New York generally, sources of reimbursement such as private health insurance, Medicaid and Medicare are available to pay many, if not all, of the medical costs that arise during the course of care and treatment for serious personal injuries. These can include hospitalization, surgery, medicine, physical therapy and rehabilitation. However, under the law, some sources of coverage for medical costs are entitled to, and will seek, repayment for medical costs if you and your family pursue compensation for serious personal injuries. These programs will assert what is known as a “lien,” which is essentially a right to money, upon any recovery had in connection with serious personal injuries for which they have made payments for medical costs.
Because not every source of medical coverage is entitled to repayment out of the proceeds of your personal injury case for medical bills paid, your personal injury attorney must be aware of the nuances of the laws surrounding liens for medical coverage and take these issues into account while prosecuting your personal injury case.
For example, under New York law and recent Federal Court of Appeals rulings, certain types of employee benefit plans governed by the Federal employee benefits statute (often referred to as “ERISA”) are not, only as of 2014, entitled to repayment for medical expenses out of the proceeds of your personal injury case; if your personal injury attorney is not aware of this legal nuance and change in the law and you have received medical benefits from an ERISA plan that is no longer entitled to reimbursement, you could wind up losing out on a considerable amount of money if your personal injury case settles or you win a jury verdict in court and your lawyer, relying on bad assumptions and an outdated understanding of the law, grants a lien on the proceeds of your case. Your personal injury lawyer must also be aware that, if he fails to ensure repayment of liens on your personal injury case from, for example, Medicare, Medicaid or an employee benefit medical insurance program run by an agency of the Federal Government (if you or a loved one works for the federal government, you may have one of these), you can end up responsible for considerable amounts of interest and other financial penalties when, somewhere down the road after your personal injury case is over and you have been paid and spent your money, they come looking for repayment to which they may be legally entitled.
Finally, there are ways that liens can be used to your advantage; and the right personal injury lawyers will know how to help you in this regard. If you require medical treatment from a doctor or other medical facility that does not accept the form of medical coverage that you have (i.e., a particular type of health insurance, Medicaid, Auto No-Fault Insurance) but you still want to treat at that facility, your lawyer can negotiate with the healthcare provider so that they will be granted a lien over the proceeds of any recovery in your personal injury case in exchange for medical services. This can be beneficial as, if you do not recover money in your personal injury case, the doctor or other medical provider cannot pursue you personally for repayment of bills; their exclusive remedy, in such a case, is against the recovery from your personal injury case.
The attorneys at my firm have decades of experience dealing with issues relating to liens on personal injury case recoveries, and will take the time to teach you about these issues if we take your case. Don’t hesitate to contact us at (718) 354-8000 if you have questions about liens on personal injury cases.
