Settlement Offer

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understanding your personal injury settlement offer, medical bill liens, subrogation, medicare

Understanding Your Settlement Offer

How Medical Bill Liens Could Affect Your Settlement and Take Care with Medicare

In a settlement, there Idaho personal injury attorney works through paperwork on an insurance claim offer and total medical expenses, damages and injuries. is always paperwork. Before you agree to a settlement offer, you and your Idaho personal injury attorney will discuss whether you understand and accept all of the terms and conditions of the settlement. The insurance company for the at-fault party will ask you to accept money in exchange for your agreement to end the case — releasing the at-fault party from any future responsibility.

First and foremost, you and your Idaho personal injury attorney will discuss whether the amount of the settlement offer is reasonable under the circumstances.

Your attorney should be able to give you a professional opinion on this, weighing the likely outcome of a trial against the certainty and benefits of settling now. Rejecting one settlement offer does not mean you will never get another. In fact, some defendants even expect to go through several rounds of offers and rejections.


Another consideration is any debt, claim or lien that you might owe to health care providers or other parties because of the accident. (We will discuss and define liens in the next section.) If the settlement offer is not sufficient to pay all of these debts, you may be liable for the rest. Sometimes, your lawyer can help by negotiating or using other remedies available under the law to make sure all of your obligations are covered. Depending on the circumstances, your lawyer might be able to convince creditors to take a lesser amount in exchange for immediate payment. But because this is an uncertain process, it is important to discuss your debts and obligations with your lawyer when analyzing a settlement offer.


At this stage, your Idaho personal injury attorney may also talk to you about subrogation.


A subrogation claim is a claim that an insurance company or other party has on the money you recover in your case. For example, if you have medical insurance, it probably covered your initial medical care. But if an auto insurance company is legally obligated to cover those costs, the medical insurer may be entitled to reimbursement from the auto insurer or from you, out of any settlement you reach with the auto insurer. Subrogation can be complex and depends on state and federal laws as well as individual contracts. Your personal injury attorney should help you understand how — or whether — it applies to you.


If you have claims against more than one defendant or insurance company, or are considering a lawsuit over the same injuries against another party, you should also consider whether settling with one defendant could limit or eliminate your right to pursue the other cases. For example, in states with at-fault auto insurance, you may have a claim against your own auto insurer for unpaid uninsured/underinsured auto insurance claims.


Sometimes, a quick settlement is one of the most important services an Idaho personal injury attorney can provide, as with one a tragic wrongful death case.


In this case, a young and growing family was in a serious car accident that killed the wife and her unborn child, leaving the husband a single parent of a two-year-old. Thankfully, the two-year-old was not seriously injured. The husband, his mother and his child filed a wrongful death and personal injury lawsuit.


Because the driver responsible for the accident did not have a substantial assets, the family's law firm knew it was important to identify and collect from all available insurance policies. The firm worked quickly and was able to settle these claims in just eight months, for an amount exceeding $1 million. Although that money could never bring back their lost loved ones, receiving this large amount relatively quickly allowed this grieving father and husband to move on with his life and the ability to take care of his child.


How Medical Liens Could Affect Your Settlement


Liens are legal claims against personal property, used to secure a debt. A residential mortgage is a common type of lien. A lien claim might be a part of your case if you have a large amount of debt stemming from the accident and you cannot pay it out of your own pocket. This is particularly common with debts for medical care. Idaho has a special law that gives medical providers strong rights against injured people's claims for damages.


Resolving lien claims can be difficult because of the many complex laws that apply to them, and because holders of lien claims are often slow to respond in writing to questions about their liens. Unfortunately, the law does not always say that lienholders are required to respond to requests for a lien amount within a specific time, and it sometimes takes months to get an appropriate answer. This delay prevents prompt payments of settlement funds to clients like you, and can be frustrating for you and your lawyer. Your law firm should work hard to obtain this information and resolve these issues, so that the settlement can be distributed and you can resolve your case.


When multiple insurers or debts are involved, things almost always become quite complex.


For example, you might run into complicated lien problems when you have your own private insurance (including a settlement from a personal injury case) but are using Medicare as a secondary insurer. When it is not certain whether Medicare is a primary or secondary insurer, Medicare will make a conditional payment. If it is later determined that some other party was responsible for that payment, Medicare is entitled to a refund from that party, or from you or the health care provider, if one of you was paid by that party. The federal government may place a lien on your property to recover this type of conditional payment. (It might also be entitled to make a subrogation claim against your settlement.) Again, your settlement funds cannot be distributed until you reach an agreement and pay Medicare.


Take Care with Medicare


Cases involving Medicare can be much more complicated than cases involving private insurers.


One family using Medicare found that out after the mother was seriously hurt in a car accident. They were unable to resolve their claim with the bad guy's insurance company, so they hired an experienced personal injury lawyer. After the lawyer was able to settle the case for $100,000, the family thought that their life would turn around. However, they soon discovered that Medicare was demanding all of the settlement proceeds for reimbursement of the medical bills it had paid on the mother's behalf. In fact, Medicare claimed it should be reimbursed for all medical care provided to the mother for the last five years, even though the accident had only happened a year earlier.


Their personal injury attorney was able to distinguish the charges for treatment of the auto accident injuries from the other types of treatment. After extensive negotiations with Medicare, the attorney was able to substantially reduce Medicare's claim, to an amount allowing this desperate family to retain enough money to help pay the mother's future medical expenses and replace their car.