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You’ve been in a collision, the police were called and took your statements, you received the at-fault parties’ contact and insurance information, and you were injured to the point that an ambulance was called. You know you need to seek treatment for your injuries, but you have a million thoughts running through your head, and you’re unsure about the overall cost of treatment and the out-of-pocket expenses. How much will the ambulance ride cost? Is the hospital in-network? Will my health insurance cover the treatments? These are all great questions, but in the middle of massive injuries, you shouldn’t have to worry about your health insurance; you should focus on seeking treatment and ensuring your overall recovery. The dedicated legal team at BK Law Group is here to help you achieve that recovery and advocate for you during the process.
Let’s break this down and see how and when your health insurance comes into play.
Minnesota is a no-fault state and requires all insured drivers to have no-fault or Personal Injury Protection (PIP) coverage. The minimum required no-fault coverage in Minnesota is $20,000 for medical expenses and $20,000 for non-medical expenses. No-fault insurance can initially seem counterintuitive, as you are using your own insurance to pay for medical costs rather than the at-fault driver’s insurance. However, this is a significant benefit available to Minnesotans, as most personal injury cases last at least a year, if not longer, and during that time, the at-fault driver’s insurance will not pay for any medical expenses. The at-fault party will only pay at the end of a case when a settlement occurs. No-fault comes into play to bridge that gap.
If Minnesota were not a no-fault state, then all medical costs would be billed to your health insurance, and when the settlement occurred, your health insurance would require repayment from the settlement amount, greatly reducing the amount of settlement money you receive for your pain and suffering. Thankfully, Minnesota adopted the no-fault standard, which prioritizes no-fault insurance in payment over your health insurance. No-fault will potentially pay up to $20,000 for your medical treatments related to injuries sustained from the collision.
To start this benefit, you will need to either set up a claim with your insurance or call your dedicated legal team at BK Law Group to handle it for you. Once the claim is established, you will then need to provide your treating physician with the claim number and notify them to bill the no-fault insurance before your health insurance. It is vital that you provide the claim number and information to all your treating providers so they bill the correct insurance. Once this pool of $20,000 is exhausted, your health insurance will then be billed for your treatments, and they will establish a subrogation lien.
A subrogation lien is a lien established by your health insurance company to recoup the costs of payments made towards the treatments you received as a result of the collision. Subrogation liens may be reduced through negotiations during the settlement proceedings; however, this is not guaranteed.
The other type of lien your health insurance may be able to establish is an ERISA Lien, which is slightly different from the other subrogation lien. It is still a lien established through your health insurance, though this ERISA lien is not subject to reduction and is often not negotiated. This type of lien is usually established when you receive health insurance through your employer.
Once a personal injury claim has been established, your health insurance has a vested interest, as the treatments you have been receiving would not have occurred if the at-fault party had not caused the collision. Since the treatments are directly related to the collision, your health insurance will want reimbursement from the at-fault driver’s insurance. This reimbursement cost will come out of the settlement money; however, on a standard subrogation lien, the cost could potentially be reduced through negotiations, though this is not guaranteed.
If you have received notice that your health insurance is establishing a subrogation or ERISA lien, it would be advisable to seek an attorney. At BK Law Group, we are well-versed in navigating subrogation and ERISA liens, and we are dedicated to ensuring that you receive the most settlement possible while handling your case with care and compassion.
The subrogation lien details the date, time, and cost of treatment, as well as the treatment received related to the injuries from the collision. Once the case has been settled, the amount on the lien will be the amount your health insurance is requesting to be repaid. At BK Law Group, we establish health insurance interest early on, so we can access and review the lien as new payments are added. It’s important to review the subrogation lien to ensure that the correct treatments are included and that any treatments unrelated to the collision are excluded.
The lien should not include any treatments you received that are not related to the injuries sustained as a result of the collision. If you seek treatment for flu-like symptoms, that should not be a part of the lien, as it is distinct and separate from the injuries sustained as a result of the collision. It’s important to review the liens and note what is related to the collision and what is not.
Personal injury cases can last a year or longer, and during that time, you might see your doctor for treatments unrelated to the injuries sustained as a result of the collision. Your health insurance should handle those treatments in standard fashion, and these types of treatments should not be included in any subrogation or ERISA lien. If you are reviewing a subrogation or ERISA lien and notice an unrelated treatment is included, you can dispute its place in the lien by contacting the subrogation team handling your case and asking them to review that date of service, or you can contact your dedicated legal team at BK Law Group, and we will ensure to review and handle the liens.
That is completely fine; the most important thing after a collision is to ensure your safety and to receive treatment for the injuries sustained.
If you received treatment before you established a no-fault claim, it is likely that your health insurance has already paid for the treatment and might have established a lien. However, you still have the pool of $20,000 in no-fault benefits to pull from. In this instance, you would want to contact your health insurance company and ask for copies of the lien and the payment made to forward to your no-fault insurance. Once your no-fault insurance receives this notice, they will likely pay the facility directly and ask for reimbursement to be sent to your health insurance.
Just because your health insurance places a treatment on the subrogation or ERISA lien does not mean it is set in stone. You can always reach out to them and dispute certain treatments you feel are unrelated to the injuries sustained as a result of the collision, or reach out to your no-fault insurance and ask them to pay from the pool of $20,000, as they are the first priority for payment.
If your no-fault benefits are exhausted, that means your health insurance will pay for the treatments and include that cost on the lien. It’s still important to review the lien to ensure no duplicate payments have been made and that all treatments listed on the lien are related to the injuries sustained in the collision.
Once you are involved in a collision and are hurt to the point of seeking treatment, it is advisable to contact an attorney. Our dedicated team at BK Law Group is here to help you navigate all aspects of your personal injury claim while advocating for you every step of the way.
If you need an attorney for a personal injury claim, BK Law Group is here for you. Please contact us by phone at (952) 314-5101 or by email at in****@*********up.com, and we will be happy to help.
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