Health Insurance Covered Medical Bills

Do I Have a Claim if My Health Insurance Paid the Medical Bills?

In this video, Attorney Robert Maranto discusses the eligibility for an injury claim if your health insurance company covered your medical bills.  Contact one of our experienced Buffalo injury lawyers if you were injured.

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In New York State, one’s health insurance should not be involved in automobile accident cases. New York State has a no-fault law, which requires the insurance company of the vehicle involved in the accident to pay all medical bills pertaining to those who were injured in the vehicle. In premise liability cases, insurance will be involved. Sometimes in those cases, medical payments coverage will provide some benefit to the individual who was injured on the premises, but if this not the case, your insurance will be involved.

The fact that one’s private health insurance has paid bills will have no impact on negligence claims against someone who may own a property. In New York State, under our laws, insurance carriers do not have a lien against any recovery that you may have. The only caveat to that is if one’s insurance has been established under a federal program called an ERISA Plan, and because the federal law surpasses state law, one’s health insurance company can have a lien. Of course, we monitor the insurance companies and ensure, if there any lien rights appear, that we protect our clients in that regard.

If Medicare or Medicaid were to pay any causally related medical benefits, we would have to reimburse them. We have departments at our office that are strictly and solely engaged in dealing with the Medicare system. However, if Medicare or Medicaid has paid a client’s bills, it will have no impact on the client’s ability to recover. This becomes a lien, and the recovery takes that lien into consideration.