Medical Bills

For those of us that handle injury cases, the TRAVCO decision was a long time coming. Basically, New Hampshire has a no-fault coverage on any automobile insurance policy issued in the state. This no-fault coverage is called “Medical Payments” coverage and is regulated by RSA 264:16. As Plaintiff’s attorneys, we long took the position that using the medical payments coverage to pay the health insurance lien was not a “double recovery” within the statute and should be allowed. Insurers refused to honor this and steadfastly refused to pay any health insurance lien. The Medical Payment Statute forbids a person from recovering from both health insurance and auto insurance for a medical bill related to the accident. However, if the person injured pursue a third-party claim…

A proposal in front of the New Hampshire legislature this month was Senate Bill 303. Senate Bill 303 clarifies language in the medical payment statute relative to payment of health insurance liens in personal injury cases. In every private health insurance policy is a provision involving a right of reimbursement, or “subrogation clause”. This clause states that if a person receives a judgment or settlement from someone relative to injuries they sustained, then the health insurer has a right to be reimbursed for any bills they paid related to those injuries. This is a complicated provision, so it is important to ensure you seek the advice of an attorney before trying to deal with this on your own. The issue that was created by the initial…

The key to understanding injury claims is that claims handling is driven by insurance requirements. The vast majority of injury claims are resolved by settlement. The parties to the settlement discussions are most commonly the injured party, his/her attorney and an insurance company. It is necessary to know how insurance companies process claims in order to achieve the best possible result. The most important thing to remember is that insurance companies rely heavily on objective information to form a valuation of each claim. This comes in the form of medical and billing records, accident reports, pictures, lost wages documentation, investigative reports and other related records. The more complete your documentation the better your chance of a satisfactory result. Gathering documentation should be your first priority…

In almost all injury cases, when the plaintiff gets injured they seek healthcare almost immediately. Most times the person’s health insurance company pays the bills generated by an accident in the first instance. Sometimes, this is a private company like Blue Cross Blue Shield, and other times it is government-provided insurance like Medicare or Medicaid. In each scenario, both types of insurance will have a “lien” or right of reimbursement from the settlement an injured party can get from a third party insurance policy. Most commonly, it is a private health insurer like BCBS that pays the bills. As part of all health insurance contracts, the health insurer reserves a “subrogation” right through the contract. This allows the health insurer to get paid back through…