LAW OFFICE OF ARKADY ITKIN
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Health Insurance Lien and Your Injury Claim Settlement (Does Not Apply to Medical / Medicare)

health insurance liens injury claim
In many, if not most cases, some time after you suffer an injury for which you seek treatment, covered by your or your family member's health insurance, you will receive a questionnaire from that insurance company asking whether or not you have an injury claim, including all the information about the parties involved and your attorney. If you are represented by an attorney, you should forward that questionnaire to him as soon as possible. Your attorney then will fill it out and will send it to the appropriate office handling these forms. If you are not represented by an attorney, then you should fill out and return that form yourself.

Under the law, your private health insurance company that pays for some or all of your medical expenses associated with an injury claim is entitled to (partial) reimbursement from any judgment or settlement you receive from that claim. Failure to fill out and return the health insurance inquiry form once you receive it is considered an insurance fraud, which is a criminal offense.

There are some good news too:
(1) in most cases, your private insurance company generally cannot recover more than 1/3 of your settlement, if you are represented by an attorney. This means that even if they spent $300,000 on treating you, and you only recover $30,000 in your case, the most that your health insurance company can receive from your settlement is $10,000.00; and
(2) generally, health insurance liens are negotiable. Your attorney will make various arguments to your health insurer to reduce their reimbursement demand. Although the results vary and some insurers are more flexible than others, generally such negotiations lead to a significant reduction of health insurance lien.

If you don't receive an inquiry from your private health insurer about whether or not you have an injury claim, you do not have an obligation to contact them yourself (except in cases of Medical/Medicare and other public health services providers).  

When your injury case settles, your attorney receives one check for the total settlement amount. He will deposit that check into his attorney-trust account and will then disburse the funds three ways (unless there are other lien holders): one check will go to the health insurance company to sataisfy their lien, one check will go to your attorney to compensate him for attorneys' fees, and one check to the claimant as a net settlement.
The net amount you receive is not taxable and you don't have to claim it in your tax return.

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Law Office of Arkady Itkin

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Law Office of Arkady Itkin - San Francisco & Sacramento Injury and Employment Lawyer
We represent employees and employers in employment and wrongful termination cases, as well as victims of serious injuries in San Francisco, Oakland, Sacramento, San Jose, Palo Alto, San Mateo and throughout Northern California. We all represent businesses and start-ups in a wide range of business and employment issues and disputes. 


57 Post Street, Suite 812, San Francisco, CA 94104; Tel. (415) 295-4730; Fax. (415) 508-3474; [email protected]
  • Home
  • Employment Law
    • Wrongful Termination >
      • At-Will Employment
      • Termination After Unfair Warnings and Write-Ups
      • Union Grievance, Workers Comp and Wrongful Termination
      • Labor Code 970 Claims
      • Promissory Estoppel and Employment Contracts
      • Implied Contract Claims
    • Discrimination >
      • Proving Discrimination
      • Age Discrimination
      • Disability Discrimination >
        • Protected Disabilities
        • Medical Leave / Disability Accommodations
        • Job Reassignment As A Disability Accommodation
        • SSI Disability Benefits and Your Court Case
        • Sample Request for Reasonable Accommodation
      • Pregnancy Discrimination
      • Race Discrimination
      • Sample Discrimination Complaint
      • DFEH and EEOC Investigations
    • Retaliation >
      • How to Prove Retaliation
      • Dealing with Retaliation While Still Employed
      • Retaliation for Complaining
      • Whistleblower Retaliation
    • Harassment
    • Defamation at Workplace
    • Prof. License Defense
    • Leaves of Absence >
      • Medical Leave as Reasonable Accommodation
      • FMLA Entitlement and Reinstatement to Work
      • CFRA Leave
      • Employers' FMLA Notice Obligations
      • Paternity Leave (FMLA)
      • Sample FMLA Leave Request
    • Wages / Overtime Claims >
      • Wage Claims
      • Employee or Contractor
      • Exempt / Non-Exempt >
        • Admistrative Exemption
        • IT Support Specialists Compensation
        • Computer Professional Exemption from Overtime
        • Recruiters / Account Executives Exemption
        • Complaining About Being Misclassified
      • Vacation Pay / PTO
      • On-Call Time Compensation
      • Deductions fr. Commissions
    • Unempl. Benefits Appeals >
      • Tips for EDD Phone Interview
      • Unemployment Benefits Appeal Hearing Representation
      • CUIAB Hearing Tips
    • Employment Law Blog
    • For Employers
  • Personal Injury
    • Five Tips For Injury Cases
    • Slip-and-Fall Injuries
    • Assault and Battery
    • Recorded Statements
    • Repairing Your Vehicle
    • Unpaid Medical Bills
    • Injury Law Blog
    • Medical Malpractice
    • Police Excessive Force
  • Practice Areas
  • About
  • Results
  • Submit Case
  • Contact
  • Resources
    • Consultations
    • Workplace Rights Checklist
    • Deposition Tips
    • Mediation Tips
    • Effective Mediator
    • Suing Current Employer
    • Severance Agreements
    • Workplace Investigation
    • Arbitration
    • Statutes of Limitations
    • Healthy Litigation Mindset
    • Trial Tips
    • Working Remotely
    • How To Find The Right Lawyer For Your Case