After a motorcycle accident, many of our clients are transported by ambulance to an emergency room at a local hospital. They receive diagnostic and emergency room care, may even stay overnight or for weeks in a hospital. As the medical bills are mounting, their health insurance will pay the medically reasonable and necessary bills.
If a motorcycle has health insurance, the health insurance company will receive the bills and provide payment to the healthcare provider based on their contractual obligations.
In California, any healthcare insurance companies, such as Blue Cross or Blue Shield, Kaiser or other health insurance companies, will seek reimbursement for any benefits paid to or on behalf of their insureds. This means, that if you have $100,000.00 in medical bills, and you recover $100,000.00 from the party at fault?s insurance company, you have an obligation to reduce or reimburse your own healthcare insurance company for the amount of benefits or costs they have paid. As such, there technically would be a net zero settlement to the client, as all the money would go directly to the health insurance company.
A California motorcycle attorney may negotiate with the health insurance company to dramatically reduce their amount of reimbursement on their behalf to seek compensation for the reimbursement. It is important that you contact a qualified California motorcycle attorney to assist you with any health insurance reimbursement claim.
There are also complications with health insurance if the employer of the motorcyclist is self-insured and governed by ERISA. Under our Ninth Circuit Court of Appeals, there is changing case law regarding whether the health insurance company is entitled to reimbursement. The investigation and evaluation of a California motorcycle attorney is necessary to determined whether a self-funded health insurance organization is entitled to reimbursement for medical benefits paid on behalf of their insured. This is very important. Please contact your California motorcycle attorney if you are employed by a self-funded company such as a union, railroad, school district, or other large employer that is a self-funded health insurance program.
It is also important that you submit and ensure that all of your medical bills have been paid for by your health insurance company. Your health insurance carrier may pay for treatment of injuries, including the cost of physical therapy, in-home care, medical equipment, prescriptions, surgery, and other services.
Sometimes, even if you have health insurance, you may receive medical bills or collection notices from the separate healthcare providers, whether they are radiologists, pathologists, emergency room physicians, or even the ambulance. It is important that you submit all of your medical bills to your health insurance for payment and ensure that the payment made by your health insurance is accepted as full payment by the other healthcare providers.
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