by Guest » Mon Sep 29, 2008 10:50 pm
Am I required by law to respond to a questionaire from my health insurance company regarding other responsible parties??? A friend was driving our vehicle in which we were passengers and he filed a claim with his insurance company. His insurance company is going to propose a settlement to my husband and I for bodily injury. My husband was badly injured. An independent company has sent a questionaire to get recovery for a $42,000 medi flight bill that my health insurance company has already paid. If we do not respond to the questionaire and receive a settlement, can my health insurance try to get some of the settlement to recover their cost for the medi flight bill???
Posted: Tue Sep 30, 2008 06:04 am Post Subject:
Hi patti,
I'm not sure I've got a grasp of your problem. If the two claims are not related the, then these need to be addresses separately. The insurance company can't deduct any amount paid to the claimant after disbursing the claim amount. Hence, it out of question that the health insurance company will take the money out of you to compensate for the amount they have paid to another party.
~Jeremy
Posted: Tue Sep 30, 2008 06:13 am Post Subject:
What information you have been asked to disclose?
An independent company has sent a questionaire to get recovery for a $42,000 medi flight bill that my health insurance company has already paid.
Are you referring to any previous incident? If your health insurer has paid you for certain injuries, then it may alter your premium rate, but will hardly have any connection with the new settlement.
Please elucidate your problem little more so that we can offer you better suggestions regarding subrogation of claims in auto insurance.
Posted: Tue Sep 30, 2008 06:18 am Post Subject:
It is not possible for a health insurance company to conduct auto subrogation against its policy holder until and unless it's a med pay claim.
In case of med pay settlements, some states allow the auto insurance company to recover the amount paid towards the treatment of the policy holder in an accident from his/her health insurance policy.
In cases you may require to return the amount paid for medical expenses after the accident to your auto coverage provider once the claim is paid by the health insurance company. However, I'm not sure if that is the situation here.
Thanks,
Rupert
Posted: Tue Sep 30, 2008 10:12 am Post Subject:
The health insurance company can't subrogate against its policy holder until and unless it's a med pay claim.
Where did you get that Rupert? Not in my state!Patti, I think I know the type of form you mean I get one about every year because I have a neck and back issue....yes, if your policy (health) has a claims subrogation clause, which I think most if not all do..they are entitled to collect on it, and if I were you I'd fill out and return that form...is your concern that they will exaust the limits? I do understand that, but if I were you I'd check with your states, Dept of Ins...better to know now for sure than to spend some of the money, and have them sue you for it later... :shock: Also you said that your friend was driving your car? Your carrier isn't paying but the drivers is?
Posted: Tue Sep 30, 2008 10:52 pm Post Subject: Clarification
A friend was driving our truck, my husband & I were passengers. He lost control and we rolled down an embankment. No other cars were involved. Since our friend was driving, we turned it in to his ins. co. My health insurance has paid most of my husband and my medical bills. They are also reimbursing our friend for any medical his health ins. didn't pay, up to $5,000 each. My auto ins. has paid us for the totalled vehicle. The quesionaire was making reference to a $42,000 medi-flight bill for my husband, that my health ins. paid in full. The questionaire is from an independent company on behalf of my health ins. wanting to know if anyone else or anyone else's insurance could be responsible, so they can recover some of what they paid. I hope this makes sense, if not let me know. Thanks
Posted: Tue Sep 30, 2008 11:55 pm Post Subject:
They are also reimbursing our friend for any medical his health ins. didn't pay, up to $5,000 each
No this isn't health ins doing this part with your friend it is medpay under yours or his auto policy...I assure you...Makes perfect sense Patti....so his carrier is only covering the Bodily injury portions, your's and your husbands...your's covered the vehicle and the medpay...apparently you have med pay on your auto policy for 5k each...I would assume that has been exausted....what is your friends Bodily Injury limit do you know? Also do you have UNDER ins. motorist coverage on your policy? You cannot lie or not answer this inquiry they will find out....see if you have spent your medpay (probably did) if not certainly give them that information...personally I would call the person that sent the letter and ask if it is legal in your state to conduct auto subrogation against your bodily injury settlement..
Posted: Wed Oct 01, 2008 11:30 am Post Subject:
Also please consider raising your med. pay. I speak from first hand knowledge of this. The other person was 100% at fault and I exhausted my med. coverage from my policy rather quickly. Now it is being paid by my personal health insurance who has asked to be paid back. It will come out of your settlement in the end. Not only that a serious injury can rack up years worth of med. bills and if you have deductibles and copays it can get really expensive for you to pay, especially if you are unable to work.
Living day to day here and learned alot from my accident...good luck.
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