by laztender » Sun Oct 24, 2010 12:32 am
a friend of mine was involved in an auto accident recently and injured. his private health insurer paid his medical bills. he told me that his attorney handling the personal injury he sustained in the auto accident, told him that he
was allowed to file a medical payment claim against
his own insurer since he carried automobile medical pay. This would pay him in addition to what the health insurer paid. Is the the law in missouri?
was allowed to file a medical payment claim against
his own insurer since he carried automobile medical pay. This would pay him in addition to what the health insurer paid. Is the the law in missouri?
Posted: Sun Oct 24, 2010 08:11 pm Post Subject:
Well, I don't know of any state that permits a person to "profit" from insurance. If medical bills are paid by one's own medical insurance, and then one recovers an equal amount of money from another insurance policy, the medical insurance company is entitled to recover what it paid. It's a concept known as SUBROGATION. (The so-called hospital or accident "indemnity income" policies are a different matter, because they are "valued" contracts that pay fixed claim amounts according to whether or not it's covered in the contract, regardless of the actual amount of a loss, or other insurance, involved. Still, even those policies are not "intended" to provide anyone with a profit.)
Strange how attorneys so often fail to understand this. It must have been something discussed on the day they were absent from class, or asleep during class.
Posted: Thu Oct 28, 2010 12:40 pm Post Subject:
Hey, it's nice to watch you attending queries with such confidence and knowledge.
Still, even those policies are not "intended" to provide anyone with a profit.
I thought with indemnity contracts, the insured will some how manage to earn a profit. How do such policies keep the 'profit motive' at bay?
Posted: Fri Oct 29, 2010 12:06 pm Post Subject:
Roddick . . .
It's not considered "profit" since an actual event causing a related loss must occur. An accident-only, hospital-only policy is rather limited . . . a person must suffer an injury due to an accident and be admitted to the hospital (not simply seen in the Emergency Dept) in order to collect a benefit.
When a person IS hospitalized, they are only an inpatient as long as it takes to stabilize their injury and begin the process of recovery. Once a patient is capable of being cared for at home, most hospitals/doctors would release the patient, since the HMOs and PPOs are not going to allow them to simply remain hospitalized.
So even if a person is hospitalized, and has their medical bills paid for by an insurance company, and/or has income replacement courtesy of a disability income policy (or not), there will still be a financial loss. $100/day may or may not cover it.
So it's not really creating a profit, even if the $100/day does cover the difference. Something of greater value has still been lost.
Posted: Mon Nov 01, 2010 03:18 pm Post Subject:
a friend of mine was involved in an auto accident recently and injured. his private health insurer paid his medical bills. he told me that his attorney handling the personal injury he sustained in the auto accident, told him that he
was allowed to file a medical payment claim against
his own insurer since he carried automobile medical pay. This would pay him in addition to what the health insurer paid. Is the the law in missouri?
I am from Missouri, and I had an accident 5 years ago. I incurred 4000 in medical expenses from a rear end collision. MRI, rehab therapy, xrays, etc. I chose to use my auto med pay policy instead of my health policy. No deductible and when I settle with the negligent drivers insurer, I will be under no obligation to repay my med pay policy. Had I use my health policy, they would have had rights of subrogation. And in Missouri, the at fault insurer can not deduct or consider the 4000 in expenses paid by my policy when settling with me.
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