by Sleepdeprivation » Mon Mar 28, 2011 04:31 am
This accident occurred in California, both parties live in California.
Party A = Motorcycle rider (not at fault)
Party B = Automobile driver (at fault)
Party B has $25k per person & and $50k per accident bodily injury insurance.
A's out of pocket medical bills are $1k, lost wages are $5k.
B's insurance was informed that A's medical bills exceeded $50k, but no lien had been placed on B's $25k bodily injury from the medical providers.
B's insurance offered the full $25k bodily injury to A in return for signing of 'Release in Full of All Claims and Rights.'
B's insurance informed A verbally that after signing the release, any of A's medical providers seeking funds would be sent directly to A.
A could then negotiate directly with A's medical providers regarding how much of the $50k medical bills would be paid from the $25k bodily injury funds provided to A directly.
B's insurance verbally informed A that medical providers were bound by CA law to only receive up to half of the amount paid to A ($25k).
B's insurance also verbally informed A that the medical providers would not know the full amount paid to A, and could only assume the CA minimum of $15k. So, medical providers would only request 50% of the assumed $15K, $7.5K. This would leave $17.5k for A.
Questions:
Is the above true?
Does CA law protect A, limiting medical provider's seeking up to $7.5k only?
Is it possible for A to be held responsible for all $50k of medical provider's bills if Release is signed?
Is there only $25k available to A (accepting that B's bodily insurance was in fact $25k/$50k)?
Party A = Motorcycle rider (not at fault)
Party B = Automobile driver (at fault)
Party B has $25k per person & and $50k per accident bodily injury insurance.
A's out of pocket medical bills are $1k, lost wages are $5k.
B's insurance was informed that A's medical bills exceeded $50k, but no lien had been placed on B's $25k bodily injury from the medical providers.
B's insurance offered the full $25k bodily injury to A in return for signing of 'Release in Full of All Claims and Rights.'
B's insurance informed A verbally that after signing the release, any of A's medical providers seeking funds would be sent directly to A.
A could then negotiate directly with A's medical providers regarding how much of the $50k medical bills would be paid from the $25k bodily injury funds provided to A directly.
B's insurance verbally informed A that medical providers were bound by CA law to only receive up to half of the amount paid to A ($25k).
B's insurance also verbally informed A that the medical providers would not know the full amount paid to A, and could only assume the CA minimum of $15k. So, medical providers would only request 50% of the assumed $15K, $7.5K. This would leave $17.5k for A.
Questions:
Is the above true?
Does CA law protect A, limiting medical provider's seeking up to $7.5k only?
Is it possible for A to be held responsible for all $50k of medical provider's bills if Release is signed?
Is there only $25k available to A (accepting that B's bodily insurance was in fact $25k/$50k)?
Posted: Mon Mar 28, 2011 06:11 am Post Subject:
I don't know of any law that states a medical provider is required to collect only 1/2 of what they billed. That makes no sense. Why would a law state such a thing? Also, why would the medical provider just not bill 150% of the norm in order to collect 100% of what they want to charge. Perhaps either this is not true or perhaps some info is being lost in the translation. Lastly, even if this law existed, by B's own admission, it has no weight... as everyone can simply have all of their medical bills reduced to 1/2 of he minimum liability insurance allowed. So I could get 1,000,000 in medical treatment and only have to pay $7500?
I think what was actually explained was that people can always negotiate with medical providers and it's not unheard of to have them reduce their bills by 50%. The patient _could_ also tell the medical providers that they were paid far less then what is owed and try to get the bills reduced by even more.
If the other person's limits are $25k per person... then yes, that is all that the insurance company will pay. If you don't want it, you don't need to sign the release and can file suit against the other driver/owner for more. You'd then pay an attorney 40% of anything obtained. B's insurance would not pay anything until the suit was over. Once it was over, if you obtained a judgement in excess of $25k, the insurance company would hand over their $25k. You'd pay 40% of this to your attorney but then you could legally attempt to collect the rest from that driver and/or owner.
Do you have UMBI on your owner policy?
Posted: Mon Mar 28, 2011 02:39 pm Post Subject:
Party A's (not at fault) UMBI is $15k/$30k.
The 1/2 was not what was billed, it was regarding the settlement. 1/2 of the settlement, which is much less than what the medical provider (Kaiser) has paid for A's medical costs. Kaiser paid $50k+ to out of Kaiser network emergency room and ambulance while they only required A (their member) to pay out of pocket $1k in copays.
I will inquire as to the CA law that B's insurance quoted regarding the medical providers being limited to 50% of the settlement to A.
What is the best course of action for A?
? Accept the $25k from B's insurance by signing the release, then hope A's medical providers do not seek more than $19k of the $25k settlement (paying for A's $1k in out of pocket medical bills and $5k in lost wages)?
Does A have any legal protection to the $6k of the settlement?
Will Kaiser seek A to repay them more than the settlement with B's insurance?
Should A just ignore the settlement offer and wait for Kaiser and B's insurance to figure it out (in 4-18 months)?
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