by alani2 » Sat Feb 25, 2012 01:06 am
I have automobile insurance with the Hartford, which includes uninsured Motorists. On 9/15/2011, I was the victim of a hit and run driver. Although my car had only scratches, my back and finger were injured. I spent a night at Kaiser Hospital and reported the incident to the police. I filed an Uninsured Motorist complaint with The Hartford and was contacted by an adjuster named Tammy R [personal information deleted by Moderator MaxHerr per TOU]. From the start she has had a nasty attitude. At first I had an attorney and she told him they would not settle. Recently I agreed to a settlement far lower than what I deserve. I received a call from Ms. R [deleted by Moderator MaxHerr] stating that there is a lien from Kaiser Hospital on my claim. She asked me if she should make out the check to Kaiser and myself or should she send seperate checks. I told her that Kaiser had not contacted me about any lien and she had not mentioned a lien when I agreed to the settlement. Then she said that it was a collection agency representing Kaiser and gave me a number. When I called the person who answered was named Mike, whose phone number is [deleted by Moderator MaxHerr]. He claimed that he had tried to contact me but did not have my current information, and that is not true. My information was and is available to The Hartford, who he sent the lien to. I thought that I was supposed to know if there was a lien on any money due me. I have previously filed a complaint with the California Insurance Commissioner regarding the treatment I am receiving from the Hartford. I believe that I am being scammed by The Hartford and am in need of advice.
Posted: Sat Feb 25, 2012 01:30 am Post Subject:
Although my car had only scratches, my back and finger were injured. I spent a night at Kaiser Hospital
Pretty severe injuries as the result of "scratches" to your vehicle. But I'm not passing any judgment here.
Recently I agreed to a settlement far lower than what I deserve. I received a call from Ms. R . . . stating that there is a lien from Kaiser Hospital on my claim. She asked me if she should make out the check to Kaiser and myself or should she send seperate checks.
Kaiser has no obligation to "contact" you at all. They have an absolute right to collect their cost of your care from any insurance company that pays you for the same thing. This is called the right of SUBROGATION, and you will find it discussed in both your auto policy and your health insurance policy.
Your Kaiser health insurance is intended only to pay for "first party claims" -- your own health or injury issues, not those caused by a third party. They have to treat you as their insured if you show up at their hospital seeking treatment. But they don't have to pay for it when someone other than you caused the injury.
The same would be true if you were injured at work and went to Kaiser for treatment. Kaiser is not your employer's workers' compensation carrier, and they would send a nice, fat bill to your employer's insurance company for payment.
she had not mentioned a lien when I agreed to the settlement
Here, you may have a genuine issue of law. If the adjuster was aware at the time that Kaiser had a lien on your claim, which I'm sure she did, failure to communicate that MATERIAL INFORMATION is called CONCEALMENT. On that basis, you would have a cause of action for insurance bad faith.
[Mike] claimed that he had tried to contact me but did not have my current information, and that is not true.
That may or may not be true, but it doesn't really matter. The Hartford has a responsibility to inform you of such a lien before you agree to a settlement. If they did not, they are at fault.
You are not being "scammed", but your claim is not being handled fairly according to CA law. You should contact a claims supervisor at The Hartford and demand to have your claim reevaluated in light of their CONCEALMENT OF MATERIAL INFORMATION from you. Whatever the total amount they were willing to pay (to both you and Kaiser) on the first attempt to settle (to which you erroneously agreed) is what your claim should be worth. They can pay Kaiser what it is owed over and above that amount.
To attempt to ask for more would be unreasonable on your part, unless that total offer is itself unreasonable. But I doubt that is the case.
So, forget about talking to Ms. R anymore. Get connected to a higher level Claims Supervisor and work this out. You don't need to involve an attorney, and you don't need to threaten them with "I'm going to sue you," either. They could care less about that, because this is not a "big bucks" matter.
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