Injured with Huge Medical Bills and the Insurance Company is Treating You Like You are the One Who Did Something Wrong

Injured with Huge Medical Bills and the Insurance Company is Treating You Like You are the One Who Did Something Wrong

 Posted by:    Jul 10, 2009  


Imagine being rear-ended and hurt. After leaving the emergency room, your bill exceeds $4,500. The E.R. doctor tells you to follow up with your primary doctor within 72 hours. You do. Your primary doctor refers you for an MRI ($1,250) and has you see an orthopedic surgeon ($650 for 10 minutes of his time) and refers you for 20 visits of physical therapy at $220 per visit. The doctor also tells you that if that doesn't do the trick, he'll do three spinal injections ($2,500 a pop). Quick math tells you that you are staring at a minimum of $20,000 in medical bills and no assurance from anyone that the bills won't ultimately be even higher.

After talking to the insurance company's assigned adjuster who represents the negligent driver, you learn that the reckless driver has no personal assets and only a minimum Colorado-compliant liability policy ($25,000). Oh...and by the way, this adjuster makes it abundantly clear that he isn't paying you anywhere near the policy limits on THIS case. What now? Hire a lawyer? You know from your research that most lawyers charge 1/3 of what they recover for you. So you do some quick math: 1/3rd of $25,000 (assuming the insurance guy ever releases his death-grip on the policy limits), is $8,333. If you stop right now and get no more care (and you're already up to $12,000 in medical expenses), you might clear $4,000 to $5,000 tops. So, you say to yourself, "I'm still hurt, can't afford anymore care and my best case scenario when the dust settles will be to clear less than $5,000?" Being a reasonable and intelligent person, you say to yourself, "it doesn't seem that the math works out, so maybe I should just quit while I'm behind and give up.

Sound familiar? Sure it does. In fact, I hear a new story like this 10 times a week. However, what I'm about to tell you has helped relieve stress and frustration for our clients time and time again.

First, the situation is not hopeless, but that is probably what the insurance company hopes you think. My comments are my own opinion, but I suspect that many thousands of injury victims quit medical care and give up simply because the math looks hopeless. When that happens, the insurance company escapes paying, and that is great for their business. They win, and the injured person loses. They won't tell you what I'm going to tell you. So here goes:

A) There is probably more money out there than meets the eye:

A guy driving a car with minimum insurance limits by no means is the end of the search for coverage. In fact, it is only the beginning. Additional inquiry is necessary as to whom he lives with and what other cars are insured in his household. Was he running an errand for his employer at the time? Does he own insurance on any other vehicle? Does he have umbrella coverage? Does any resident relative in his household own such a policy? How old is he? Is there any adult responsible for his conduct? What sort of auto insurance does the adult have? What sort of uninsured/underinsured motorist coverage do you have? How about similar coverage owned by any resident relative in your household? Were you running an errand for your company? Do you have an umbrella policy with added UIM benefits attached to it?

The above examples are just some of the inquiries that need to be made before you know how much coverage is REALLY available. Since January 1, 2009, the law allows the stacking of multiple policies that was not permitted prior to that date. Any attorney who only looks at the policy limits on the reckless driver's car and nothing else is missing the boat and needs to find another profession before he does irreparable harm.

B) You probably don't really have to pay that much back from your settlement related to your medical costs.

1) Med-pay: If your medical care is being paid by "med-pay" coverage from your own auto insurance, and the collision occurred after January 1, 2009, there is NO payback required by state law.

2) Health Insurance: The three things you need to know about health insurance are: 1) They don't always ask for their money back; 2) They always pay a fraction of the full value of the medical services and 3) They nearly always negotiate DEEP discounts on their claims. I recently got a health insurer to agree to waive more than $700,000 in paid hospital and medical charges related to one of my extremely injured clients. I have honed my skills at these types of negotiations over years and years of practice.

3) No Insurance: About forty percent of our clients have huge medical bills and no health insurance whatsoever. But you need to understand that doctors, hospitals, and collection companies are chomping at the bit to settle these claims and they play "Let's Make A Deal" all the time. Depending on the services provided, we often convince them to accept half of their claimed bill by making the right arguments to the insurance companies, showing them what the right thing to do is.

4) The law of Interpleader: Believe it or not, there are doctors, hospitals and health insurance companies that won't play fairly by accepting reasonable reimbursement for their services. That is when knowing how to involve the court serves as an invaluable equalizer. Just seeing our filed court documents asking the court to slash a bill based on it being neither usual, customary, reasonable, or necessary, often causes these health providers to negotiate quick and painless resolutions - especially when they realize that it is our firm who has filed the documents and we are ready and willing to go to the mats on these issues.

HOW HOPELESS IS IT REALLY?

My last seemingly hopeless situation involved my client being told that there was only $25,000 in total insurance and $400,000 in incurred medical expenses paid by an ERISA health insurer. In that case, there ended up being far more insurance available than a mere $25,000. I recently settled with the THIRD insurance company surrendering their limits ($50,000). This is in addition to another policy with limits of $100,000, and another with limits of $50,000. The health insurance agreed to take NOTHING on their claimed right to repayment of medical expenses. There is still one more $100,000 policy out there. That one ought to give up and surrender its limits by next week.

Is that a success story? You better believe it! But that is why it is so critical to take your seemingly hopeless situation and come see us. There certainly are cases where we simply cannot help you. But you would be surprised how often Anderson, Hemmat & McQuinn can infuse hope into your seemingly hopeless situation.

Before you give up, give us a call.









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