If your medical insurance provider is Blue Cross CareFirst, they will typically send you a subrogation letter if they notice treatment that could potentially involve a tort claim.
Why does CareFirst do this? People get angry when they learn that CareFirst wants repayment for the medical bills they have paid. Our clients often are understandably upset wondering why they bought health insurance in the first place. We agree. But Maryland law is clear that if your injuries were the result of someone else’s negligence and you are compensated for those injuries, health insurance carriers are allowed to require repayment if there is a settlement or verdict in your case that gives money to you for the accident. So we have to deal with these liens and try to do the best we an to pay back as little as possible. In some personal injury cases, they best think we do for the clients is negotiate their liens.
A lot of our clients have Care First/Blue Cross/Blue Shield liens. In my office, we talk about "Blue Cross Blue Shield liens" but it is really a misnomer. Technically, the health care provider does not have a lien. What they have is a contractual agreement with you that if you are injured by a third party and that party makes payment for your medical bills, you will pay them back.
Do you "have to" pay them back? Well, that depends on your definition of "have to." First, in some states, your lawyer cannot disburse your settlement funds if they have been put on notice of a claim by CareFirst or another health care provider. So that is the first hurdle in trying to blow one past CareFirst Blue Cross.
Let's assume for a second that either your lawyer is willing to ignore the lien or CareFirst has never put the lawyer or the client on notice. If you don't pay back the lien, a lot of bad things can happen.
First and foremost, you can lose your health insurance. No explanation is necessary as to why this is a bad thing. But if you have been badly hurt, you are more susceptible to future injury. So the risk is the same risk as everyone else, only squared.
The health insurer will do more than just cut off future coverage. It will likely retract all of its payments to the healthcare providers. When this happens, the client loses the "health insurance paid for it" discount, which means it may be obligated pay the full amount in some, probably most, cases. Moreover, you can expect Care First to file a lawsuit to get their money. At least in Maryland, CareFirst is relatively easy to deal with on these lien issues (Eugene Seidel's office in Baltimore handles most non-federal Care First subrogation claims). But they demand to be treated fairly and you should expect consequences if you are not. If you lie or mislead any lienholder, you will never again get the benefit of the doubt.
Federal CareFirst liens are handled out-of-state and they are more difficult to deal with in reducing liens. Cases sometimes go to trial because you just cannot talk sense to the adjuster. But if there are unique aspects to your case, there is a meaningful chance they will make an accommodation for you. But you have to work hard and separate yourself from hundreds of other lawyers that are looking for a reduction that do not lay the appropriate foundation for a meaningful reduction.
Keep in mind that these are general rules that may vary from state-to-state. You will want to speak to an accident lawyer who knows the law in your jurisdiction. We are writing about Maryland personal injury cases.Getting Help from a Lawyer
We guide our clients through this process with health insurance liens. We have done it hundreds of times and have saved our clients literally millions of dollars by getting reductions in their liens. Our lawyers do it in the right way so it does not come back to bite them. If you have been injured in an accident or by medical malpractice, call one of our lawyers at 800-553-8082. We handle accident lawsuits throughout the United States. You can also get a free no obligation online consultation.