Car Accident - Does your health insurance have a medical lien?

If you were in a car accident in Pennsylvania-- you have medical coverage through your auto insurance. But, depending on the amount of medical coverage you purchased, that coverage may "exhaust" or run out. Whether you were in a car accident on Route 422, or a truck accident on Route 202 or Route 100, if you are a Pennsylvania Resident, you must have at least $5,000 in medical coverage on your policy. You have the option to purchase more than the mandatory $5,000. So, after that happens after that medical coverage "exhausts", your health insurance would then have to pay for medical bills. (NOTE: Even if it's the other driver's fault, part of what you pay auto insurance premiums for in Pennsylvania is for medical coverage. It's called "No Fault" or First-party medical). But, if the car accident or collision is the fault of the other driver, your health insurance will say that the at-fault driver's insurance should pay them back. This is called "subrogation" or sometimes referred to as a medical lien. If you never recover any settlement or money from the at-fault driver's insurance carrier, then you probably would not have to ever repay your health insurer because you have a contract with them. But, once you accept any settlement or recovery against a "third-party" (that is, the other driver's insurer), your health insurance may have a right to a lien (to be reimbursed what they paid out). This subrogation issue gets complicated. It's important to consult with an experienced personal injury lawyer in Pennsylvania on this. The at-fault insurance company will not likely explain this to you. They are just trying to get out of your claim for as little as possible. Whether your health insurer has a right of subrogation will depend on several things. First, what type of plan you have. In Pennsylvania, there is a "Motor Vehicle Financial Responsibility Law" which has as a general rule that insurers can't subrogate. But, there are exceptions. ERISA-based and self-funded plans and certain HMOs may have a right to subrogate. It will also depend on the language contained in your health insurance plan itself. You have an obligation to notify your health insurer if there is a "third-party" claim and your health insurance has paid any related medical bills. (Probably, because you have exhausted your auto medical coverage). You would then need to determine if your health insurer is asserting a lien, whether it's valid and then find out the amount owed. This can be part of your damages in your case against the at-fault driver's insurance company. Again, these are complicated legal issues that you should consult with an experienced injury lawyer in Pennsylvania about. David Schreiber concentrates his practice on Pennsylvania Injury Law and Insurance Disputes. He can be reached at 610-792-3304.

Injury from Fall on Dangerous Condition in Pennsylvania: What's needed to prove your case and Things to Remember

So, you fell and were seriously injured in Pennsylvania because someone else was at fault. Now, you can't work. Or, no one is paying the medical bills and the property owner or business owner won't return your calls. Maybe the insurance company for the store or business where you fell is calling you and you don't know what to do. What's needed to prove your case? Examples: You fell because of a hole or defect in the parking lot of a supermarket in Pottstown. You were seriously injured. OR You fell on steps at an apartment complex in Phoenixville that were cracked or missing a railing. In any case where you fell because of a "defect" or unsafe condition, you must be able to prove that the owner or property manager: 1.knew that the condition was there (this is called "actual notice") or 2. should have known that the condition was there (called "constructive notice") Most important, if possible, is to have someone get photos of the condition as soon as possible. The best proof of the condition are photos. Hopefully the owner or manager will fix the condition so now one else gets hurt, but once fixed or changed, you've lost the chance to get proof via photos. Second, it's critical to get the names of any witnesses who either saw the injury happen or who knew about the condition before. It's also important to speak with an experienced personal injury lawyer who handles premises liability cases like yours. You want to ask the lawyer if they've handled fall injury or slip and fall cases - especially, whether they've handled them through to a jury verdict. If the property manager or owner or their insurance company is calling you, it's really important that you not give them a statement without speaking to a lawyer on your behalf. You may think it's "cut and dried" or straightforward, but there may be issues or pitfalls in providing information to the opponent. Remember, the insurance company does this everyday. They are not on your side. The insurance company is looking to protect their property owner and get out from the claim without taking responsibility or for taking as little responsibility as possible. David Schreiber Wolpert Schreiber P.C. 527 Main Street Royersford, PA 19468 We Work for Your Case Concentrating in Injury Law and Insurance Claims

Pennsylvania Motorcycle Accidents and Medical Coverage

In Pennsylvania, unlike for a car, you are not required to have medical coverage on your Motorcycle Insurance Policy. It is optional. Many insurance companies don't even offer medical coverage. It's referred to as "first-party" medical coverage or "PIP" ("Personal Injury Protection"). If you are injured in Motorcycle crash in Pennsylvania and don't have medical coverage on your policy, then your medical bills would need first go through your health insurance. It may seem strange that the at-fault driver's auto insurance won't pay your medical bills. They do-- sort of. Basically, the insurance company for driver at fault would be responsible to pay medical bills outstanding or incurred by you. But, they would not pay until the end of the case with a Release of all claims. So, while your case is ongoing, you must use your health insurance if you don't have the first-party coverage. If you have no health insurance, then you have to make some type of payment arrangements with medical providers. You should contact a personal injury lawyer who is experienced in handling Motorcycle Accidents. If you use your health insurance, then depending on the type of plan you have, your health insurance may have a right to be reimbursed at the end of the case from any settlement or recovery. This is called "subrogation" and it can get complicated. An experience personal injury lawyer could explain that process to you. Additional information.