What Are Medical Liens and How Do They Affect Personal Injury Cases?

If you were injured through another person’s negligence or intentional wrongdoing, you should not be the one paying for the resulting medical treatment and other costs. Although you may be able to obtain compensation by filing a personal injury claim, there are some circumstances when a claimant’s net recovery is reduced. This might happen, for example, if a medical lien is asserted against your recovery.

A lien is a claim for a right to payment for services provided on a lien basis. A medical lien could be brought by a health insurance company, government agency (such as Medicare or Medicaid), or healthcare services provider. If you received care on a lien basis, the payment for that care would come out of your recovery.

Sometimes it is possible for an attorney to get a medical lien reduced or waived. At the end of the day, there are all sorts of potential ways for a personal injury lawyer to help a client pursue the highest possible compensation, so it is certainly worth discussing your situation with an attorney in a free consultation.

Who Can Assert a Medical Lien Against a Personal Injury Settlement or Verdict?

We’ve already touched on a few of the parties who can assert a medical lien. They include:

  • A Healthcare Provider: The doctor or hospital that treated you may assert a lien against your recovery to recoup the cost of treatment.
  • Health Insurance Companies: Some health insurance companies have lien clauses embedded in the language of their policies.
  • The State of Florida: The State of Florida might file a lien for Medicaid benefits paid to a hospital for services rendered, but such a lien can only apply to payment related to the injury. The State is statutorily required to be paid from the proceeds of the personal injury case whenever Medicaid has paid the victim’s medical bills.
  • The Federal Government: The federal government may file a statutory lien for Medicare payments under the Medicare Secondary Payor Act. When a conditional payment has been made by the government even though payment should be made under a workers’ compensation plan or insurance policy, the United States can bring an action against the primary plan responsible for paying.

Knowing about the liens that might be asserted against your recovery can go a long way to helping you create future financial plans. It takes time to resolve a personal injury case—sometimes several years—so it’s important that you know what to expect upon the conclusion of your case. Your lawyer can help you understand any liens that might be asserted against your recovery.

Getting Medical Liens Waived or Reduced
If a medical lien is asserted against your recovery, your lawyer can determine if it is valid. There may be clerical errors you can contest. Also, hospitals are usually prohibited from filing a lien against a patient for the balance of medical bills when they can bill their health insurance company instead.

Healthcare providers are required to charge patients reasonable rates for services rendered. If the cost of your care was excessive, your lawyer might be able to get the lien reduced. Successfully challenging the cost of care requires extensive evidence and might involve medical expert deposition.

The liens asserted against your recovery could impact how your lawyer approaches the settlement negotiations. Your attorney’s primary goal is to help you walk away with the highest possible compensation. If there are liens asserted against your recovery, your lawyer will know their amount and can therefore pursue a settlement or verdict that is sufficient to cover your liens and hopefully provide you with the funds needed to cover your other damages and move on with life without being burdened by financial uncertainty.

Health Insurance and Medical Liens
Medical facilities and healthcare providers are usually prohibited from filing a lien against patients for the monetary difference between the regular price for treatment and the pre-set treatment rates negotiated between your insurer and the hospital on your behalf. After you cover copay’s and deductibles set out in your insurance policy, your insurer is responsible for paying your medical bills up to your policy limits.

Liens Asserted by Medicaid and Medicare
Generally, if the government pays for your medical care, they have the right to recover the cost of care from the settlement or judgement pertaining to the injuries that were subject of the care. Different government programs and agencies have different rights regarding medical liens.

Liens Must Be Paid Before the Plaintiff Obtains Compensation
When a personal injury plaintiff wins a settlement or verdict, any liens against the recovery must be paid before compensation is distributed to the plaintiff. It is therefore important that you take the necessary steps to resolve medical liens as quickly as possible. Complications often arise that significantly delay when a plaintiff collects compensation, which can of course be incredibly stressful—especially after you’ve navigated through complex and protracted legal proceedings.

When negotiating a settlement, the plaintiff must typically tell the lien holder about the claim, and the lien holder must agree to release the lien as part of finalizing the terms of the settlement. An attorney can help you avoid unnecessary delays and complications regarding the payment of medical liens.

How Else Might an Attorney Help Increase My Recovery?
No attorney can guarantee to win a settlement or verdict in your case. The best lawyers are completely transparent about the strengths and weaknesses of every claim they handle. Although your attorney cannot promise to attain a particular outcome, he or she can explain the strategies that might be employed to give your case the best possible chance of yielding fair compensation. Such strategies may include:

  • Accounting for All the Damages Incurred: There are many categories of damages that might be available in a personal injury case. Depending on the circumstances, it may be possible to obtain both economic and non-economic damages. These might include past and future lost income, past and future medical bills, property repairs, other direct financial losses, pain and suffering, loss of life enjoyment, and emotional distress. Sometimes the spouse of an injured party is entitled to loss of consortium. Your lawyer can help you account for all of the damages you may be owed.
  • Researching the Liable Party’s Finances and Asset Value: If there’s not enough insurance between the liable party’s coverage and your own policies to pay for your losses, it may be possible to collect the difference by bringing a claim against the liable party directly. Often, though, the defendant does not have sufficient finances or asset value to justify such an action. Your lawyer can find out if bringing a claim against the liable party would be worth considering.
  • Helping You Mitigate Damages: If you do not take reasonable steps to minimize your damages, the opposing party might argue that your award of damages should be reduced. This could add up to a significant loss depending on the value of your claim and the percentage of fault imposed on you. Your lawyer can explain the steps you need to take to mitigate damages, which will include taking your medical care seriously and following all of your doctor’s orders.
  • Helping You Avoid Mistakes: One minor mistake could be enough to reduce the amount of compensation you recover. For instance, if you post a description of the accident on social media or a photo of you taken with friends, such content will likely be admissible in court, and it might be used by the insurance company to challenge liability, causation, or the value of damages, or to assert that you have failed to mitigate damages. Other common mistakes made by accident victims include providing a recorded statement to the insurance company or failing to account for all damages incurred.

Discuss Your Case with a Stuart Personal Injury Lawyer
If you were injured due to the negligence or intentional wrongdoing of another party, you may be coping with severe pain, mental suffering, and financial uncertainty. A seasoned personal injury lawyer can help you fight for the compensation you need to move on with life.

Your attorney can take over all correspondence with the insurance company, defendant, and your healthcare providers. Your lawyer can evaluate the options for getting medical care while your case is pending and make sure any liens asserted against your potential recovery are valid.

At Donaldson & Weston, our attorneys are well-versed in the statutes and case law pertaining to medical liens. We know the circumstances when these liens can be reduced or waived outright. You can rest assured that our team will do everything in their power to help you pursue the highest recovery possible.

Our lawyers have won millions of dollars in damages for accident victims and their families. Call 772-266-5555 or send us a message to speak with a member of our team. The initial consultation is free, and we accept these claims on contingency fee basis. That means you won’t be charged any attorneys’ fees unless we win your case.