Legal Question in Insurance Law in California

Auto Accident Settlement Reimbursement to Health Insurance Provider

I had an three car auto accidant causing me a few

injuries and a totalled car. The insurance company

of the at fault driver settled my claims covering

everything.

My employer provided health insurance

company now have asked me to reimburse them

for the expenses they incurred for my

initial hospitalization, and other miscellaneous

medical costs.

Am I now required to send a part of my

settlement claim money to my health

insurance company ? I would like to know

about the California law on this.

Thanks a lot.


Asked on 4/05/04, 3:33 pm

2 Answers from Attorneys

Michael Stone Law Offices of Michael B. Stone Toll Free 1-855-USE-MIKE

Re: Auto Accident Settlement Reimbursement to Health Insurance Provider

Since you handled the claim yourself and achieved a settlement "covering everything" without a lawyer, you must be a smart cookie! So, no doubt, the settlement you negotiated with the insurance company included money to reimburse your employer-paid health insurance -- which, as you know since you are obviously someone who knows your rights under California law, you do owe them. I bet your comprehensive settlement also included money to compensate you for your lost earnings, lost earning capacity and money for your pain and suffering as well. Way to go! Of course, as you know, the release you signed precludes you from renegotiating the claim and from getting any more money from the other driver's insurance company. But you knew that.

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Answered on 4/12/04, 4:24 pm
Phillip Cooke Law offices of Phillip A. cooke

Re: Auto Accident Settlement Reimbursement to Health Insurance Provider

Many people try to not make a big deal out of an auto injury. Most people try to be reasonable and try to make a settlement that they think would be fair. Unfortunately, insurance companies don't warn you about potential liabilities when they are settling with you.

The answer to your question may vary depending on

who your employer is or what the circumstances of your employer's insurance carrier involvement is.

You should see a lawyer who provides a free initial consultation. If the facts are right, the release might be able to be set aside. If the employer's insurance was under workers compensation, you may have certain rights, and they may have certain rights. If the employer's insurance is an ERISA plan, in California, they might not have a reimbursement plan that was approved by Congress. If you had auto medical pay that has not been exhausted, there may be some other options.

You should see a lawyer about this without delay. In all injury cases, delay may cause prejudice, and you should act promptly.

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Answered on 4/12/04, 5:01 pm


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