Legal Question in Insurance Law in Texas
Involved in a car accident, taken to the hospital. Daugher insurance paid her medical expenses @ the time. Person responsible for accident has AAA Ins. PI is being discussed & offering $1750 less medical ($878). Daughter's insurance is medicaid and they paid all of the medical bills. AAA Ins. is telling us they have to deduct the ($878) from the settlement. We have filed claims in the past and have never had the medical deducted from the settlement.
2 Answers from Attorneys
Coordination of benefits provision must be negotiated w/ medicaid. Insurance company cannot represent you. You must talk to medicaid to reduce
It appears that Medicaid has a valid lien, and unless the medical services are unrelated to the accident, the lienholder (Medicaid) must be protected. Unless you can get the lienholder to reduce their lien, AAA is correct and they owe those bills that were legitimately incurred.
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