It’s the ultimate gut-punch when you are injured in a car accident. Your No-Fault carrier decides to cut off your medical benefits (that you pay for! Don’t get me started) in the middle of your treatment. Your medical provider tells you or your lawyer, “Sorry, I can’t treat you any more because you were denied….unless you sign this lien against your settlement proceeds.” What can you do? You feel stuck. You want to keep treating because, holy crap, you are in pain. You may ultimately need surgery. Your No Fault insurer doesn’t care. So, what can you do?
You Have a Few Options
- If you have medical insurance, you can provide your major medical information to your provider. Hopefully they take it. Good luck with that. Also, note, if your provider does accept your insurance and it is a specific type of ERISA plan, the plan will be able to claw back what it paid out. Your lawyer will know which ERISA plans qualify. If you don’t have a qualifying ERISA plan, you will not have to pay back anything to your major medical.
- You can sign that stupid lien and pay your provider back. BUT that’s not the end of the equation. Have your lawyer call me. I can help you get your medical payments back in your pocket. How do I do that? I will bring an action against your No Fault Insurance Company for you. What do I need? I will need evidence:
- a “Paid In Full” letter from your doctor;
- The original bills from your doctor;
- The treatment notes/evaluations/medical reports from your doctor (or from your personal injury lawyer);
- The denial of benefits from the No Fault insurance company (or from your lawyer). And, guess what.
You Don’t Pay Me!
If I win or settle your case, the insurance company is responsible for my fees. Gotta love the No Fault Regulation.