Normally, when you are ill or injured, you look to your own
health coverage through health insurance or a health maintenance organization,
Medicare or Medicaid to take care or your medical bills. When you have been
injured in an accident, however, you may also eventually receive compensation
from another person’s insurance company or from your own vehicle insurance
company if you had an accident with an uninsured motorist.
If you
do receive compensation for your injuries but your medical bills have already been
paid through your health coverage. You may be obligated to repay some or the
entire amount to the health plan. Whether & how much you have to repay varies
with the type of plan & is determined by the terms of your policy or
membership agreement with the health plan & by how the plan enforces those
terms. Many health plans pay no attention to whether accident insurance
compensates you for the same injuries that the health plan covers, & you
get to keep your whole settlement. Other health plans, however specify that you
must reimburse them out of any accident insurance award you receive.
Following
an auto accident you may have the option to pay medical bills through either
your health the option to pay medical
bills through either your health plan or through the medical payments provision
of your auto insurance policy. As discussed of your health plan or your vehicle
insurance medical payments coverage requires you to reimburse it fully if you
collect later from another source. If one requires reimbursement & the
other doesn’t, you are usually better off using the one you don’t have to
repay.
Health
Coverage with Insurance Company
Whether
you must reimburse your private health insurance company depends on the terms
of your health insurance policy. Read your policy to see if there is a section
entitled “Right to Reimbursement”. If so, & if the policy states that a
right to reimbursement applies to third party claims, then the insurance
company has a right to ask you to repay it any amount that it paid related to
your injuries from the accident.
Even if
a health insurance company has a right under the policy to seek reimbursement
from you, whether it actually does so depends on whether it knows you have
filed an accident claim, it may ask whether the injuries were the results of an
accident. It may ask whether or not you have filed a claim for damages against the
liable party. But if your claim form doesn’t pose such questions, the insurance
company may have no idea that you have filed & settled a claim for damages.
Even if the company does file a request for reimbursement, you don’t
necessarily have to repay the full amount it claims.
