Dealing with private health insurance liens can be tricky. But there are many tactics in reducing the total lien amount. Work zealously and diligently in negotiating the final lien amount early on in the case to minimize lien recovery.
- Reduce For Unrelated Charges
Review the lien, all the dates of services, and make sure that only visits related to the injury are include.
- Reduce For Unreasonable Charges
Review the total lien amount and reduce anything that seems too much. Check the CPT codes for standard rates for the area of service.
- Reduce For Comparative Fault
If the settlement was reduced for comparative fault, make sure to reduce the lien amount for the same percentage.
- Apportionment For Claimants
If the settlement is for multiple parties, make sure to apportion the settlement for the lien claimant only.
- Deduct For Out Of Pocket Expenses
Reduce the lien amount for any out of pocket expenses such as deductibles and co-pays.
- Determine The Portion Of Settlement Related To Medical Bills
Settlements often cover past and future medical bills, lost wages, and pain suffering. Determine the amount of the settlement for medical bills and reduce the lien amount accordingly.
- Priority Of Liens
Make sure to pay out liens in priority. If there is an issue of liens, make sure all lien claimant’s rights are accounted for and apportioned accordingly.
- Consider The Made Whole Doctrine
The Made Whole Doctrine limits the recovery when the injured victim has not fully recovered from the settlement. The doctrine allows a reduction for attorney fees and costs.
- Consider the Common Fund Doctrine
The Common Fund Doctrine further limits the recovery to a pro-rata share of the total settlement.
Most likely you will deal with the lien claimant again on other matters. Make sure to maintain civility throughout the entire process.
Consult with an attorney
Damages are limited but the type of damages is very case specific. Given the severity of an incident, a party may even recover for the lost earning capacity and loss of ability to provide household services. Others allow for the recovery of emotional distress, even when the party making the claim was not directly harmed by the incident.
It is important to understand the extent of your damages and what can be recovered based on the specific facts surrounding the claim. It is just as important to consult an attorney in your state immediately following an incident to better understand and protect your legal rights. Do not wait, never hesitate, and reach out to a professional who is ready to serve your needs.
Location: Los Angeles, CA 91403
Consultation: Free - 60 minutes
Tel: (310) 363-0551
Email: jonathan [ at ] ellisbakh.com
Jonathan Bakhsheshian , Esq.
is an associate attorney at Ellis & Bakh, LLP where he specializes in wrongful death and catastrophic injury litigation.
He obtained his Bachelor of Arts in Philosophy at the University of California, Los Angeles and earned his Juris Doctorate from Pepperdine University School of Law. At Pepperdine, Jonathan was the Lead Articles Editor of the Pepperdine Dispute Resolution Law Journal and a lead member of the negotiations and mediations Team. He competed in several nationwide and international negotiation and mediation competitions. Jonathan continued his studies at the number one, nationally-ranked Straus Institute for Dispute Resolution and obtained his Masters in Dispute Resolution.
In addition to his classroom training, Jonathan externed for the United States District Court, Central District of California; United States Attorney’s Office, Department of Justice; Honorable Judge Robert Kwan, Bankruptcy Judge of the United States Bankruptcy Court for the Central District of California; Los Angeles Superior Court; and for the Los Angeles District Attorney’s Office.
Jonathan is dedicated to the principal and philosophy that every injured victim is entitled to the best representation, regardless of their personal financial status or complexity of their case. Jonathan prides himself on being a tough, creative, and fair legal advocate for all of his clients.
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