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Posted in Accidents and Injuries

Protecting a Settlement from Your Health Insurance Provider


Protecting a Settlement from Your Health Insurance Provider

In the present circumstances, when hospitals have started claiming a part of settlement amount of the victim on their medical bills, it has become important to know that how you can go for a settlement from yourhealth insurance provider.

In order to know how one can go for the settlement from health insurance provider you must know about the working of health insurance for you. Health insurance policies are bought from a provider who has links with various hospitals. It pays a fixed amount to the hospitals in lieu of the services provided by them to their clients. Moreover the terms of the policy also direct their clients that they will have to pay the hospitals a cetin amount against the services availed by them. But ultimately there remain some amount that is not paid by anyone to the hospital and that amount is claimed by the hospitals from the patients as a part of the settlements received by them from insurance company.

It can be understood through an example, suppose a hospital charges $200 against some of its services. $80 are paid by the insurance company to the hospital and the client is directed to pay $80 against the services availed by him. Thus hospital receives only $160 as against $200 as its usual fee. The remaining $40 is not paid by anyone. So this remaining amount is claimed by the hospital from the settlements received by the clients. Though such claims of balance billing are confirmed as illegal by some state governments but still the hospitals are securing their profits by ignoring the law.

Suppose a person has a health insurance from any medical insurance company. In case, he meets an accident and gets admitted to a hospital covered under his health insurance policy, he should inform the hospital about his health insurance policy. Generally, hospitals are authorized to file a claim on any medical settlement to be received by the patient, after the person has been discharged after receiving care from the hospital. Hospital must file the lien within 10 to 30 days for which it need not obtain a permission of the patient. But certain amount of medical bills still remain balance from the insurance lien, which the hospitals try to claim from the health insurance settlement amount to be received by the patient to make up their losses.

Though the hospitals are working against law but still patients paid the hospital’s claims from their settlement amount due to ignorance of the law. With the spreading of awareness about the illegal claim of the hospitals from settlement from health insurance provider, many of the patients sued the hospital for the recovery of the amount claimed by them. Courts have passed landmark decisions in several cases against the claim of the hospitals from the patients. According to court, hospitals have no lien on patients once they have received their total lien amount from the medical insurance provider company of the patient.

Thus, your due from your health insurance provider can be protected on the basis of the legal decisions passed by the courts.