Thousands of verified Experts are ready to answer your specific questions 24/7.
Satisfaction is guaranteed and you pay your Expert only if you are satisfied.
Just type your detailed question and click "Get an Answer."
In minutes you'll get a response from an Expert. You can always ask follow-up questions.
Happy with your answer? Just click "Accept" to pay your Expert.
I had a worksmans comp claim back in 2006, it was my heart, I'm a pd officer, I won but then the county appealed it & rather then going to court to fight it out workmans comp settled, they agreed to pay all medical up until the settlement date & also 11K pay out, all is fine for 2 years, I continue with my heart health care & my health insurance has been paying, recently though they started taking back their money, I have been getting billed, I was informed that my heart is no longer covered under the health insurance because I had a workmans comp settlement. One week ago I had another serious heart issue, thank goodness the county felt sorry for me & agreed to insure me again but that I would have to pay the settlement back. I told the lawyer I thought he made a mistake, he doesn't agree. I have the contract language between the county & our health insurance, it's just one paragraph, but I couldn't fit it in this questiion box, I wanted to see if you would agree or disagree.
State/Country of Question: Maryland Already Tried: Here is the paragraph in the county blue cross blue shield health insurance booklet, this is the contract between the county and our health insurance: Employer or Governmental benefits. Coverage under carefirst does not include the cost of services or payment for services for any illness, injury or condition for which, or as a result of which a "benefit" (as defined below) is provided or is required to be provided either: A. Under any federal, state, count or municipal workers copensation or employer's liability law or other similar program; or B. From any federal, state, county or municipal or other goverernment agency, including , in the case of service-connected disabilities, the veterance administration, but excluding medicare benefits and medicaid benefits. Benifits defined: As used in this provision, "benefits" includes a payment or any other benefit, including amounts received in settlement of a claim for benefits. So that is the info. My lawyer is arguing that because it couldn't be proven to be work related that the county can't have this stance, I pointed out the above paragraph and stated the county doesn't care about all that, the fact is I took a settlement. I ofcourse would never have taken a settlement knowing I would lose my health coverage. I want my lawyer to pay the 11k tha tthe county wants back. Can you help me with this matter before I have to go out and hire an attorney. Thanks!
Thanks for your question. You certianly may have recourse agaainst your lawyer here Tome he cerrtainly ahs harmed you and this may well be a malpractice case.I do believe that you have to come up with the money here or they won't cover you under this policy. I think you are going to need a lawyer here to seek recovery in a malpractice case if you want the $11k back from the lawyer.I wish you good luck resolving. Your lawyer may fork it up if your malpractice lawyer sends demand letter for malpracice suit..
So after you read the paragraph about the "employer or governmental benefits" you think the lawyer has made a mistake? The lawyer kept reading the paragraph (I had a meeting with him) and kept stating that he didn't agree with the county on this stance. He offered to pay me back the 3k he made (the total settlement was for 15k but he got 3k) then he said he would talk to his partner but that he wouldn't agree to pay more then half back. What should be my next move, should I get an attorney or approach him again. Why is he offering me money but not the the total amount. he says its a goodwill gesture.
I already knew that I would have to get a lawyer, and the insurance deal is fixed thank goodness but now I owe the money to the county, I wanted your openion on that paragraph, I think u may have given it when stating he has harmed me, i just wanted to get someone with legal experience to read that paragraph and to confirm what I think I already knew, can you one more time read it and get back to me. I see u are now offline, so I guess I will wait till later. Thanks in advance.
I think somebody here has to pay the $11k back. To me this would be your malpractice claim as well as pain and suffering from having to go through all of this. He should of checked this out for you as your lawyer as it was bound to affect you down the road..
Ok, so as in the paragraph I provided above, where it says "benefits defined", do you think even though I didn't win the case, but the county offered us a settlement, and all my medical was paid up until the settlement date, would that in your opinion fall under the benefits defined? The lawyer is arguing that since I didn't win it doesn't matter, I am arguing that it doesn't matter if we won or not, I got a settlement. Thanks, XXXXX XXXXX my last question.
I would tkae your side here. You are arguing that it doesn't matter if we won or not, I got a settlement and therefore he would be liable for my damages here since he represented and negotiated such a deal and I have suffered losses or harm. That pretty much sums it up to me.
Lawyer
25 years in civil, criminal, family, probate, elder issues, and administrative law