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LawTalk
LawTalk, Attorney
Category: Personal Injury Law
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Experience:  I have 30 years of legal and litigation experience.
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was in car accident insurance company said would pay for med

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was in car accident insurance company said would pay for med .exp. according to policy coverage we had. then this company called optumsaid they wanted 5040.89 and the balance was 31,304.84. the offer was for 35,000.00. if I took the offer I would get 29,959.11. and then be responsible for the rest of the med bills. is this a fair offer.
Submitted: 9 months ago.
Category: Personal Injury Law
Expert:  LawTalk replied 9 months ago.

Good morning Jody,

I'm Doug, and I'm very sorry to hear of your and your husband's situation. I hope that you have made a full recovery from your unfortunate injuries. My goal is to provide you with excellent service today.

I am an attorney with nearly 30 years of personal injury law experience and I have successively handled more than 2000 personal injury cases in my career. In order to give you a clear and concise answer, I will need some additional information about the circumstances, please.

I empathize with your situation in having to make a claim against your own insurance company because this was an accident in which no party was truly at fault.

1. Is Optum either the collection arm of your major medical health insurance company, or is Optum your actual health insurance company (OptumHealth)?

2. Are you fully recovered from your injuries now---aside from minor aches and pains that are quite common?

3. Are you saying that your total medical expenses related to this accident were $31,304.84?

4. Aside from your husband having a heart attack, did he do anything that you would consider to have been negligent in causing the accident?

Doug

Customer: replied 9 months ago.

optum is an arm to the health care company toget their money back. Yes I am recovered from my injuries. This is the impression I get from them that the balance is 31,304.84. I don't know. I think it maybe the total of what Medicaid paid. am unsure. . My husband did nothing negligent in causing the accident.

Expert:  LawTalk replied 9 months ago.

Good afternoon Jody,

Thank you for the additional information. I am very happy to hear that you are fully recovered.

While Wisconsin is a rather unusual state in that even family members may sue and collect from their own insurance companies based on the negligence of their spouse in a car accident---in order to collect in court, they still have to show the same proof as any other person in another car would have to show---and that is that the driver was negligent in causing the accident.

A person who has a heart attack is virtually never found to be negligent in causing an accident that results from having the heart attack. And so, in this situation, even if you were to sue your husband or arbitrate the claim against the insurance company, it is unlikely that you could get a better settlement than is being offered you, and you could get less. And accordingly, I have to believe that the settlement being offered you is fair under the circumstances that you have mentioned.

If you do not have private health coverage and you only have MediCaid, then Optum is probably collecting for MediCaid---but you will definitely want to determine that to be the case before settling. You can simply contact Optum and ask them if they are collecting for MediCaid and ask them to send you a final lien for the amount claimed for medical expenses relating to your accident.

On the other hand, if you have MediCaid and another form of medical insurance, be sure to get lien amounts from each of your medical insurance providers who might have paid anything for your injury medical expenses. That way, once the liens are taken care of, anything left over from your settlement will be yours to keep.

Please keep in mind that, even though you have already paid your deposit money over to JustAnswer, until you rate me highly for my service, I will not be paid for having assisted you with your questions.

If you have additional questions, you may of course reply back to me and I will be happy to continue to assist you further until your questions have been answered to your satisfaction.


I wish you the best in your future.

Doug

 

LawTalk, Attorney
Satisfied Customers: 27887
Experience: I have 30 years of legal and litigation experience.
LawTalk and 11 other Personal Injury Law Specialists are ready to help you
Expert:  LawTalk replied 9 months ago.
Thank you for your positive rating of my service, Jody. It has been my pleasure to assist you and I hope than you will ask for me on JustAnswer should a future need ever arise. I am generally available at least 6 days a week, and often 7, and it would be my privilege to assist you again in the future.

I welcome you to request my assistance in any future legal questions you may have, by simply placing my name in the first sentence of your new question.


Thanks again.

Doug

When you receive your Customer Satisfaction Survey from JustAnswer, please do rate me highly (9-10) there as well. It would be tremendously appreciated.
Customer: replied 9 months ago.

Doug it was a pleasure working with you and I thank you very much for your help. you have surley given me the direction in which I need to go, I again thank you. Be Blessed today and always. Jody :)


 

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