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Patrick, Esq.
Patrick, Esq., Attorney
Category: Personal Injury Law
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Experience:  Attorney with significant personal injury experience
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After receiving a settlement from the Auto Insurance

Customer Question

After receiving a settlement from the Auto Insurance company, the Health Insurance company wants their co-pays back for Emergency Room treatment following a car accident. Are they truly entitled to such, is it not their responsibility, no matter?
Submitted: 1 year ago.
Category: Personal Injury Law
Expert:  Patrick, Esq. replied 1 year ago.

Hello and thank you for entrusting me to assist you. My name is ***** ***** I will do everything I can to answer your question.

Unfortunately, yes, health insurance companies are generally entitled to reimbursement for what they paid for accident related medical treatment. The terms of your health insurance policy almost certainly require this, as the language is standard, though you can ask your health insurance company for the contractual language they are relying upon just to be sure. The good news is that even though the benefits must be repaid, health insurance companies are usually willing to accept a reduced amount as payment in full. It is standard for them to take 1/3 off the total amount they paid, and an even greater amount might be negotiated if you can explain why the accident did not fully compensate you for your injuries.

I hope that you find this information helpful. Please do not hesitate to let me know if you have any questions or concerns regarding the above and I will be more than happy to assist you further.

Customer: replied 1 year ago.
Would they have a way of knowing if we had GAP insurance?
Expert:  Patrick, Esq. replied 1 year ago.

GAP insurance usually refers to insurance which covers the gap between what is owed on a car and what the car is worth at the time it is totaled. In otherwords, if you owed $20,000 on a car and it was only worth $19,000 at the time you got in the accident, GAP insurance would cover the $1,000 difference. GAP insurance does not have any relationship to medical bills, though, unless you are talking about some other form of GAP insurance I have never heard about. Can you clarify?

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