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Posted in Personal Injury on August 17, 2017   |  by Gary Burger

Do You Have to Pay Back Insurance After an Injury Claim?

Do you have to pay back your medical insurance company if the injuries for which you had those payments were related to a personal injury claim? The answer is maybe. So, if you’re injured in a personal injury case, car crash, truck crash, slip and fall, workers comp, product liability case, medical malpractice case, it doesn’t matter. You want to go get all your medical care and put it on your health insurance, and then get better.

If you have a claim against someone else. You’re rear-ended and you make a claim against the car insurance company. You make a claim against the truck company. You slipped in a grocery store and you make a claim against them. You have a medical malpractice claim, against the medical provider, and you recover from them.

Sometimes, the medical insurance company — they paid your benefits — is entitled to their money back and Medicare and Medicaid as well because they’re health insurers as well. The way you figure that out is if it’s a local plan in one state, typically you don’t get your money back. If it’s a multi-state plan governed by ERISA, the Employee Retirement Income Security Act of 1974, then they often are entitled to make a lien, a subrogation lien, or a lien in your case, and they’ll put you on notice, and they have these big companies that try to collect this money back. Everybody wants their money back these days.

One of the things we do at our firm, I’m Gary Burger, I’m a lawyer, I’m at Burger Law, 314-542-2222, 866-599-2222, in Illinois 618-272-2222. Find me on the interweb at

One of the things we do is not only do we try to collect as much as we can from the defendants in the case. We try to lessen or reduce the liens as much in the back end. So, we’ll negotiate with these lien providers and say, “Hey, you got a free lawyer to collect this money for it. Knock it down a third. Hey, there’s a hard liability case. We had to discount the recovery by 50% because our client was partially at fault,” or, “We had to reduce the liability because although our client’s damages were huge, there was a cap in insurance, this is only as much as we can get,” or we say, “Hey, send us the EOBs. Hey, we looked at all these EOBs, you’re saying you have $50,000 in medical you paid on this, but if you look at this, only $7,000 was paid for this case, the other $43,000 was for other care not related to this injury, so you need to reduce the lien in that way.”

There are a variety of ways we get a fair resolution for you, still pay back your medical insurance providers, so you can continue on, put as much money in your pocket as we can in this case, both by getting as much in the front end from the defendants and reducing the payments on the back end, and putting as much money tax-free into your pocket. Personal injury settlements and verdicts and judgments are tax-free, but we also want to keep your health insurance, so you don’t jeopardize that.

If you have any questions about whether your health insurance can get their money back, MedPay, other issues, there are a variety of issues that can come up in this. It’s a complicated matter. I teach other lawyers about it. You can give us a call. I already gave you all our phone numbers in this video, and you could email me at Thanks.