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Stephen Tashiro
09-10-2016, 4:28 PM
I've asked about this topic before ( http://www.sawmillcreek.org/showthread.php?208883-Paying-medical-bills-after-auto-accidents&highlight=insurance ) however the answers there are mostly too "theoretical" versus the situation that has evolved. The answers in that thread generally say to tell the medical providers to bill the auto insurance company that is paying bodily injury claims. In the situation at hand, all the medical expenses due to an accdient were paid by Medicare, Blue Cross or by co-payments before there was any settlement in the insurance claim. In fact, the claim hasn't been settled yet.

The question I have is: When a claim is settled with the auto insurance company, how will money be distributed? Will Medicare and Blue Cross be compensated for their payments before any funds are paid to the insured? (That might be fair, but is it what actually happens ?) If Medicare and Blue Cross are compensated by the insurance company, do their claims have priority over the clams the insured can make for copayments?

I'll be executor for the estates of two friends. One died as the direct result of an auto accident. Another was injured in the same accident, but lived for several years afterwards and died of causes that I myself cannot attribute to the accident. I'm sure the "bodily injury" claim the estate has against the insurance company (of the other driver) is less that the total medical expenses of my late friends. So, as a matter of financial planning for the estate, do I expect the estate to get zilch from the settlement? Or do I need to assemble a stack of paperwork documenting all relevant copayments that my friends made and expect the estate to be compensated for them before Medicare and Blue Cross get anything from the settlement?

John Lifer
09-10-2016, 5:13 PM
One word - lawyer

If you want to squeeze anything out of an insurance company, especially auto, get a lawyer.

Stephen Tashiro
09-10-2016, 11:56 PM
If you want to squeeze anything out of an insurance company



That wasn't my question. The estate already has lawyer.

From researching my question on the web tonight, i think that Medicare will make a claim against the settlement, demanding to be reimbursed for payments it made for medical care due to the accident. For example: http://www.idonotwanttobeyourlawyer.com/paying-back-medicare-after-a-lawsuit/

Robin Frierson
09-11-2016, 6:38 AM
Medicare and Blue Cross will have a lien against any settlement. Depending on the size of the settlement they will frequently take less than what is owed. You can negotiate with them. Most states have personal injury protection auto insurance laws which require some health insurance coverage, usually $10,000. Those are usually primary and should pay first. If the medicare paid first and they will be compensated from the PIP coverage to the limit of the coverage. It all varies state to state so you're going to need to get some advice on what the current laws are in the state you are in.