I was involved in accident while riding in another car that was hit
by a car that ran a red light. My health insurance paid most of the
medical bills. Now the at-fault insurance has a settlement
for me, but my medical insurance wants to put a lien on it to
recoup the money they paid. Do they have the right to do that? Why
do I pay insurance if they are going take my settlement?
Yes, your health insurance company can put a lien on your car
insurance settlement. Your medical insurer isn't trying to be
greedy and take your settlement with the at-fault driver; instead,
they just want to recoup the monies that should instead have been
paid for by car insurance.
In most states, car insurance pays first, before health
insurance, for injuries sustained in an automobile accident.
State laws vary, but in general the order of recovery for loss (if
coverage is applicable and/or available) is:
- Workers compensation
Personal injury protection
Medical payment coverage
- Liability coverage (other party's
bodily injury liability
Uninsured motorist bodily injury
or underinsured motorist bodily injury
- Health insurance or other applicable coverage
If your claims had been made under the auto policy first, then
the medical policy wouldn't have had to pay at all for the medical
But since the medical expenses were paid for by your health
insurance provider already, it has the right to get some or all of
what they paid out back, from the responsible party. This ends up
coming out of your settlement because the car insurance company is
compensating you for these medical expenses in their settlement
If as part of your settlement with the at-fault driver's car
insurance company you are receiving compensation for pain and
suffering, work loss, and other non-medical expenses, then this
money should come to you. Your health insurer only wants back
what it paid out.
Insurance is meant to restore you to where you were before an
accident, not put you ahead.
Also, insurers won't double pay. You can't have your
health insurer pay for your medical expenses and then recoup that
money and keep it for yourself. Your health insurance company
isn't taking this money away from you since you weren't out this
money to begin with; they were.
Health insurers putting liens on car insurance settlements, to
recoup the money they paid out for injuries sustained in a car
accident, helps keep down your premiums with them.
If health insurance companies paid out for these claims and
didn't recoup any money from the auto insurer that should have been
primary, then your health insurance rates would go way up.
If you are still concerned about the lien on your settlement,
you can contact your state's insurance regulator to discuss the
insurance laws that govern this situation and what your consumer