Insurance Companies Illegally Seeking Payments from Personal Injury Victims




Insurance Companies Illegally Seeking Payments from Personal Injury Victims

In an investigation that could affect personal injury cases nationwide, the state of Connecticut announced Wednesday that it is investigating health insurers for illegally recouping expenses from patients that had won awards in personal injury suits.

Health Net of Connecticut, one of the state’s largest healthcare providers, agreed to pay $166,671.71 in fees that were repaid by some 98 health plan members.  The repayment comes after a class-action lawsuit was filed against the healthcare provider.  The lawyer representing the victims, Michael A. Stratton, believes that this particular case is just a small part of a much larger problem.

The practice of health insurance companies of going after members who received awards in personal injury cases is largely illegal in Connecticut and other states.  Many health insurance companies still seek to recover funds from the personal injury victims. 

A person who was involved in a car accident and goes to the hospital pays their co-pay for resulting medical care, if they have health insurance.  When the person is awarded a settlement in a personal injury case, some of the award is based on these related health care costs. 

The reasoning of the health care insurance company is that the person should not be awarded for services the healthcare company provided.  The healthcare company then sends the person a bill for services rendered, usually the cost of their services without insurance and much higher than the co-payment that the insured person paid.

In Connecticut it is illegal for health insurance companies to seek payment from members of regular fully insured health plans.  In most personal injury cases, the court tends to reduce the amount in order to cover these fees.

Connecticut health insurers Health Net, Aetna, and Anthem Blue Cross and Blue Shield maintain that they do not collect funds from members anymore.  Attorneys involved in the state’s investigation believe that the practice still continues however.  Attorneys are expecting to uncover a much wider amount of healthcare recovery cases as the investigation continues.

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