Before you settle your personal injury case without the assistance of an attorney, you need to find out whether another entity is claiming that it is entitled to a portion of your settlement proceeds. Some possible entities that might claim that they should get a portion of your settlement are as follows:

  1. Your health insurance company.  If you have health insurance that is provided through your employer or a family member's employer, that health insurance company may claim a right to be reimbursed out of your settlement for any medical bills they have paid on your behalf.  In Missouri, it can be difficult to determine whether the insurer's claim to a portion of your settlement is valid. That is because only self-funded plans governed by federal law (ERISA) have any right to claim reimbursement in Missouri, and it can take some considerable investigation to determine whether a health plan is self-funded under federal law. A lawyer's assistance may be vital in order to make that determination.
  2. Medicare or Medicaid. If any of your bills have been paid by Medicare or Missouri Medicaid, the law grants these govermental agencies some rights to be reimbursed for the amounts they have paid towards your medical bills from the accident.  Medicare is entitled to be reimbursed for their conditional payments made while your case is pending, but they will reduce that repayment amount somewhat, based upon a formula that takes into account your attorney's fees and litigation expenses.  Medicaid is also entitled to reimbursement under the law, but the law does set out a procedure whereby your attorney can request a court reduce the amount that you have to repay Medicaid.  If Medicare or Medicaid has paid any of your bills, beware of settling your case without the assistance of an attorney.
  3. Missouri Workers' Compensation payments.  If any of your accident-related medical bills or lost wages were paid by your employer or its insurance company under the Missouri Workers' Compensation Law, the state law does grant the workers' compensation carrier a right of "subrogation."  It is ill-advised to settle your personal injury case if you have a workers' compensation claim out of the same accident that is still open. 
  4. Unpaid doctor or hospital bills. If any of your medical bills remain unpaid, a doctor or hospital has the right to place a "lien" upon your case.  If the doctor or hospital follows all of the procedures required under the Missouri hospital lien law, the insurance carrier may be required to pay that lien out of your settlement. A lawyer can help you to determine whether a medical provider has followed all the requirements of the law to place a valid lien on your case.

As you can see, when you have a personal injury case in Missouri, there can be many entities trying to take a piece of your settlement or judgment.  You need to know which entities might have valid claims and which entities do not. If you have a personal injury case in Missouri and want to know whether an entity has a possible right to a portion of your settlement or judgment, give us a call at 314-315-8111.  

Jill S. Bollwerk
Helping St. Louis area residents with personal injury, workers' compensation & insurance appeals/disputes.