After an auto accident can my health insurer refuse to pay medical benefits until I sign a subrogation form?

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After an auto accident can my health insurer refuse to pay medical benefits until I sign a subrogation form?

The form forces me to pay all legal costs to recover their money. Until I sign it they will not pay any medical bills. Is that legal?

Asked on September 21, 2011 under Personal Injury, Illinois

Answers:

Mike Harvath / Harvath Law

Answered 10 years ago | Contributor

     Hi.  I am a Missouri and Illinois personal injury attorney that routinely handles auto accident claims.  I am sorry to hear about the accident you were involved in and the injuries that have resulted.

     Health insurers do have a right to subrogation, or, in other words, a right to stand in your shoes and sue the insurance company of the negligent party that caused your injuries.  Depending upon the terms of your health insurance coverage and what they are trying to get you to sign to receive paid treatment, it may be more financially advantageous to seek treatment from medical providers that will allow you to be treated on a "medical lien" basis.  It would be necessary to review a copy of the subrogation forms that they are requiring that you sign to make a determination if it would be in your financial interest to seek treatment on a "medical lien" basis.  Treatment provided on this basis would require no up-front payment from you, or insurance coverage.  The medical provider would place a "lien" on your claim, meaning that you would agree to pay them off out of your settlement.  However, statutory medical liens are negotiable, and can often be reduced in amount.

     There are several factors (primarily the language of the forms that they are asking you to sign) that have to be considered before making a decision of whether to proceed with treatment through your health insurer.  The type of injury and the type of medical provider at issue is highly relevant as well (primary care physician, specialist, physical therapist, chiropractor, etc...).  You could end up compromising a fair portion of your eventual settlement amount un-necessarily if you are not making informed decisions on how to pay for your medical treatment.

     I hope this helps, perhaps to some extent, anyhow.  For convenience, I can be reached via e-mail at [email protected].  Website-www.harvathmissouriillinoislawyers.com.

NOTE: This answer is for educational purposes and does not constitute legal advice.  The use of this site does not create an attorney-client relationship or privilege between the user and the attorney responding. 


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