How does reimbursement apply in a worker’s compensation case?

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How does reimbursement apply in a worker’s compensation case?

If I, the injured worker, pay medical bills with my private insurance, is my employer’s insurance company supposed to pay me back the full amount of the doctor’s bills ($36,000) or the amount of my deductible ($5,000)?

Asked on May 1, 2012 under Insurance Law, California

Answers:

FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 9 years ago | Contributor

In the worker's compensation context, your own medical bills paid either by you or your own insurance carrier would be reimbursed under your employer's presumed worker's compensation policy in place at the time of the accident and afterwards throughout the period you are getting treatment for.

If you are actually out $5,000 of your own money as your deductible (as opposed to the $36,000 in actual medical bills incurred by you as a result of the work related injury), you would be entitled to receive under worker compensation law the $5,000 representing your actual out of pocket costs from your employer's worker's compensation insurer.


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