Personal injury clients who have been in a catastrophic car wreck, or been
injured by a defective product, or who have medical malpractice cases,
often are seriously injured and have enormous medical bills. As a
personal injury lawyer and
medical malpractice attorney, I spoke in my last blog post about potential liens that medical insurance
companies may have. A lien is when someone paid money on your behalf,
and if you get money, they are allowed to make you pay them some or all of it.
In Georgia, if a medical insurance company has paid your bills, they do
not have a claim to get you to pay them back until you yourself have been
fully compensated for the personal injuries you incurred in the car wreck,
product liability case, pharmaceutical recall case, etc. Georgia only
requires drivers to have a tiny, $25,000 insurance policy. For someone
who gets a brain injury or a head injury, or a spinal cord injury, a broken
bone, or a broken knee, etc., that paltry amount of insurance is nowhere
near the cost of the medical bills, let alone the pain and suffering the
plaintiff and his family went through. In that case, the medical insurance
company may not be entitled to get paid back. I will write more about
that issue in a future blog post.
On the other hand, Georgia law says that medical providers can have a lien
against the amount a personal injury or medical malpractice plaintiff
gets. Also, personal injury plaintiffs may have outstanding hospital liens.
Here’s what the Georgia code section says:
“Any person, firm, hospital authority, or corporation operating a
hospital, nursing home, or physician practice or providing traumatic burn
care medical practice in this state shall have a lien for the reasonable
charges for hospital, nursing home, physician practice, or traumatic burn
care medical practice care and treatment of an injured person, which lien
shall be upon any and all causes of action accruing to the person to whom
the care was furnished or to the legal representative of such person on
account of injuries giving rise to the causes of action and which necessitated
the hospital, nursing home, physician practice, or provider of traumatic
burn care medical practice care, subject, however, to any attorney’s
lien.”
Under Georgia law, medical providers argue that they are entitled to be
paid even when the plaintiff is not getting fully paid. That argument
is very questionable under Georgia law, but be that as it may, medical
providers make that argument.
Here is why that is really, really unfair to plaintiffs who do not have
medical insurance, Medicare, Medicaid, etc.
If you have insurance, you will see on you bill (and I am copying this
from an actual example, I am not making it up), a written statement like this:
Amount billed $ 489.00 Amount paid $ 125.66
The two amounts are different because the hospital has an agreement with
the medical insurance company that it will not charge more than $125.66
for that particular service.
What happens is pretty obvious: the hospital charges a ridiculous amount,
so that by the time it negotiates with the insurance company, or Medicare
or Medicaid (which pay even less), it will get enough to cover the medical care.
So what happens if you don’t have insurance? The hospital charges
you the maximum amount! It charges you the whole $489.00 – and then
claims it has a lien that entitles it to 100% reimbursement from you if
you get paid by the person who injured you!
Serious? Really serious.
Unfair? Really unfair.