Neuberger, Griggs, Sweet & Froehle, LLP

Medical Liens: Definition, Causes, Solutions

According to the CDC personal injuries result in more than 3 million people being hospitalized and 27 million being treated in emergency rooms. The cost for non-fatal injuries in 2013 was more than $456 billion. Non-fatal injuries cost twice as much as fatal injuries in lifetime medical and work loss costs. 

When you suffer injuries you concentrate on recovery while your personal injury attorney negotiates the best settlement possible. Your attorney negotiates a settlement.  From the settlement, medical liens must be paid.

What are Medical Liens?

A medical lien is a claim against any personal injury settlement by your medical insurance provider. Filing a lawsuit includes recovery of your medical expenses, but your lien will be less due to the provider’s contractual compensation agreements with providers.

Anyone who paid for your medical treatment may file a lien against your settlement. The lien is a demand for repayment of the money they spent on your treatment.

There are several different types of lien holders that may arise in a personal injury claim, including:

  • Hospitals, doctors, physical therapists, ambulance, or any other health care provider
  • Health insurance company
  • Auto insurance company for med-pay
  • Veterans Administration
  • Medicare and Medicaid
  • Workers’ Compensation Insurance

In a personal injury claim, the person’s injuries are due to the negligence of another party. When a health insurance provider pays for medical treatment, generally the contract between the provider and insured provides the medical insurance company the right to seek repayment of the benefits they paid.

Wisconsin’s Made Hole Doctrine

Under Wisconsin law, the insurance company has the right to request reimbursement of their loss against lawsuit settlements. This is a process called subrogation.  Subrogation grants them the ability to recover expenses depends on the language in your insurance policy.

Wisconsin’s Made-Whole Doctrine governs the making whole of a person suffering injuries. The doctrine dictates what happens when a plaintiff in a personal injury case is not made whole by the jury verdict or settlement. In this instance, the parties with subrogation claims may not be able to recover all of their costs.

This may happen if the medical expenses incurred exceed the amount that is recoverable from the lawsuit. For example, the at-fault driver’s insurance is not sufficient to cover the costs of the injured person’s medical expenses.

The party filing subrogation may feel the Plaintiff is being made whole. If Plaintiff disagrees, then a Rimes hearing will take place. The purpose of this hearing is to determine whether subrogation is proper.

In  Rimes v. State Farm Mutual Automobile Insurance Company, the ruling is that a court may determine if the items of damage a jury awards a plaintiff are sufficient to make the insured whole.

Medical Provider and Hospital Liens

When you receive medical treatment, that provider may assert a lien against your settlement. Some medical treatment providers request a signature on a lien letter. This is your agreement to them submitting a lien against your personal injury settlement.

This allowance is due to the medical facility providing treatment without receiving payment. They provide treatment with the understanding that they may recover their costs from your lawsuit. If you do not file a lawsuit or lose your case, you may be personally liable for your medical care costs.

Personal medical liens are generally requested of people who do not have insurance, but not always. If you have health insurance from a private company, Medicaid or Medicare, a personal lien is normally not requested.

Government Medical Liens

If you have government coverage that pays your medical costs, they may claim reimbursement from your settlement. The laws on government liens vary depending on what agency paid your expenses. Reimbursement depends on coverage is from the Veteran’s Administration, Medicare, or Medicaid.

Negotiating a Lien Release

It is possible that during negotiations your attorney will be able to reduce or eliminate a medical lien. If you receive any lien notices, be sure to provide them to your attorney.  It is also possible your attorney may receive liens directly from your medical provider or a health insurance claim against your settlement.

What a Personal Injury Attorney Can Do

In addition to the filing of a lawsuit, your attorney will negotiate with insurance companies, medical care companies, and opposing counsel to reduce the amount of the lien. They may dispute portions of the lien claims by assessing the validity of the claim.

Your personal injury attorney will also include the actual costs of the medical care as evidence of your damages during negotiations and trial. A medical lien is generally substantially less than the actual charges for medical care by providers.

There are numerous things to consider when hiring a personal injury lawyer. During your free in-person consultation, you will have the opportunity to learn about their courtroom experience, success rate, and legal opinion on your case. They will discuss with you what they refer to as your ‘walk away’ recovery.

Reduce Your Medical Liens

The best way to eliminate or reduce the medical liens against your personal injury case is to hire a law firm with experience in this area of law. Here at Neuberger, Griggs, Sweet & Froehle, LLP our attorneys have 150 years of combined legal service and employ highly skilled legal assistants with 200 years of combined legal knowledge.

We invite you to contact us to schedule a consultation at our Watertown office (920) 261-1630 or Lake Mills office (920) 648-8381. Let us explain how we can help you with your personal injury claim. WE’RE HERE, WE CAN HELP.

The materials on this website are provided for informational purposes only and do not constitute legal advice. These materials are intended, but not promised or guaranteed to be current, complete, or up-to-date and should in no way be taken as an indication of future results. Transmission of the information is not intended to create, and the receipt does not constitute, an attorney-client relationship between sender and receiver. You should not act or rely on any information contained in this website without first seeking the advice of an attorney.


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