Cupertino, CA asked in Car Accidents for California

Q: Insurance company wants to give entire car accident settlement to Medi-cal. I still have med bills and am homeless.

The at-fault driver only had $15K coverage and is broke. How do I recover court filing fees to cancel the case & negotiate with Medi-Cal to recoup some of it for treatments they don’t cover, since I did all the legal work myself to file lawsuit and recoup full amount on their behalf?

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4 Lawyer Answers
Alexander Bakhache Perez
Alexander Bakhache Perez
Answered
  • Personal Injury Lawyer
  • Fullerton, CA
  • Licensed in California

A: So the best thing is to hire an attorney to help you with this case, sounds like the medical exceeds the policy limits.

difficult to answer - costs are waived by the court unless you collect - so the court will get fees paid, you can not charge attorney fees without an attorney license to practice law (not sure if you do have one)

The adjuster will issue payments and disbursements since you do not have an attorney,

an attorney can take control and negotiate reductions and disbursement but the attorney will also charge a fee.

maybe something is better than nothing - you could have saved yourself a lot of work doing legal work yourself by hiring the attorney - if you end up hiring an attorney in the end.

I think it is better for you have an attorney on your side to handle the disbursement of funds than the adjuster to discuss with Medi- CAL.

Dale S. Gribow
Dale S. Gribow
Answered
  • Personal Injury Lawyer
  • Palm Desert, CA
  • Licensed in California

A: you are always best advised to use a lawyer. On accident cases, a lawyer will set up a free consultation and if s/he accepts the case, will do so on a contingency.

Consider a company like Synergy Settlement Services that specializes in dealing with Medicare liens at 877 242 0022

William John Light
William John Light
Answered
  • Personal Injury Lawyer
  • Riverside, CA
  • Licensed in California

A: Medi-cal follows a statutory procedure to reduce its lien on third party recoveries. You need to notify Medi-cal of your claim, and of the settlement of the action, and of your expenses incurred in obtaining the recovery, and of your out of pocket medical expenses. Medi-cal will inform you of the amount of its lien, in writing in 2-4 months. It takes a while. You can then show the letter to the insurer so that it can issue a check to Medi-cal in that sum. The insurer will not disburse the settlement money to you without that information.

Under Welfare & Institutions Code section 14124.71(a) "When benefits are provided or will be provided to a beneficiary under this chapter because of an injury for which another party is liable, or for which a carrier is liable in accordance with the provisions of any policy of insurance issued pursuant to Section 11580.2 of the Insurance Code, the director shall have a right to recover from such a party or carrier the reasonable value of benefits so provided."

Under section 14124.74(a) "If the action or claim is prosecuted by the beneficiary alone, the court or agency shall first order paid from any settlement, judgment, or award the reasonable litigation expenses incurred in preparation and prosecution of the action or claim, together with reasonable attorney’s fees, when an attorney has been retained. After payment of these expenses and attorney’s fees the court or agency shall, on the application of the director, allow as a first lien against the amount of the settlement, judgment, or award the amount that the director is entitled to recover as satisfaction of the director’s lien, as provided in subdivision (d) of Section 14124.72, and as a second lien, the amount of any claims, pursuant to Section 14019.3, owed to a provider, as provided in Section 14124.791"

Under section 14124.78: "Notwithstanding any other provision of law, in no event shall the director recover more than the beneficiary recovers after deducting, from the settlement judgment, or award, attorney’s fees and litigation costs paid for by the beneficiary. If the director’s recovery is determined under this section, the reductions in subdivision (d) of Section 14124.72 shall not apply."

This section means that, after deducting attorney fees and costs, the maximum that Medi-Cal can recover is 50% of the remaining funds. That sounds like the most likely result in your situation.

Manuel Alzamora Juarez
Manuel Alzamora Juarez
PREMIUM
Answered
  • Personal Injury Lawyer
  • Berkeley, CA
  • Licensed in California

A: Since you do not have a lawyer, you should call the Medical adjuster and tell them that you paid for legal fees and other expenses. They should adjust your bill and send you approximately half of the money back. Best of luck.

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