Middletown, NY asked in Personal Injury for New York

Q: If I got a settlement for a legit injury (slip and fell) lawsuit, can my insurance company go after what they paid?

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2 Lawyer Answers
Jonathan R. Ratchik
Jonathan R. Ratchik
Answered
  • New York, NY
  • Licensed in New York

A: Yes, it can. You have a written contact with your insurance company which probably contains a right to reimbursement. This basically means that if another party causes you injury for which you receive a settlement, you are required to use the settlement proceeds to pay back your insurance company for any benefits you received from the insurance company for that injury. Hopefully you (or your attorney) was aware of how much would be needed to be paid back to the insurance company before accepting the offer.

Keep in mind that in New York, you are only required to reimburse an insurance company if the insurance plan is an ERISA plan and the plan is self-funded. To find out whether your company's plan is self-funded, ask for a copy of its Summary Plan Description (SPD). Self-funded plans are common with large corporations which oftentimes pay the actual medical benefits of members and simply hire an insurance company to administer the plan.

Tim Akpinar agrees with this answer

Tim Akpinar
Tim Akpinar
Answered
  • Little Neck, NY
  • Licensed in New York

A: Yes, this is common. It sounds like you may have been contacted by the subrogation department of the insurance carrier. Your attorney is likely aware of the fact that some medical liens are sometimes subject to negotiation, either by operation of law or the discretion of the carrier. Congratulations on the conclusion of your case. Good luck

Jonathan R. Ratchik agrees with this answer

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