How Does Private Insurance Work During A Personal Injury Claim In Louisiana?

A medical professional holds a notebook titled HEALTH INSURANCE claim personal injury

In this article, you can discover…

  • What to do if your health insurance seeks to be paid through your settlement.
  • Whether your insurance could lower your bills after an accident.
  • Why it can be valuable to file a lawsuit, even if you have good insurance.

How Can My Private Health Insurance Fit Into My Personal Injury Claim?

In the same way that you have to enter a contract with your health insurance company for them to provide services to you, these same companies also enter into contracts with the providers in their network, requiring their providers to accept your insurance.

This applies whether you were in an accident or not, and it can be very frustrating when doctors or hospitals try to avoid billing your insurance so they don’t have to take the lower contracted amount. Even though, if you were at fault in an accident, even if you were grossly negligent, they would take your insurance.

Private health insurance can also impact how much the defendant is required to pay. The current rule in Louisiana is that the injured party can recover the contracted rate plus 40% of the write-off. This means that if you received a $100 medical bill that your insurance paid $50 of before writing off the rest, you could recover $70. You’re paying into expensive health insurance, and there’s no reason you shouldn’t receive some benefit for that.

What If My Insurance Company Wants To Be Paid Back Through My Settlement?

Given that your health insurance is a contract, they are not automatically entitled to be paid back, as this all depends on what the contract says. If you are a client of ours who uses health insurance to cover any claims related to your accident, we will notify your insurance company that you have a claim and require that they produce the portion of the contract that gives them the right to be reimbursed.

We ask for this because it’s not uncommon for a contract to limit the health insurer’s right to reimbursement, so it’s important to be aware of what reimbursement you are responsible for.

Limitations to reimbursement could mean a number of things depending on your contract’s terms. In certain situations, this could mean that your insurance company may not get paid at all if there is not enough money to fully compensate you for your damages. Contract details can also affect reimbursement for legal fees, uninsured motorist coverage, and overall settlement details.

Ultimately, it’s important to have a qualified attorney review the terms of your health insurance contract to be sure you aren’t paying reimbursements that you aren’t required to.

Attorney Cheryl Wild-Donde'Ville with a 4.6-star rating displayed below.

Attorney Cheryl Wild-Donde’Ville is a seasoned lawyer based in New Orleans, Louisiana who has helped countless clients just like you navigate the intricacies of personal injury law. With more than two decades of experience assisting clients, she is prepared to assist you in negotiating with your insurance company so that you can maximize your personal injury settlement.

Still have questions? Ready to get started? Contact Waltzer Wiygul & Garside today to schedule an initial consultation.

Can My Insurance Lower The Bills I Owe After An Accident?

Of course, your insurance company agreed to contracted rates with providers. You can even see contractual adjustments and write-offs on explanations of benefits sent by your insurance company. This contractually adjusted amount is what the doctor has agreed to receive for their services since you are subscribed to that policy. This will reduce your bills, but it will also reduce the amount you can claim from the defendant.

What Challenges Might I Face When Handling A Personal Injury Case With My Private Insurance Company?

Sometimes, medical providers will refuse to take your insurance despite having contracts with your insurance company. Ambulance services, hospitals, and emergency room physicians will often send your bills to third-party collectors to force payment of your full bill from settlement proceeds.

It can be a very frustrating process, but we work hard from the outset of your case to make sure you are not paying more than you should, maximizing the amount of money in your pocket at the end of your case.

What Cases Have You Worked On Where Private Insurance Played A Key Role In A Client’s Financial Protection?

I once worked on a case where a woman had suffered a catastrophic brain injury. This was a terrible set of circumstances for this poor client, who only had about $100,000 in coverage. We were going to do our best to make sure she kept some money in her pocket.

Her health insurance actually ended up being a private insurance plan that was self-funded by her employer, meaning that the employer paid out of pocket for medical bills up to a certain amount. I called the employer’s lawyer and asked them to waive everything, as the client was really hurt and provided 30 years of service to their company. You do not see this often at all, and I may never see it again, but they waived every penny from their former employee and for my client.

Are You Ready To Get Started?

If you are the victim of a personal injury looking to learn more about How Your Private Insurance Can Help During A Personal Injury Claim In Louisiana, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling 1 504 230 5222 today.

Attorney Cheryl Wild-Donde'Ville with a 4.6-star rating displayed below.

Attorney Cheryl Wild-Donde’Ville is a seasoned lawyer based in New Orleans, Louisiana who has helped countless clients just like you navigate the intricacies of personal injury law. With more than two decades of experience assisting clients, she is prepared to assist you in negotiating with your insurance company so that you can maximize your personal injury settlement.

Still have questions? Ready to get started? Contact Waltzer Wiygul & Garside today to schedule an initial consultation.

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