Legal Question in Insurance Law in Maryland

repayment of health insurance

My son was rear-ended in June 2001 and ended up with a

herniated disc. With an initial manifestation of muscle spasms and 'afraid' of surgery he has been treated by a pain management specialist with shots to stop the pain, shots to sever the nerves to the muscle, and finally nucleo-plasty last November. We have not settled yet, but his attorney is saying he will have to pay back his health insurance that he has through work - that's who all was submitted to after PIP ran out. Why would he have to pay it back? Isn't that what it's for? The attorney also says if they offer $50K we should settle - if we go to court we could end up with nothing. But this is a legitimate and permanent injury he has to deal with for the rest of his life. He is only 21. It also affects his job as he is an

Apprentice Plumber and this injury limits some aspects - ie digging trenches, etc.


Asked on 3/23/05, 8:56 am

2 Answers from Attorneys
Daniel Press Chung & Press, P.C.

Re: repayment of health insurance

Employer-provided health insurance is entitled to be reimbursed. If you think about it, the health insurance company is who paid the medical bills, so it is the one who was damaged in the amount of the medical bills. Your son was not because he did not have to pay them. As for the amount of the settlement, your attorney is in the best position to assess the merits of the case and the likely verdict.

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Answered on 3/23/05, 9:12 am
G. Joseph Holthaus III Law Offices of G. Joseph Holthaus

Re: repayment of health insurance

In almost all instances the health insurance entity has a right to reimbursement or a right to subrogation or both.

Each of the health insurer's options has benefits and imputed costs to your son. The net effect may be different depending on the option employed.

Other options exist and your son's attorney should know about these.

Not knowing all the details, I cannot say whether a settlement offer of $50K is reasonable. Based on the limited

information in your question, such an offer may not be reasonable. I would need to know more information to express

an experienced opinion.

Joe Holthaus

(410) 750-2567

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Answered on 3/23/05, 10:15 am


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