Legal Question in Personal Injury in North Carolina
Auto Accident
My elderly mother was seriously injured requiring back surgery in an auto accident where the other driver was cited and their insurance company has taken responsibility. Mother has Medicare and Medicaid. Does Medicare and Medicaid negotiate subrogation or is there a standard percentage of the medical services paid by Medicare and Medicaid that must be reimbursed? Is the insurance company required to tell her the policy limits? If there is anything left in settlement after subrogation, would monthly annuity payments be a better option than lump sum for prevention of loss of Medicaid benefits? Would annuity payments revert to her estate if she were to die before the annuity is exhausted?
2 Answers from Attorneys
Re: Auto Accident
Thank you for your question.
Please remember that it is very difficult to give full advice on limited information, and by e-mail. As is the case many times under the law, there is not necessarily a clear answer. Cases like this cases be very fact specific and further information may be helpful.
Based on the limited facts and the questions raised, it sounds like your mother has a very serious and complicated situation. I personally don�t think this situation is appropriate for e-advice and would suggest that you consult with competent legal counsel very promptly.
Thank you again, and please feel free to contact us if we can provide further information.
Best Wishes,
David D. Daggett
(I apologize in advance for poor typing skills)
Winston-Salem Office
www.lewisdaggett.com
www.safeandsober.com
Re: Auto Accident
That is indeed a complicated situation, which probably does require more in-depth analysis by an attorney with more facts. With most annuities, there is a contingent beneficiary. Medicaid and Medicare do have valid liens, and negotiating them is very tricky; there is not necessarily a standard percentage. I am not aware that the insurer must disclose its limits (prior to a lawsuit). As for the structuring of the settlement to maximize her other benefits, that is a good question. In some situations you may be able to set up a trust to maximize benefits, such as a "special needs trusts" or a pooled trust; this again is a very complicated area of law. You should probably try to find an attorney to help you through these issues.
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