Legal Question in Insurance Law in Virginia

My health insurance company put a lien against my settlement

Hi-

Aetna U.S. Healthcare, which I have through my work, paid out my medical bills for my accident under plan coverage. I have just accepted a settlement in my personal injury case, but when I did my attorney said Aetna placed a lien against my settlement portion for the amount that they paid out to my doctors, hospital, etc.--There is a debate between Aetna and my atty over whether or not they are self-funded. My attorney says all of it will come out of MY portion of the settlement if the lien turns out to be legit--Is there anything I can do to avoid paying this? I already pay premiums ad copays to get the insurance. Will contacting the company I work for and trying to get them to intervene help? THANK-YOU so much for addressing this--I am between a rock and a hard place, and I do not know where to turn--Thanks--


Asked on 2/23/01, 12:28 am

1 Answer from Attorneys
Daniel Press Chung & Press, P.C.

Re: My health insurance company put a lien against my settlement

If this is an employer-funded ERISA plan, they have a right to such a lien (subrogation). If not, if it is a Virginia plan, they do NOT have such a right. So your lawyer needs to review the plan documents to be sure. As to whether it comes out of your portion, generally that is the case, but it depends on the fee agreement you have with your lawyer. Also, some health insurers will allow the legal fee to be pro-rated between their share and yours, or otherwise agree to reduce their claim. This negotiation should always be attempted. But in the end, the lawyer is bound to honor their lien, and can be held personally liable if s/he does not.

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Answered on 4/05/01, 9:28 am


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