Health Insurance Liens and How to Reduce Them

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Health Insurance Liens and How to Reduce Them

health insurance liens


Health insurance liens attach to settlement proceeds when your health insurance pays for treatment needed due to a personal injury, and you receive a settlement. Most health insurance plans have language in their policy that entitles them to claim a health insurance lien. If lien language is in your health insurance policy, you would have agreed to reimbursement when you signed the policy. Most people are not aware of the legal effects of the policy language. They only become aware of the health insurance lien after an injury. If you have to deal with a health insurance lien, there are a few things you should know.

The first thing to determine is what law applies. Health insurance policies written in Florida and not subject to Federal preemption are governed by the plan’s terms and Florida Statutes. The 4 things you should know when you find yourself injured because of the negligence of others, and end up with a health insurance lien in Florida:

  1. Read your health insurance policy to determine if there is a health insurance lien

First, your health insurance policy is a contract. Contracts are based on the terms of the agreement; it is not safe to assume that your health insurance company has a health insurance lien. We have seen insurance companies claim to have a health insurance lien even when the health insurance policy did not provide for that right. Read your policy or share it with your attorney to confirm the policy authorizes a health insurance lien. The policy language will outline exactly what, if any, health insurance lien your health insurance has on settlement proceeds. Keep in mind some policies only apply to third-party settlements and not to uninsured or underinsured motorist settlements.

  1. Your health insurance company may only recover payments for the medical care related to your claim

Second, if your health insurance company has a right of recovery for the payment of medical care; keep in mind, they only have a lien for payments related to your injuries. Your attorney should confirm the lien is only for the bills related to your injury claim. The first step to confirming this is to request an itemized lien from the insurance company which lists all of the payments they are seeking to recover. Your attorney should notify the insurance carrier immediately if any of the listed payments are unrelated to your claim.

  1. Liability matters in health insurance liens

Third, when more than one person is at fault for an accident, a jury may assign each party a percentage of fault. In cases involving comparative negligence, the health insurance carrier can only assert a health insurance lien on an equal portion of the settlement proceeds. Meaning, if the opposing party is assigned 50% fault, the lien holder may not recover more 50% of their lien.

  1. Health insurance companies must take into account attorneys’ fees and costs when determining health insurance liens

Forth, most personal injury attorneys work on a contingency fee basis. This means that their payment is contingent upon their client obtaining a monetary settlement. In these cases, the attorneys’ fee is a percentage of the client’s recovery. In addition to the fee, the client must reimburse the attorney for costs incurred during the case. Florida Statute 768.76(4) limits lienholders recovery to the actual amount of settlement minus the percentage of attorney’s fees and costs. For example, the lien must be reduced by 35% if attorneys’ fees and costs total 35% of the settlement.


Call 1-800-ASK-DAVE now if you need legal assistance resolving your health insurance lien.



Florida Statute 768.76


By |2018-09-05T17:31:04+00:00August 12th, 2018|Categories: Consumer Alerts, Insurance|Tags: , |