Comments on: Government Lies in Texas http://dallaspersonalinjurylawblog.com/2007/08/10/government-lies-in-texas/ A Discussion of Personal Injury Laws Affecting Texas Citizens Sun, 28 Jun 2009 02:17:18 -0700 http://wordpress.org/?v=2.9.2 hourly 1 By: Dina Steele http://dallaspersonalinjurylawblog.com/2007/08/10/government-lies-in-texas/comment-page-1/#comment-159 Dina Steele Sun, 28 Jun 2009 02:17:18 +0000 http://dallaspersonalinjurylawblog.com/?p=21#comment-159 The way that Governer Perry, and now most Courts, have chosen ot interpret the law is that with respect to medical expenses, you may only recover the actual amount of expenses that you or someone acting on your behalf (such as your health insurance company) has paid. If the victim has health insurance, the amount paid at the negotiated rate is often less than actually billed by the hospital or treating physician. Using your example, if your bills were $5000 and your health insurance provider paid $2500, then you may only recover the $2500 paid by your health insurance company, along with any copays or out of pocket expenses that you can prove you personally paid. Your health insurance company will then demand repayment for the $2500 that they paid (this is called subrogation). Of course, you are not entitled to repayment of the health insurance premiums that you may have been paying for years. The way that Governer Perry, and now most Courts, have chosen ot interpret the law is that with respect to medical expenses, you may only recover the actual amount of expenses that you or someone acting on your behalf (such as your health insurance company) has paid. If the victim has health insurance, the amount paid at the negotiated rate is often less than actually billed by the hospital or treating physician. Using your example, if your bills were $5000 and your health insurance provider paid $2500, then you may only recover the $2500 paid by your health insurance company, along with any copays or out of pocket expenses that you can prove you personally paid. Your health insurance company will then demand repayment for the $2500 that they paid (this is called subrogation). Of course, you are not entitled to repayment of the health insurance premiums that you may have been paying for years.

]]> By: Dina Steele http://dallaspersonalinjurylawblog.com/2007/08/10/government-lies-in-texas/comment-page-1/#comment-3 Dina Steele Wed, 22 Aug 2007 19:20:11 +0000 http://dallaspersonalinjurylawblog.com/?p=21#comment-3 Well, thanks to Governor Perry this law remains a bit unclear at this time. At least one Court has held that the 2003 statute limits your recovery to the amount actually paid by you or your insurance company for your medical treatment. Here is an example of how it works: 1. You have a hospital bill for $5,000.00 2. Your Health Ins. paid a negotiated Rate of $2,500.00 3. You were personally charged $1,000.00 for your co-pay and deductable 4. The hospital "writes off" the remaining $1,500.00 pursuant to its contract with your Health Ins. Company. 5. Under the interpretation of the law that is currently being applied, the settling defendant or insurance company (such as the other driver's insurance company in a car wreck) is only required to pay medical expenses on the $3,500.00 that you and your insurance company have had to pay to the hospital. Bear in mind that the Health Insurance Company in the example above will likely require that you pay back the $2,500.00 that it paid to the Hospital. You should also understand that this limitation only applies to the portion of your claim that is for medical expenses. In most personal injury cases, you will also be entitled to reimbursement for other losses, such as lost wages, pain and suffering and future medical expenses. There are also additional losses, such as disfigurement, that may entitle an injury victim to compensation in certain cases. It is always advisable to speak with an experienced personal injury attorney about the specifics of your case so that you have a full understanding of your rights before you negotiate with an insurance company. Steele Law offers free consultations on these matters and may be contacted through the website at www.steelelawfirm.com or by telephone at 972-888-6088. Well, thanks to Governor Perry this law remains a bit unclear at this time. At least one Court has held that the 2003 statute limits your recovery to the amount actually paid by you or your insurance company for your medical treatment. Here is an example of how it works:

1. You have a hospital bill for $5,000.00
2. Your Health Ins. paid a negotiated Rate of $2,500.00
3. You were personally charged $1,000.00 for your co-pay and deductable
4. The hospital “writes off” the remaining $1,500.00 pursuant to its contract with your Health Ins. Company.
5. Under the interpretation of the law that is currently being applied, the settling defendant or insurance company (such as the other driver’s insurance company in a car wreck) is only required to pay medical expenses on the $3,500.00 that you and your insurance company have had to pay to the hospital.

Bear in mind that the Health Insurance Company in the example above will likely require that you pay back the $2,500.00 that it paid to the Hospital.

You should also understand that this limitation only applies to the portion of your claim that is for medical expenses. In most personal injury cases, you will also be entitled to reimbursement for other losses, such as lost wages, pain and suffering and future medical expenses. There are also additional losses, such as disfigurement, that may entitle an injury victim to compensation in certain cases. It is always advisable to speak with an experienced personal injury attorney about the specifics of your case so that you have a full understanding of your rights before you negotiate with an insurance company. Steele Law offers free consultations on these matters and may be contacted through the website at http://www.steelelawfirm.com or by telephone at 972-888-6088.

]]> By: ruth hesskew http://dallaspersonalinjurylawblog.com/2007/08/10/government-lies-in-texas/comment-page-1/#comment-2 ruth hesskew Mon, 20 Aug 2007 12:55:34 +0000 http://dallaspersonalinjurylawblog.com/?p=21#comment-2 So does this mean that if you settle with a insurance company without going to court that in Texas the insurance company is allowed to only reimburse you for the amount the health care provider paid. If my bills were $5,000.00 and my health provider only paid $2,500.00 I can only get the 2,500.00 added to my settlement? I am unclear as to what the rule is. So does this mean that if you settle with a insurance company without going to court that in Texas the insurance company is allowed to only reimburse you for the amount the health care provider paid. If my bills were $5,000.00 and my health provider only paid $2,500.00 I can only get the 2,500.00 added to my settlement? I am unclear as to what the rule is.

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