Personal injury clients who have been in a catastrophic car wreck, or been injured by a defective product, or who have medical malpractice cases, often are seriously injured and have enormous medical bills. As a personal injury lawyer and medical malpractice attorney, I spoke in my last blog post about potential liens that medical insurance companies may have. A lien is when someone paid money on your behalf, and if you get money, they are allowed to make you pay them some or all of it.
In Georgia, if a medical insurance company has paid your bills, they do not have a claim to get you to pay them back until you yourself have been fully compensated for the personal injuries you incurred in the car wreck, product liability case, pharmaceutical recall case, etc. Georgia only requires drivers to have a tiny, $25,000 insurance policy. For someone who gets a brain injury or a head injury, or a spinal cord injury, a broken bone, or a broken knee, etc., that paltry amount of insurance is nowhere near the cost of the medical bills, let alone the pain and suffering the plaintiff and his family went through. In that case, the medical insurance company may not be entitled to get paid back. I will write more about that issue in a future blog post.
On the other hand, Georgia law says that medical providers can have a lien against the amount a personal injury or medical malpractice plaintiff gets. Also, personal injury plaintiffs may have outstanding hospital liens.
Here's what the Georgia code section says:
"Any person, firm, hospital authority, or corporation operating a hospital, nursing home, or physician practice or providing traumatic burn care medical practice in this state shall have a lien for the reasonable charges for hospital, nursing home, physician practice, or traumatic burn care medical practice care and treatment of an injured person, which lien shall be upon any and all causes of action accruing to the person to whom the care was furnished or to the legal representative of such person on account of injuries giving rise to the causes of action and which necessitated the hospital, nursing home, physician practice, or provider of traumatic burn care medical practice care, subject, however, to any attorney's lien."
Under Georgia law, medical providers argue that they are entitled to be paid even when the plaintiff is not getting fully paid. That argument is very questionable under Georgia law, but be that as it may, medical providers make that argument.
Here is why that is really, really unfair to plaintiffs who do not have medical insurance, Medicare, Medicaid, etc.
If you have insurance, you will see on you bill (and I am copying this from an actual example, I am not making it up), a written statement like this:
Amount billed $ 489.00
Amount paid $ 125.66
The two amounts are different because the hospital has an agreement with the medical insurance company that it will not charge more than $125.66 for that particular service.
What happens is pretty obvious: the hospital charges a ridiculous amount, so that by the time it negotiates with the insurance company, or Medicare or Medicaid (which pay even less), it will get enough to cover the medical care.
So what happens if you don't have insurance? The hospital charges you the maximum amount! It charges you the whole $489.00 - and then claims it has a lien that entitles it to 100% reimbursement from you if you get paid by the person who injured you!
Serious? Really serious.
Unfair? Really unfair.
