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Do you have to pay your health insurance back if you recover money in a personal injury case?

Personal Injury VideoFrom the Personal Injury Attorneys at Tucker Griffin Barnes:

The general rule in Virginia is “NO”. Virginia Code  §38.2-3405(A) states in pertinent part, “[n]o insurance contract providing hospital, medical, surgical and similar or related benefits . . .  delivered or issued for delivery or providing for payment of benefits to or on behalf of persons residing in or employed in this Commonwealth shall contain any provision providing for subrogation of any person’s right to recovery for personal injuries from a third person.” If your health insurance policy was 1) written in Virginia OR 2) delivered to you in Virginia AND you 1) live in Virginia OR 2) receive your health insurance through your job in Virginia, the insurance company cannot ask to be paid back for medicals bills it paid in a personal injury case.

Some exceptions exist to this rule. Most of them relate to insurance that is paid by taxpayer money. The most common exceptions to this rule in Virginia include: Workers’ Compensation payments; Medicare; Medicaid; ERISA plans (self-funded by the employer); and federal employee (including active duty and retired military or nonmilitary employees) health insurance. These excepted health care payors must be paid back; however, the good news is that you only have to pay back what the program/plan paid the healthcare provider (usually 80% or less of the bill). The at-fault driver is liable for 100% of your related medical bills – even if health insurance has already paid them. If you don’t receive any money for your injuries, you don’t have to pay Medicare, Medicaid, ERISA plans, Workers’ Compensation, or other state or federal programs for bills resulting from personal injuries.

Read Virginia Code §38.2-3405 regarding Virginia’s position on paying back your health insurance company.

Written by Attorney Yvonne T. Griffin

Experienced Personal Injury Attorneys:

We concentrate our personal injury practice in vehicle accidents, motorcycle accidents, wrongful death cases, slip and falls, and animal bites.

Please contact us if you’ve been injured.  We offer a free, no-obligation consultation.  We have four convenient office locations: Charlottesville, Lake Monticello, Harrisonburg & Staunton.

If you’re too injured to come in, we’ll be happy to meet you at the hospital or your home.  We will fight to get you the full value of your case.

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