Ingenix and Healthcare Recoveries Health Insurance Reimbursement Requests after a Car Accident


If you have medical care paid for by a health insurance company after a car accident in Atlanta or anywhere in Georgia, you are likely to get a letter from ACS or Healthcare Recoveries asking that you reimburse the company if you get any settlement money. Like most of my clients, you may be asking, what are my rights and duties here?

Most health insurance policies contain some language in their contracts giving them the right to be reimbursed. Georgia has a law that says you don’t have to pay them back unless you settle your claim for every penny it was worth. Cigna, United, Blue Cross Blue Shield and all of the other insurance companies take the position that they are always entitled to reimbursement.

So, is my health insurance company allowed to ask for money from my settlement?

1. It’s true that almost all health insurance contracts contain a right of reimbursement.

2.  It’s true that most insurance companies have the correct language that allows them to get a recovery from any settlement money you get.

3. It’s true that the state of Georgia has a law that says you don’t have to repay e insurance company unless you receive a settlement that pays for all of your economic, medical and human suffering damages.

4.  It’s true that most health insurance plans are ERISA plans that are self funded and therefore federal law preempts the Georgia law that protects you.

5. It’s true that even if you are screwed and have to honor the right of reimbursement, most health insurance companies will negotiate with you to some degree.

6. It’s true that even if they have dubious rights they can put the at fault drivers car insurance on notice of their claim which can have the effect of freezing any settlement talks without the health insurers consent.

Best solution? If the medical insurance paid more than a thousand dollars, consult with a car accident lawyer in Savannah, Atlanta or Athens Georgia.

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