Georgia Law Blog

-  ERISA Subrogation Interests - This is a very common type of issue. Basically, an injury victim's medical bills are paid by his or her health insurance company (or the health insurance company of a spouse or parent) and the health insurance plan falls under ERISA. This type of subrogation interest requires special attention.  Recently, there have been several important cases, including one from the United States Supreme Court.  Under ERISA, injured victims and their attorneys face personal liability for not addressing ERISA subrogation. 
-  Non-ERISA Subrogation Interests - Fortunately, Georgia's subrogation / reimbursement statute is very friendly to car and truck accident victims.  A letter can be sent which may insulate an injured victim from claims made by health insurance companies if a response is not sent within 10 days. Unfortunately, the letter must be sent properly worded under the law via certified mail or statutory overnight mail.  The other difficulty that I encounter is whether you are dealing with an ERISA or Non-ERISA health plan.  They are treated very differently under the law, and the subtleties can by confusing.
-  Governmental subrogation / reimbursement claims - Often, Medicare or Georgia Medicaid pays the medical bills of those involve in car accidents in Georgia.  Other times, various other governmental entitles pay medical bills in personal injury cases through various programs.  These claims must be carefully addressed, as well.  Medicare reimbursement is particularly difficult because of their slow response or, worse yet, lack of any response.  Georgia Medicaid reimbursement is simpler as the State of Georgia has contracted with a private company that has been responsive in my experience. Please understand that other governmental entities may have paid medical bills that warrant mention.  Some examples include the Department of Veterans' Affairs, Georgia's Crime Victim's Compensation Fund, and CHAMPUS. 
-  Liens under the so-called Hospital Lien Statute (O.C.G.A. 44-14-470).  Many times, auto accident victims in Georgia do not have health insurance.  Emergency rooms still treat the uninsured and ought to be repaid if they follow the law.  Also, some medical providers will treat people without health insurance.  A growing and disappointing trend is for certain hospitals to chose to file a lien under this Statute instead of billing a person's health insurance.  Most notably, this happens in Medicare claims where reimbursement rates are very low.  This is not done typically when a person has private health insurance as such a practice may run afoul of the hospital or physician's contract with the injured party's health insurance company.
-  Workers' compensation subrogation - When a workers' compensation insurer pays medical bills and weekly benefits and a third party claim is made against a person who caused a wreck, the law says they are entitled to be repaid.  The caveat is that they are only to be repaid if the personal injury victim is "fully compensated" for all economic and non-economic loses.   Admittedly, this  is a high threshold for a workers' compensation insurer to meet.

    I believe it is prudent to make it a practice to scan all files for these subrogation / reimbursement issues.  I keep a special part of each file dedicated to subrogation / reimbursement so these issues are not overlooked when it comes time to settle or distribute funds after a verdict.