My health insurance paid my bills in an auto insurnace. The other party's auto insurance is ready to settle but is willing pay the 'negotiated rate/adjusted rate' that my health insurance paid for and not the invoiced rate.
Ex. The actual MRI was billed at $ 1700 but the negotiated rate my health insurance paid was $ 400
Secondly, they are paying only 80% of lost wage
They are saying that this legally true citing House Bill 4.
Is this true?
I was under the impression, that they need to pay the total medical expenses (not the negotiated rate) and the total lost wage (not the 80% crap) plus pain and suffering
Please help and guide me
Thanks!
Is it a law to pay 80% of lost wage?
How much would be an appropriate Pain and suffering offer, if the special damages (medical and lost pay) is $ 6200
Because I pay a premium to my health insurance , we get a discounted rate - would the other party pay more considering I pay a premium every month to get the discounted medical rate?
I live in Texas, is there any specific law for texas?
Answer by la428282
You can't get paid double your medical bills.. thats called "double dipping"- if they have been partially paid for.. you will only get the amount that wasnt covered. Why should you get paid twice? how is that fair? You didnt win the lottery.. if you arent permenantly injured its the at fault parties responsibility to make sure you have no out of pockets.. which they are.
and likely in your state the at fault partie only pays 80% of lost wages.. thats varies by state.
Answer by bundysmom
What state do you live in? If you live in CA, there is case law supporting the insurance company calculating the bills based upon the "negotiated rate." If the insurance company is quoting you any legal statute, it's correct, but to find further info on House Bill 4 do a search with your state legislature to read the bill itself.
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Orignal From: In an Auto Accident claims settlement, are medical bills settled at the adjusted rate or the invoice bill?
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