Insurance question for the lawyers out there

DzynKingRTR

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Dec 17, 2003
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Could someone please explain to me the point of health insurance? Why do we have it? Everyone should know by now what happened to me last year. My health insurance is now asking for reimbursement for what they paid into it. So again I ask I did I even have insurance to begin with if they will not pay for things that happen? I might as well not have even had insurance.
 

2003TIDE

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You need health insurance because probably 98% of people are 1 catastrophic health event from living on the street.
 

Intl.Aperture

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Aug 12, 2015
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Why is this a legal question, anyway?
I think it's just pure frustration and at the moment it seems like there's no good reason why he should pay health insurance every day of his life if they just turn around and ask for the money back when they DO have to pay out.

I've found myself feeling much the same after a few trips to the emergency room. I could obviously look at the bill and see how much my insurance had reduced the total cost but it was not nearly as effective as I thought it should have been. In comparison to other plans I have one that could be considered middle of the road to slightly better than average.
 

TIDE-HSV

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Oct 13, 1999
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I think it's just pure frustration and at the moment it seems like there's no good reason why he should pay health insurance every day of his life if they just turn around and ask for the money back when they DO have to pay out.

I've found myself feeling much the same after a few trips to the emergency room. I could obviously look at the bill and see how much my insurance had reduced the total cost but it was not nearly as effective as I thought it should have been. In comparison to other plans I have one that could be considered middle of the road to slightly better than average.
I've never heard of insurance asking for reimbursement except in cases where the injured was also compensated for medical expenses by the perp's insurance or the perp himself...
 

CrimsonForce

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Dec 20, 2012
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I'm not sure I understand the situation. Did you go to an in network provider? I've never heard of an insurance company asking to be reimbursed for the costs you explained. I'm not saying it doesn't happen I've just never heard of it..
 

2003TIDE

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The only insurance I know of to ask for money back is disability insurance. Not health insurance.
 

seebell

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Mar 12, 2012
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Don't know all your circumstance but something seems fishy. Was the settlement for medical costs? Or for pain and suffering and future costs?

I am not a lawyer but I love to give advice.
 

TIDE-HSV

Senior Administrator
Staff member
Oct 13, 1999
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Yes I received a settlement. If I pay my health insurance, I will then have nothing left.
Sorry, but it's there in all insurance contracts. In fact, I get an annual query from BCBS as to whether I'm being reimbursed by any other source. It sounds like a really crappy settlement, if you settled for meds alone, with all the pain, suffering, loss of work, etc., you endured. A good plaintiff's lawyer structures the settlement for the only the bare bones of meds and specials, and allocates all the rest to pain, suffering, etc. If you had your meds paid by insurance and then turned around and collected them from the defendant, you would have been paid double. Just the way it works. Blame your lawyer, if he didn't explain this to you...
 

Bamaro

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Oct 19, 2001
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The settlement was for all 3. My out of pocket, pain and suffering and future cost
Insurance is to reimburse you fro your medical expenses. If someone else already reimbursed you the insurance company has every right to ask for their money back. IOW, you cant collect twice for medical expenses.
 

DzynKingRTR

TideFans Legend
Dec 17, 2003
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Vinings, ga., usa
My lawyer did mention this might happen. He said we will fight it as much as we can.

I personally think this is total garbage. Why do we pay premiums? The insurance should owe me money for all the times I didn't use it.

This stupid accident seems to be the gift that keeps on giving. My left hand is weak and I keep getting tendonitis in it just from normal use.
 

Bamaro

TideFans Legend
Oct 19, 2001
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Jacksonville, Md USA
My lawyer did mention this might happen. He said we will fight it as much as we can.

I personally think this is total garbage. Why do we pay premiums? The insurance should owe me money for all the times I didn't use it.

This stupid accident seems to be the gift that keeps on giving. My left hand is weak and I keep getting tendonitis in it just from normal use.
Thats basically what you are asking them to do now. Take it up with your lawyer and he will tell you what everyone else here has already said.
 

TIDE-HSV

Senior Administrator
Staff member
Oct 13, 1999
84,552
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437
Huntsville, AL,USA
My lawyer did mention this might happen. He said we will fight it as much as we can.

I personally think this is total garbage. Why do we pay premiums? The insurance should owe me money for all the times I didn't use it.

This stupid accident seems to be the gift that keeps on giving. My left hand is weak and I keep getting tendonitis in it just from normal use.
You don't pay premiums to collect double...
 

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