Question:

I was in a car accident in Arizona (not my fault, police arrived and issued a ticket to the other driver).  I had a concussion and went to the emergency in California twice: first time for CT scan and second for X-rays.  The insurance company has accepted the liability and is offering me $6000 settlement from which $5300 are for my emergency bills and $700 is for pain and suffering.  There have been no medical liens filed against my settlement and the hospitals in California don’t know anything about it.  I would like to receive the $6000 check so I can negotiate with the hospital and pay them directly (maybe even negotiate a payment plan), but my insurance claim adjuster insists that all bills must be paid directly to the hospital and I will only receive the $700.  Are there any laws regarding this in Arizona?

Answer:

If the insurance company insists on paying the providers directly, like in the case of hospital liens, a claimant can agree with the insurance company on a settlement amount but then negotiate reductions with the medical providers prior to disbursement of the settlement funds.  After the claimant has negotiated reductions, the insurance company can pay the reduced amount directly to the providers and then send the remaining funds to the claimant.  That way, the claimant receives the benefit of the negotiated reductions. 

Important: Any person making a third party insurance claim needs to be aware that the hospital may have recorded a lien.   An attorney can help find out if any valid liens exist.  An attorney can also certainly help a claimant know wither the offer the insurance company is making is fair under the circumstances.