Personal Injury: If you Have ERISA Privately Funded Health Insurance

When you are the victim in a car accident and your primary care provider is an ERISA plan provided by your employer (generally a large corporation) , there is a likelihood that you will have to reimburse the health care plan for a portion of your medical expenses from over payouts you stand to receive due to your injury. Of course, your first course of action is to get better and receive necessary treatment after your accident. While all injury cases vary, a claim cannot be submitted on your behalf if you do not obtain treatment for your injuries. Therefore, upon seeking the treatment you need – it is in your best interest to contact an attorney.

Your insurance will know that the treatment you are receiving is due to an accident that was not your fault – and thus want to be reimbursed for your treatment because they know you will generally receive compensation from other parties involved in the accident. An experienced attorney is the best ally to have in this process, as dealing with your health insurance plan may prove difficult. This is because the ERISA plan that your employer had must be both qualified an approved before placing a lien on your treatment and demanding repayment from the at-fault driver’s insurance company or your own auto insurance. The lien is not automatic and its presence might affect the amount of financial compensation you stand to net from the at-fault driver and/or the Med Pay coverage on your auto insurance. This process may play out over many months and can be enriched by the presence of an experienced attorney. Contact Pak & Moring to discuss your situation, and see if we can help you navigate the waters of insurance companies and medical bills.

(Please note: while informative, these posts are not intended to be formal legal advice and should not be solely relied on as a primary basis for legal action.)

New Changes to the Arizona Anti-Deficiency Statute:

What It Means for Homeowners

The Arizona State legislature in conjunction with Governor Jan Brewer recently passed a new bill amending the Arizona Anti-Deficiency Statute. As explained in a previous article on the Pak & Moring site, this law had generally served to protect borrowers by prohibiting mortgage lenders from suing a homeowner for the difference between the amount the property sold for at a foreclosure auction and the amount owed to the lender. This statute only protects homeowners in certain circumstances. Generally, a homeowner may not be sued by his or her lender if the property in question is located on 2.5 acres or less and is a single family residence or duplex.  However, this statute only applies if the decrease in value is not due to the homeowner’s neglect.

The new law now requires that a homeowner must have “utilized” the property for six consecutive months and a certificate of occupancy must have been issued. This new requirement is primarily directed at non-resident investors; however, it could adversely affect Arizona investors.  Arizona residents who are living in their home as their primary residence and are facing foreclosure will still be protected under the new law.

This new requirement for the anti-deficiency law will go into effect on September 30, 2009, which could have significant ramifications on pending foreclosures and short sales.

Does my property qualify for the anti-deficiency statute?

1. Is your home located on 2.5 acres of land or less?
2. Is your home a dwelling for one or two families?
3. Is your home fully built and have you received a certificate of occupancy?
4. Do you live in the home and have you done so for 6 consecutive months?
5. Was the decrease to the value of your property the fault of the market (as opposed to neglect on your behalf)?
6. Was the mortgage(s) used for the original purchase of the home, or at the very least, for improvements made to the property?

If you answered yes to all of the above questions, you may still be able to protect yourself under Arizona’s anti-deficiency statute. Ii you meet the criteria under the new law, your lender may be prevented from pursuing you for its losses from the foreclosure. However, every situation is different. Your individual factors may affect the outcome of your foreclosure. To find out if you are protected under Arizona’s anti-deficiency statute, contact Pak & Moring to look into all of your legal options and discuss your pending or possible foreclosure.

(Please note: while informative, these posts are not intended to be formal legal advice and are not completely authoritative and should not be solely relied on as a primary basis for legal action.)

For a previous introduction and explanation of the Arizona Anti-Deficiency Statute, see the Pak & Moring Blog

Balance Billing or Provider Liens

An Important Note on Personal Injury Settlements

If you are fortunate to have health insurance, you may still be held liable for a portion of the cost of your medical care for injuries suffered as a result of an automobile accident. This is because the amount of money paid by your insurance company for your post-accident care is generally less than the amount billed for your treatment. Due to the nature of your injuries and the care provider’s knowledge that you will be receiving a financial settlement from the at-fault driver’s insurance, many medical providers will place a lien on your case. This type of lien is referred to as a balance billing lien. The balance billing lien is for payment of the difference between what the insurance paid your medical provider and what the original cost of your care happened to be. For an illustration of how this works with personal injury cases, see below:

For example:

If you have health insurance, go hiking and break your ankle – your hospital bill could be $5,000. However, because of your coverage, the health insurance company may pay the hospital about $1,500 instead of the full price – as per their agreement with the health care provider. Aside from any co-pays you might have, the $1,500 is all that is paid to the hospital and the rest of the debt is written off per their contract.

However, the responsibility for payment changes if you are injured in a car accident and break your ankle. Like the example above, let’s assume your hospital bill is $5,000. In this situation, your health insurance would still pay the $1,500, as per its agreement with the hospital. However, the hospital may still demand the remaining $3,500 from you since the injuries were caused by a third party.

Balance billing liens are a relatively new form of recovery for medical providers who, in the past, received payment from the insurance carriers via their contracts and wrote off the balance. Since there is a third party at fault for the injuries for which they provided medical treatment and incurred expenses, many medical providers have looked to balance billing liens to recover the full value of their services. Although they are entitled to recover the full balance of their liens, many providers are willing to negotiate and compromise their liens.

A knowledgeable and experienced attorney can help negotiate your liens for you at no cost when he or she is representing you on your case. If you find yourself injured in an automobile accident, contact Pak & Moring for a free consultation to discuss your situation. We can help.

For further information of that the personal injury process is like given your type of medical coverage see

• I Have Private Health Insurance
• I Have Medicare or Medicare HMO/Medicare Advantage Organizations
• I have AHCCCS
• I have an ERISA plan
• I don’t have health insurance, and pay for all expenses out of pocket

Personal Injury: If you have AHCCCS

If you get hurt in an automobile accident, then your first priority should be to seek treatment for your injuries and get better as soon as possible. However, if your medical expenses are covered by the Arizona Health Care Cost Containment System (AHCCCS), you may run into several obstacles that may hinder the time and effort needed for your recovery.

AHCCCS is a publicly funded health insurance plan supported by the state. With this type of insurance, you will be able to go the medical providers you already frequent and seek treatment as necessary with AHCCCS footing the bill as per usual. However, at the end of your case and generally, when you are about to receive compensation for your injuries from the at-fault driver’s insurance company, you will have to reimburse AHCCCS for the amount paid for your treatment. The reason being is AHCCCS holds a lien on your case as a publicly funded insurance plan, which affords it the right to be reimbursed if you receive funds as a result of your personal injury claim.. It should be noted that many cases differ and AHCCCS’ lien may or may not be an accurate figure of the expenses AHCCCS paid towards your medical bills related to your accident. If AHCCCS is your primary health insurance, often times unrelated medical bills are included in the lien amount. If so, you would not be responsible for the reimbursement of those expenses unrelated to your accident.

AHCCCS will usually send you notice of its lien via mail; however, if it does not, you may not know that AHCCCS has a lien on your case. If you receive a settlement and fail to reimburse AHCCCS, you may not be covered for any future medical expenses whether or not they are related to the car accident. AHCCCS will not pay any future medical expenses until or unless you pay AHCCCS the balance of its lien. As an additional penalty, you may also be responsible for the costs incurred to recover this money from you and your credit may be negatively impacted from its lien and collection efforts.

If you, like many others, are inexperienced in these types of matters and would prefer to concentrate on your recovery, please contact Pak & Moring to discuss your case. We can help.

Personal Injury: If you Have Medicare

If you find yourself injured from an automobile accident, your primary focus is to get better. However, this can also be a confusing time, as insurance companies may be contacting you for various details of the accident and the medical care you received. While all accidents are different, an experienced attorney would be invaluable in helping you navigate the waters of the personal injury process.

When you are the victim of an accident and have Medicare – the process of obtaining treatment for your injuries is the same as it is for any other medical issues that you may have. However, what happens behind the scenes with regard to payment of your medical bills and reimbursement of these expenses is vastly different. Unlike private health insurance, because your injuries were caused by someone else, Medicare will automatically have a lien against your case for any medical bills it has paid for your treatment and will expect to be reimbursed from any payment you may receive from the at-fault driver’s automobile insurance company. This type of lien has generally been referred to as a “super lien” because Medicare does not have to notify anyone of the existence of its lien. Therefore, when you receive any compensation for your injuries as a result of a car accident, you will need to reimburse Medicare for the amount they spent on your care.

If you fail to reimburse Medicare for the benefits you received, then the ramifications can be significant. Anyone related to your case – you, the third party, the third party’s insurance carrier, and any lawyers involved in the case – could be liable for twice the amount of the lien. Medicare can also refuse to cover any future medical expenses whether or not they are related to the accident until the lien is paid. Dealing with Medicare and obtaining the amount of its lien is a cumbersome and lengthy process, which is often frustrating even to lawyers.

The amount of time required to handle Medicare’s lien can take away the time and effort needed for your recovery. The added stress may also hinder your recovery. We at Pak & Moring understand that your ultimate goal is to fully recover from your injuries, and therefore, we can handle the lengthy and complicated personal injury claim process for you. If you would like a knowledgeable and experienced attorney to assist you with your case, please contact Pak & Moring. We can help you juggle the letters, phone calls, and payments that may arise in your case.

(Please note: while informative, these posts are not intended to be formal legal advice and are not completely authoritative and should not be solely relied on as a primary basis for legal action.)

Personal Injury: If you Have Private Health Insurance

If you are hurt in a car accident, need medical attention, and have your own health insurance, your insurance should cover the cost of your treatment. Upon seeking treatment, your primary health insurance will cover as much as is mandated by your policy. Arizona case law dictates that these plans may not assert a lien (a form of security interest or legal claim to then recoup the money spent on you) on your case or seek subrogation to recover for medical costs paid to your providers on your behalf. However, you will still be responsible for all of your co-pays as well as any additional costs your primary health insurance does not cover.

If you are fortunate to have car insurance with medical payments benefits or MedPay coverage, you can expect your insurance company to cover a portion of your medical bills up to the limit of your coverage. MedPay is a no-fault insurance coverage that will cover your medical costs regardless of who is at fault for the accident. MedPay can be used as the primary insurance to cover your medical expenses (if you do not have health insurance) or to supplement your primary health insurance.

If you do not have health insurance, MedPay provides one major benefit: you do not generally need to wait until you settle with the third party insurance company to pay your medical expenses or to cover your co-pays. Therefore, even before you receive any sort of settlement from the defendant’s car insurance, your out-of-pocket costs should be minimal. Of course, whether or not MedPay will take care of all or a majority of your medical expenses depends on your coverage limit.

Depending on the circumstances of your case, you could have multiple MedPay coverages available. For example, let’s say you have MedPay coverage on your own car insurance, but you are involved in a car accident as a passenger in your friend’s car. Since your MedPay coverage follows you if you are involved in an accident, your MedPay will cover your medical expenses up to the limits of your policy. If your friend also has MedPay coverage, you would have the benefit of her MedPay coverage because you were a passenger in her vehicle. Some insurance carriers may be entitled to reimbursement of the MedPay benefits paid on your behalf from any available third party coverage (i.e. the insurance that covers the car of the person who was at fault for the accident), but they are generally limited to recover for benefits paid in excess of $10,000.

Do not hesitate to contact Pak & Moring to discuss your situation, and to see if we can help you through this process.

(Please note: while informative, these posts are not intended to be formal legal advice and are not completely authoritative and should not be solely relied on as a primary basis for legal action.)

Liens and Personal Injury: An Introduction

If you find yourself injured in an automobile accident, your primary focus is to get better. What you really want is to return to your pre-accident condition from a physical standpoint. However, this can also be a confusing time. In addition to focusing on your recovery, you will need deal with the insurance company for the at-fault driver. You may be contacted by numerous people who will want to know everything about the accident from the extent of the damage to your car to the nature and extent of your injuries, if any. The number of people that you might need to deal with can be overwhelming. Everyone – from your private health insurance, to your automobile insurance, to the at-fault driver’s insurance - must be contacted. Each of them will have questions regarding any injury you received and medical expenses you incurred. This process can be daunting and time consuming, particularly if you are navigating the insurance system by yourself. A knowledgeable attorney can manage all of the parties involved in your personal injury case and help you receive the appropriate health and auto insurance payments to cover the medical expenses involved in your recovery. A lawyer experienced at handling accident cases can maximize your recovery, often at no out-of-pocket cost to you.

The law firm of Pak & Moring is authoring a series of articles about the personal injury process in an effort to help citizens be more informed when making decisions after an accident. Depending on your level of health and auto insurance coverage and the nature of your injury, the amounts you receive to cover your bills may vary. In addition, some companies use liens to ensure repayment. This series of posts will focus on the different scenarios a victim of a car accident might face. Of course, each case is different.

If you find yourself in need of legal representation, contact Pak & Moring to discuss your situation.  We can help you navigate the waters of insurance companies and medical bills.

Debt Collection Activities, continued

The for Arizona business owners, four most effective and common types of debt collection activities are the demand letter, mediation, arbitration, and litigation. The value of these processes varies in every case, but the explanations of each one are explained below. This is the last in a series of articles from the Pak & Moring law firm about debt collection and business contract law, and deals with arbitration and litigation as they relate to contract debt collection for a business.

Arbitration

This is a similar procedure to mediation, but the final outcome is completely binding upon both parties involved. In arbitration, the legal council of both parties selects and agrees upon a private judge, and each side presents their case to this arbitrator in an out-of-court proceeding. This third party participant then issues a binding decision about the outcome of the conflict at hand. Arbitration will resolve the conflict faster than litigation and have a set answer to a business’ or debtors legal woes in a quicker manner. In many cases, this process will also be less expensive to both parties than a jury trial would otherwise be.

Litigation

The lengthiest and most involved option in collecting debt owed to you or your business would be to go to trial. This is the common process of moving a lawsuit though the count system in order to resolve the debt collection dispute. This is likely the first action many businesses think of, and consists of a suit being filed against the debtor  in an attempt to recover the money that the company is owed. In this scenario, both the debtor and the business hire legal council and move a case thought the courts until it is tried in front of a judge (and possibly a jury). This course of action is more appropriate for bigger debts of those where there is a substaintial dispute as to the debt itself. Litigation may be placed in Superior or the Justice court. Justice court handles matters of disputes totaling less than $10,000, while the Superior court is utilized for larger debts. Many companies will try their own cases within the Justice court, generally with the guidance of legal council. Of all the options for debt collection, litigation will likely generate the highest attorneys’ fees and take up the greatest amount of time.

To decide which method of debt collection is right for you, please contact Pak & Moring for a FREE consultation discuss your situation, and see what options is right for you.

(Please note: while informative, these posts are not intended to be formal legal advice and are not completely authoritative and should not be solely relied on as a primary basis for legal action.)

Types of Collections Activities

The four most effective and common types of debt collection activities in Arizona are the demand letter, mediation, arbitration, and litigation. The value of these processes is all case-specific, but the particulars of each one are explained below. This is the fourth in a series of articles from the Pak & Moring law from about debt collection and business contract law. It deals specifically with the benefits of Demand Letters and Mediation to Arizona businesses, with Arbitration and Litigation discussed in the following article.

Demand Letters

This as letter from Pak & Moring drafted on your behalf and sent to the debtor. It features a history of the transactions, evidence of all money owed, and demands payment of your account receivable.
This approach has many advantages: it is the quickest and least expensive action that a law firm can take to resolve your debt issues. Likewise, official statements drafted by lawyers tend to expedite the actions of debtors who are stalling for no good reason. Demand letters get attention, and are generally the very first legal step a business should take to convince a customer to pay debt they owe.

Mediation

A medication is out-of-court method of resolving the debt in question. All parties (the business and the debtor), as well as their legal council and a 3^rd party mediator facilitate. In this process, a trained mediator (generally a lawyer with many years of contract law experience) will function as a liaison between the desires of both groups in helping them understand one another’s position. Mediation avoids the costly and lengthy process of litigation and will generally result in a decision faster than waiting for a trial. However, this method is contingent upon both sides reaching an agreement at the mediation. Both sides come out of the mediation understanding one another, even if the case does not settle. If you find yourself interested in pursuing any type of debt collection against someone who owes you money, contact Pak & Moring to discuss your situation, and see if we can help you receive the funds you are owed.

(Please note: while informative, these posts are not intended to be formal legal advice and are not completely authoritative and should not be solely relied on as a primary basis for legal action.)

Affirmative Defenses

If a business is demanding debt repayment from a client, a common reaction of the debtor within the legal process is that of an affirmative defense, such as payment, or an argument that the work was sub-standard. This means that the defendant admits to the nonpayment of debt and provides a justification for that action. This is legally defined as admitting fault and “[a] defendant’s assertion raising new facts and arguments that, if true, will defeat the plaintiff’s or prosecution’s claim, even if all allegations in the complaint are true.” (Black’s Law Dictionary (7th ed. 1999); ) (Arizona Rules of Court 8(c)). It is possible that a business pursuing legal action against a customer might be faced with an affirmative defense on the debtor’s behalf. In this situation, however, the burden of proof resets on the party asserting the affirmative deference. Therefore, with experienced legal counsel, a company could navigate the waters of debt collection. If you are a business in need of legal help with debt collection, contact Pak & Moring to discuss your situation and see if we can help you through this process.

What if I’m a business who is being sued for money I don’t owe?

If you do not actually owe another party any money, your accuser would have to show the way in which you accrued the debt. Using an affirmative defense, the opposing side would need to prove that you do, in fact, owe them money. This is an effective legal tool for a business who feels victimized by the prosecuting good or service provider because they do not actually owe any money. However, all affirmative defense cases are different. If you are a business who is facing litigation or any other legal action because of debt you do not owe, please contact Pak & Moring for a consultation with an experienced attorney who can help you decide on the right course of action in your situation.

(Please note: while informative, these posts are not intended to be formal legal advice and are not completely authoritative and should not be solely relied on as a primary basis for legal action.)