Use My Health Insurance or Treat on a Lien?

This is some inside baseball kind of stuff, but it’s important info if you’re injured in an automobile accident in North Carolina.

Generally speaking, I tell people that in these situations (auto accident injury claims in NC) you want to use use your health insurance. It’s there for that reason, so use it!

There are exceptions to every rule, though, and one of those exceptions is treatment with chiropractors. Those folks often offer to treat you on a lien basis. Read this article for more explanation on what a lien is, but in short, it means they don’t bill your health plan, or you for that matter; they just wait until the case gets settled and then expect to get paid then.

But what happens if your claim falls apart, or something else wacky happens? How do you know what to do? Well, sadly, there’s rarely a one size fits all answer for these situations. For that reason, I broke down the good and bad of health insurance v. liens…


Good: No out of pocket up front, no co-pays.  Hopefully the at-fault carrier pays for it through the settlement.  When it works, it’s great.  But what if it doesn’t?  

Bad: IF we don’t settle or get enough money, then you’re possibly on the hook for some or all of it with no health insurance discounts.  VERY unlikely in most cases that I’m involved in (not because of me, but because I can normally pick cases that work!). Then again, we can never really know and it depends on the facts of your case. Did you have really big balances at a hospital?  

Health Insurance

Bad: Paying co-pay every time you go, gets expensive out of pocket.  That’s right, depending on your plan, you’ll probably have to fork out like $50 every time you go, so that can add up and might make you treat less than you should. Also, sometimes you have to pay your plan back! That depends on the plan, but it happens! Not the end of the world, but something to consider.

Good: You don’t have to worry about being on the hook for the whole bill (remember, you get discounts with health insurance) if this whole thing goes to heck. 

I can never tell you anything is a sure thing.  But then again, it’s very rare for me to have a case that simply doesn’t work out and the client gets left holding the bag.  Does it happen?  Yes.  Does it happen often?  No.  I personally see this maybe 3 times a year, if that, out of maybe 100 cases or so, but I can’t say if you’re going to be that unlucky 3% or not.  

TLDR: Attorneys are really bad at saying “yes” or “no” to questions.  There are good and bad points to both.  You’re probably fine to do a lien with most chiropractic claims in auto accident cases but I can’t say anything is for certain!  As always, seek educated and experienced advice. Call me at 919-929-2992.

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Jeffrey Allen Howard, Attorney at Law, PLLC
1829 E. Franklin St. - Bldg 600
Chapel Hill, NC 27514

(P) 919-929-2992
(F) 919-636-4779

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