A federal judge is asking the Third District Court of Appeal for clarification regarding how to proceed when there is legal wrangling among a health insurer, an injury lawyer and an injured person following a car accident.The case, UnitedHealth v. Harvey, involves the kind of convoluted legal question that often crops up when a health insurer pays for medical treatment following a collision and then the injured party hires an attorney to sue the at-fault driver for damages. The federal judge wants the 3rd DCA to make a determination on whether the health insurance company is shielded from lawsuits for legal fees by a policyholder’s attorney if the health plan includes a provision requiring total reimbursement of benefits in the case of a third-party settlement.
Here, the accident attorney sued the health insurer for legal fees after it obtained a $150,000 judgment from an at-fault driver on behalf of an insured. Much of that money went to reimburse the health insurer. Should the health insurer be allowed to benefit from the legal legwork of the plaintiff and her attorney without having to chip in for those legal costs? The injury lawyer says no, but the health insurer said language in the policy protects it from having to pay those legal fees. Continue reading