Who or What is ERISA?

When an insurance company pays for your medical expenses resulting from a motor vehicle accident, it should come as no surprise that the company expects to be reimbursed from the proceeds of your settlement/judgment. The amount to be reimbursed will vary depending on the type of insurance plan and coverage you have. An ERISA-based plan stands for Employee Retirement Income Security Act, which is governed by its own set of rules.

Employer-Based Health Insurance

If you have health insurance through your employer, it is likely that you are a part of an ERISA based health insurance plan. ERISA-based plans are governed by federal law and as a result, the rules for such plans are different. This means that when you obtain a settlement resulting from a motor vehicle accident, you will likely have to reimburse your medical insurance carrier in full for the medical costs they covered. Thus, the amount of money you keep will be substantially less unless you were able to reduce or completely waive the right to reimbursement.

Keeping More of Your Settlement Dollars

However, there are certain ways to reduce the amount of reimbursement under an ERISA plan. Though technically the insurance company is entitled to reimbursement in full, the plan also considered that without your personal injury attorney pursuing settlement, they would not have received anything for your paid medical bills. Thus, the ERISA based plan is sometimes willing to work with your personal injury attorney in negotiating at least something of a reduction, even though they don’t have to. It is important to hire the right attorney that is qualified and capable to negotiate such a reduction if the ERISA-based plan is a part of your personal injury lawsuit. If you’ve been injured in a car, motorcycle, bicycle or other serious accident, contact Scott j. Corwin law offices to learn more about an ERISA based plan and what we can do for you.