Liens and Subrogation in Auto Accident Cases

By: Roger D. Horgan

Medical liens and subrogation. These obscure misunderstood words can have a dramatic impact on the victim of automobile negligence. These concepts come into play when the victim’s auto insurance is insufficient to pay all of the medical expenses arising from an accident. After the auto coverage has been exhausted, the victim’s health plan will step in to pay the remaining bills, under the terms of that plan. The health plan’s claim well then seek reimbursement from the proceeds of the accident litigation, also known as enforcing a lien or seeking subrogation.

The problem with medical liens is that they can overwhelm a case and lead to negative and unjust results. If the defendants liability coverage is inadequate, and the health plan insists on 100% reimbursement of what it paid, the true victim may bear the shortfall and be left with little or nothing. Many accident victims are sorely disappointed to find that they must reimburse their health insurance company even though they have paid for that coverage.

The lienholders have enormous power over the resolution of the case and how much the accident victim ultimately receives. The best way to prevent being held hostage in this manner is to purchase as much uninsured and underinsured motorist protection as you can possibly afford. This enlarges the pot from with you and the lienholder are paid, and it increases the likelihood that you, the accident victim, can be fully and fairly compensated.

ZUber v. Boscovs–A Lesson in Completeness

By: Douglas A. Williams

In Pennsylvania, if an injured worker and his employer wish to settle a workers’ compensation claim, they must do so with a document known as a Compromise & Release Agreement (C&R). The C&R is typically prepared by the attorney that represents the insurance carrier. The injured worker’s attorney then reviews the C&R and makes any changes that are necessary. Ultimately, the C&R is presented to a Workers’ Compensation Judge. The injured worker must appear before that Judge and convince the Judge that he understands the terms of the C&R. If the Judge believes that the injured worker does understand the C&R, the Judge will issue an order approving the C&R and, at that point in time, the employer must issue payment to the injured worker in accordance with the terms as outlined in the C&R.

In a recent Federal Court case, Zuber v. Boscov’s, the United States Court of Appeals for the Third Circuit ruled that the existence of a C&R did not prevent the injured worker from suing his employer under the terms of the Family Medical Leave Act (FMLA). Mr. Zuber sustained a work-related injury in August of 2014 while working for Boscov’s. He returned to work shortly after the injury and Boscov’s ultimately terminated his employment approximately a month after the injury. The following year, Mr. Zuber and Boscov’s entered into a C&R resolving all aspects of his workers’ compensation claim. Subsequently, Mr. Zuber filed suit against Boscov’s in Federal Court. In his suit, Mr. Zuber claimed that Boscov’s had violated the FMLA. Boscov’s moved for dismissal of the suit claiming that Mr. Zuber, by entering into the C&R, had waived his right to file suit under the FMLA. The District Court agreed with Boscov’s and dismissed Mr. Zuber’s claim. However, on appeal, the United States Court of Appeals for the Third Circuit reversed that decision and held that Mr. Zuber, by signing the C&R, had only released his rights to workers’ compensation benefits. The Court held that the C&R did not prevent Mr. Zuber from suing Boscov’s for a FMLA violation or, for that matter, for any other cause of action unrelated to the Workers’ Compensation Act.

It is important to note that Zuber v. Boscov’s does not prevent an employer from insisting that an injured worker sign a General Release separate and apart from the Compromise & Release Agreement that resolves a workers’ compensation case. In fact, this is frequently done in workers’ compensation cases. General Release documents often include language in which the injured worker not only resigns his employment but forfeits his right to bring suit against the employer for any reason. Again, this document is separate and distinct from the C&R and is not reviewed by the Workers’ Compensation Judge. Some employers will refuse to resolve a workers’ compensation case unless an injured worker signs such a General Release. Of course, the injured worker has the right to refuse to sign the General Release. However, this may mean that the workers’ compensation case will not resolve without litigation.

At Abes Baumann, we strongly discourage our clients from signing General Releases, or any other documents, before they have the opportunity to speak with a competent employment lawyer who can advise them as to whether or not signing such agreement is a wise decision. If you are considering settling your workers’ compensation case and are concerned that your employer may try to pressure you into signing a General Release, please contact our firm to discuss the matter further.


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