QuestionI was in a car accident recently (Indiana) and between my auto insurance, health insurance, and the hospital that treated me, I've been cheated out of both the full insurance coverage I was due and out of my own personal cash. I've fought them on the matter and have reached a wall. How should I proceed?
Here's what happened:
My hospital bill was around $6200 and it was submit to both my auto insurance and my health insurance.
My auto insurance responded first, automatically paying out my plan maximum of $5000.
My health insurance then adjusted the entire bill per their contracted pricing down to around $4400, paid $1700 in coverage, AND automatically withdrew $800 from my FSA and paid it to the hospital to cover what they assumed would be an owed portion on my behalf.
Obviously, the hospital was overpaid altogether, and partly with funds of mine when I had no financial responsibility in the situation. The other overpaid party is the auto insurance, which if reimbursed would allow me to utilize the rest of my auto claim coverage for injuries that require additional treatment.
The problem is that the hospital refuses to reimburse me for the overpayments I made from my HSA. It also refuses to reimburse my auto carrier's overpaid portion to them. The hospital says that the total overpayment has to go back to my health insurance carrier according to "coordination of benefits" even though they are NOT the ones who overpaid. What this means is that my own money will be lost when I shouldn't have had to pay anything AND my auto claim coverage will have been cut short and my injuries untreated due to how the hospital insists on handling the excess balance on my account.
Please help. I just want my personal money back and I want the full auto claim coverage I am entitled to so that I can continue getting treatment on my knee and shoulder.
AnswerDanielle,
So it seems that the hospital was paid $7500, which is an approximated $1200.00 over payment. Due to the relatively small amount, you will have a difficult time finding legal help. I don't want to leave you without assistance, but there is no possible way I can guide you on this situation due to the complexity involved. This issue will need to be investigated based on the contractual language of all your policies and the subrogation and lien laws in Indiana.
I think if I were in your shoes, I would look into filing a small claims suit against the hospital and your health carrier for deceptive trade practices. Get copies of all the cashed checks and the original bill and simply prove what you say is true to a judge. That's about the best I can offer. Unfortunately I will not be able to provide you with any magic / easy fix for this one. It is infuriating.
