Using Private Health Insurance in a Maritime Injury Case
If you are an offshore worker who has been injured on the job, you may have extensive medical bills. If your maritime employer has asked you to run your medical care through your own private health insurance, instead of offering to pay your “cure” as required under maritime law, you need to think before you act.
Problems using private health insurance to pay for injuries cause by another’s negligence:
- Health Insurance Contract Language: Chances are, you have never seen a complete copy of your health insurance policy or contract. They are long and full of language that the average person will not understand. Private health insurance policies can state that your coverage will not include on the job accidents or work-related injuries. Even if your policy allows for coverage, in the event you file a lawsuit later, the defense attorney will openly question why you ran the charges through your health insurance as opposed to the employer paying them. Meaning that if you thought your employer was at fault, they should have paid your medical bills; therefore, it can be inferred if you paid that maybe you thought it was your own fault.
- Subrogation Liens: Most private health insurance will seek to subrogate their claims for paying your benefits against the responsible party. Your private health insurance company will secure a lien for repayment of all work-related medical treatment. A lien allows your insurance company to receive full repayment for medical expenses paid on your behalf. This repayment will come out of any money or settlement that you receive for your Jones Act claim. In other words, if you are later able to successfully resolve your maritime lawsuit, and you receive any type of settlement or judgment, your health insurance company will require you to repay medical expenses it paid on your behalf relating to your work injury.
- Proving Up Employer Notification of Injury: In a Jones Act injury case, maritime employers make a big deal out of whether or not an injured worker notifies the employer quickly he was hurt. It is considered extremely important to immediately notify your employer and/or the marine adjuster for your employer’s insurance company of your on-the-job injury. If private health insurance is used to pay for medical treatment, this could be seen as a delay in proper reporting of your work injury to your employer and/or its maritime insurance company. Don’t give your employer any additional ammunition to go after you with. They will try to dispute your accident being properly reported in a timely manner.
Maritime lawyers believe that the safest and best practice is to immediately report your Jones Act injury to your employer and/or the other responsible parties, and to insist that they pay for all injury related medical expenses. For more information about your maritime injury case, email Schechter, McElwee, Shaffer & Harris, L.L.P. today at info@smslegal.com.
