Insurance Co. Can’t Use Possible Medicare Lien as Excuse not to Pay P. I. Victim

Posted on: June 26th, 2012       Attorney Thomas Newell

A November 17, 2010 decision of the Pennsylvania Superior Court was a major victory for PA personal injury victims. A car accident victim filed a lawsuit in Luzerne County versus a negligent driver. She suffered soft-tissue injuries and her auto carrier paid for her medical bills. As of the time of trial, she had not yet exhausted her PIP medical coverage.

The Luzerne County Court of Common Pleas jury awarded her $5,000.00 for future medical expenses and $10,000.00 for her non-economic injuries. The insurance company representing the defendant demanded that it be permitted to draft a $15,000.00 check made payable to the plaintiff, her attorneys and Medicare. In the alternative, it proposed paying the money into a court fund that would only distribute the $15,000.00 verdict payment after written notification from Medicare that all outstanding Medicare liens had been satisfied.

The Luzerne County Trial Judge denied the defendant’s request and the PA Superior Court affirmed its decision. Neither the Medicare Secondary Payer Act (MSPA) nor Pennsylvania Law authorizes a private entity to assert the interests of the United States government in any context. The jury verdict and subsequent judgment in favor of the car accident victim can’t be satisfied if Medicare were to be added as a payee to the award check. The plaintiff and her attorneys were to be paid independent of any legal obligation owed under MSPA. Zaleppa v. Seiwell, 2010 PA. Super. 208 (2010)

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