Detailed Answer
1. Identify All Potential Medical Liens
After a car crash, slip-and-fall or other injury, every provider—hospitals, urgent care centers, physicians, physical therapists—can assert a lien against your personal injury recovery for treatment related to the incident. Private health insurers and Medicaid may also seek reimbursement (subrogation) from your settlement.
2. Statutory Basis Under Missouri Law
Missouri Revised Statutes § 478.410 grants health care providers a lien on any judgment or settlement for services rendered due to a personal injury. To enforce this lien, a provider must file a written notice with the clerk of the court within 90 days after the last treatment or discharge. The lien attaches to the injured party’s recovery in that lawsuit.
Link: Mo. Rev. Stat. § 478.410.
3. Confirm Lien Validity and Amounts
Request written statements from each provider showing the date of service, billed amounts, payments received and outstanding balances. For private insurers, ask for a subrogation statement detailing benefits paid and the amount they will assert against your recovery.
4. Negotiate Reductions Before Settlement
Many providers will accept less than the full billed amount. An experienced attorney can negotiate with hospitals and medical offices to reduce the lien. Insurers may agree to lower subrogation claims once they see the net recovery and your attorney’s arguments on reasonableness.
5. Ensure Court Approval of Settlement and Lien Payment
In Missouri, a court may refuse to approve a settlement unless all liens are addressed. Prepare a proposed order listing each lien claimant, the amount to be paid and proof of negotiation or agreed reduction. Submit this order with your motion for settlement approval.
6. Distribute Funds and Obtain Releases
Once the court signs the order, the settlement administrator or attorney pays each lien holder directly. In exchange, you should receive a lien release or satisfaction document. Keep originals in your file.
7. Finalize Your Recovery
After all liens are satisfied and releases obtained, you can distribute the remaining funds to yourself (or co-plaintiffs) and close the case. Keep detailed records in case of later disputes.
Helpful Hints
- Start lien review early—before mediation or settlement talks.
- Get all lien waivers in writing before disbursing funds.
- Compare billed charges to customary rates; that supports negotiation.
- Check private insurer subrogation deadlines—some demand repayment within 60 days of notice.
- Retain copies of all court orders, releases and payment receipts.
Disclaimer: This article is for educational purposes only and does not constitute legal advice. Consult a qualified attorney for advice specific to your situation.