Can an Insurance Adjuster Reduce My Medical Bills Under Nebraska Law?

Disclaimer: This article is for informational purposes only and does not constitute legal advice.

Detailed Answer

In Nebraska, there is no “Rule 414” that governs an insurance adjuster’s authority to reduce your medical bills. Instead, medical bill reductions commonly arise in two contexts: (1) medical payments coverage (“MedPay”) and (2) subrogation and reimbursement when you settle a personal injury claim.

1. Medical Payments Coverage (MedPay)

MedPay is an optional part of your auto insurance policy that pays reasonable medical expenses up to a set limit, regardless of fault. An adjuster may negotiate directly with your health care provider for a discounted rate if your policy’s MedPay clause allows it. Such discounts are contractual and depend on the language of your policy, not a state “Rule 414.”

2. Subrogation and Reimbursement

If another party’s negligence caused your injuries, your health insurer (or your auto insurer’s MedPay) may seek subrogation—meaning they pay your medical bills first, then recover those costs from the at-fault party or its insurer. Under Neb. Rev. Stat. § 44-5128, after you recover money from the at-fault party, your insurer can be entitled to repayment of medical payments it made:

• They must provide you with written notice of the subrogation claim before you settle. (Neb. Rev. Stat. § 44-5128.)
• They can negotiate a reduced lien (the amount they claim) in exchange for releasing your settlement funds.

Link to statute: Neb. Rev. Stat. § 44-5128.

Often, health care providers agree to accept a reduced amount from an insurer or subrogee to secure prompt payment. An adjuster cannot unilaterally slash your bills beyond what your policy or your health plan contract permits.

Key Takeaways Under Nebraska Law

1. No Nebraska “Rule 414” governs medical bill reductions—policy terms and subrogation statutes govern instead.
2. An adjuster may negotiate discounts under MedPay only if your policy allows it.
3. Under § 44-5128, insurers can seek repayment but must follow notice requirements.
4. Your health care provider may agree to reduced payment to resolve liens or expedite payment.
5. You can negotiate with both adjusters and providers; consider consulting an attorney if disputes arise.

Helpful Hints

• Review your insurance policy’s MedPay provisions closely for language on discounts or direct billing.
• When you settle a claim, ask for written confirmation of any subrogation lien and verify the calculations.
• Talk to your health care provider’s billing office about potential write-offs or payment plans.
• Keep all correspondence with adjusters and health plans in writing.
• If you face a large subrogation demand, consider getting legal advice to protect your settlement.