Detailed Answer

When you reach a settlement in a personal injury case in New Hampshire, you must clear any hospital or insurer liens before distributing funds. A lien is a legal claim against a portion of your client’s recovery to secure payment for medical services or insurance subrogation. Under New Hampshire law, hospitals can file liens under RSA 507:50–507:60, and insurers often assert contractual subrogation rights.

1. Identify Potential Liens Early

1. Review medical treatment records to list all providers, including hospitals, imaging centers, rehabilitation facilities, and ambulance services.
2. Ask the client for all health insurance and auto insurance information, including policy numbers and contact details for claims departments.
3. Check for notices of lien filed in the county where treatment occurred. New Hampshire hospital liens attach to any claim for personal injury under RSA 507:50 and must be recorded with the county registry of deeds.

2. Send Lien Inquiry Letters

• Issue a “round-robin” letter to every medical provider and known insurer, requesting a written statement of lien amount and basis.
• Include claim number, patient name, date of injury, and settlement date in your request.
• Give a reasonable deadline (e.g., 30 days) for response. Follow up if you don’t receive a timely reply.

3. Obtain and Review Lien Statements

Under RSA 507:55, hospitals must produce an itemized statement of charges. Review each statement to verify:

• The services billed relate directly to the injury at issue.
• There are no duplicate or excessive charges.
• Insurer subrogation amounts reflect only what was paid by the insurer, excluding co-pays and deductibles.

4. Negotiate or File an Action to Challenge the Lien

If a lien amount appears excessive or invalid, you may:

• Discuss reductions with the provider’s billing department or lienholder.
• File a lien dispute in the Superior Court under Rule 13 of the New Hampshire Rules of Civil Procedure seeking a hearing on the lien’s validity and amount.

5. Secure Lien Releases and Satisfactions

• After payment, obtain a signed lien release or satisfaction document from each hospital, provider, and insurer.
• Record the satisfaction with the county registry if the lien was recorded under RSA 507.
• Maintain certified copies in your file before disbursing any settlement funds.

6. Document Clearance and Disbursement

Prepare a settlement statement listing all liens paid, attorneys’ fees, costs, and net proceeds to the client. Ensure the client signs off, acknowledging receipt of net funds.

Failing to clear liens can expose you to malpractice liability and subject your client to collection actions. By following these steps, you protect both your client’s recovery and your professional responsibilities.

Disclaimer: This article provides general information and does not constitute legal advice. Consult a licensed attorney in New Hampshire for guidance about your specific situation.

Helpful Hints

• Track deadlines in a case management system to ensure timely lien inquiries and responses.
• Get written confirmation from all providers that no further bills or liens will arise.
• Remember that Medicaid and Medicare have unique lien and subrogation rules—treat them separately.
• Use template letters but customize facts for each provider or insurer.
• Consider ordering a Medicare Conditional Payment Report early to identify outstanding obligations.