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  1. #1

    Default Can I Get Reimbursed for My Attorney Fees if a Suit is Based Solely on Errors

    My question involves insurance law for the state of: New York
    A rehab sued to collect money for part of mom’s stay. The last 6 months mom was there, although all 6 were approved & 1 out of the 6 months was paid in full by error, her days of coverage expired under her private primary insurance. We weren’t aware til 2 months post discharge. Instead of dealing with provider services to recover payment, Medicare was retroactively billed leaving us around $11,000 in co-insurance charges. The lawsuit then increased as the primary insurance requested reimbursement for the month paid in error. On another instance 3 months prior to the dates of the suit, the primary stated $16,119.27 was paid, but only wrote a check for $4,464. Instead of recovering the difference, again Medicare was billed when they shouldn’t have been. This effected the 20 day co-insurance grace period factored into the settlement amount. I spoke with a supervisor at the primary insurance company who saw all the pre-approvals & stated it was their responsibility to pay what was approved, regardless of date last insured. They issued a check for over $43,000 to cover the cost of approved, not paid by the primary & ultimately paid by Medicare. There’s now around $30,000 in double payments! No need for this lawsuit! Had the insurance not mistakenly approved 6 months & miscalculated payment for another month, the problems wouldn’t have started. Had the nursing home contacted provider services to collect the money, there would be no suit! I straightened this entire matter out doing something they should have done 2 years ago! Do I have grounds to request reimbursement of my $3,000 attorney fee?

  2. #2
    Join Date
    Mar 2013
    Posts
    18,340

    Default Re: Can You Recover Your Attorney Fees if a Collection Suit is Based on Errors

    Your post is incredibly confusing and I have no idea who did what to who and why they did it.

    Quote Quoting LongIslandDisciple
    View Post
    Do I have grounds to request reimbursement of my $3,000 attorney fee?
    That's a question you should be asking your attorney.

    But my gut tells me that nobody is going to give you any money without a judge ordering them to. And to get to that point even if remotely possible (unlikely) you'd have to spend several thousand on an attorney to take it back through the courts.

  3. #3

    Default Re: Can You Recover Your Attorney Fees if a Collection Suit is Based on Errors

    In a nutshell, the primary insurance company approved a 6 month stay when there actually were no days left of coverage. Instead of contacting Provider Services to question no payment, the nursing home filed with Medicare then sued me for patient responsibility. I called member services at the primary insurance and they released all pre-approved payments, which is what the nursing home should have done 2 years ago. Primary insurance sent a $43,000 check to the nursing home for those 6 months approved but not paid! There are other things the nursing home did not follow procedure on but for brevity and trying to not lose people reading this, I'm omitting. The point is, due to negligence of the nursing home suing me, can I file in small claims court on my own providing a paper trail of negligent practices and request the money spent in legal fees?

  4. #4
    Join Date
    Oct 2014
    Posts
    8,238

    Default Re: Can You Recover Your Attorney Fees if a Collection Suit is Based on Errors

    Quote Quoting LongIslandDisciple
    View Post
    My question involves collection proceedings in the State of: New York
    Do I have grounds to request reimbursement of my $3,000 attorney fee?
    What were the attorney’s fees paid for, i.e. what services did the attorney provide, and for whom? Who paid those attorney bills? You? Your mother?

    Very generally in most states the rule for litigation is that each party bears his/her own expenses unless they have a contract between them in which the contract states that the loser will pay the winner’s legal fees. A few states have a different rule for contract cases, but NY is not one of them. If all the claims arising from this have been settled, you may find that the settlement documents preclude seeking any more out of this even if you might have otherwise been entitled to the attorney’s fees. So read the contract and read any settlement documents you have to see what they say.

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