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  1. #1
    Join Date
    Apr 2020
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    22

    Default Settlement Hold Harmless Agreement vs. Trial

    My question involves an injury that occurred in the state of: New York

    The injury stems from being hit by a car before retirement and before going on Medicare.

    A settlement is being offered now by defendants' insurance whereby in addition to a general release, they are requesting a 'Hold Harmless' agreement for anything known or unknown, past or future, by lien or otherwise. All potentiality of cost or expense would be chargeable to the settlement. Medicare has already stated that they have no lien, but it appears, if I understood correctly, that Medicare may refuse to cover any future expenses if they determine they are related to the injury.

    The questions are, in order to be safe rather than sorry, if I choose to go to trial and a judgement is entered:
    1. Would I still have to 'Hold Harmless' the defendants against future medical expenses, if any?
    2. May Medicare still make a determination that future related medical expenses, if any, are chargeable to the judgement? As I understand it now, in case of future expenses, Medicare does go after defendants' insurance, and a 'Hold Harmless' agreement would shift the responsibility to me, and thus the settlement or the judgment would have to be exhausted first.
    3. Is there any other solution to my dilemma?

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

    Default Re: Settlement Hold Harmless Agreement vs. Trial

    Would I still have to 'Hold Harmless' the defendants against future medical expenses, if any?
    The judgment award might or might not specify that.

    May Medicare still make a determination that future related medical expenses, if any, are chargeable to the judgement?
    I don't think you are going to find anybody on line who tell you what Medicare can or cannot do or will or will not do. The best advice I can give you is to get a lien compromise in writing from Medicare before you agree to the settlement.

    Is there any other solution to my dilemma?
    Have an attorney review your situation and deal with the Medicare issue. Or sign what you have to sign to get the money and then live with whatever consequences (if any) come up later.

  3. #3
    Join Date
    Apr 2020
    Posts
    22

    Default Re: Settlement Hold Harmless Agreement vs. Trial

    I don't think you are going to find anybody on line who tell you what Medicare can or cannot do or will or will not do. The best advice I can give you is to get a lien compromise in writing from Medicare before you agree to the settlement. Have an attorney review your situation and deal with the Medicare issue.
    Medicare sent me a letter stating that the "insurance" must pay for medical items and services before Medicare pays per U.S.C Section 1395y(b)(A) and (B), and that Medicare makes the payments while the insurance claim is being processed, and once there is a settlement or award, Medicare is entitled to be repaid. Can someone tell me whether this law applies to future expenses? As it is, I do not anticipate any future expenses, but one of the injuries is not completely resolved but the specialist handling it recommended against surgery, and as such it is somehow considered resolved. My concern is what if surgery becomes necessary at a certain point in the future, can this law be used by Medicare to ask me to pay for the surgery. The reading of the letter seems to address expenses before a settlement or award. I cannot get a straight answer from my attorney. It seems to me he is only interested in making a fast buck. He initially said we will not give them a "Hold Harmless Agreement", now he is saying that the law requires that we give them this agreement, and when I suggested going to trial just to be safe, he came back saying that we would have to give them the "Hold Harmless" even if we go to trial. I hope this explains why I need some independent honest response from a person who has no personal interest in the case. I really appreciate all ideas and suggestions.

  4. #4
    Join Date
    Mar 2013
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    18,340

    Default Re: Settlement Hold Harmless Agreement vs. Trial

    Quote Quoting karl3712
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    Medicare sent me a letter stating that the "insurance" must pay for medical items and services before Medicare pays per U.S.C Section 1395y(b)(A) and (B), and that Medicare makes the payments while the insurance claim is being processed, and once there is a settlement or award, Medicare is entitled to be repaid. Can someone tell me whether this law applies to future expenses? As it is, I do not anticipate any future expenses, but one of the injuries is not completely resolved but the specialist handling it recommended against surgery, and as such it is somehow considered resolved. My concern is what if surgery becomes necessary at a certain point in the future, can this law be used by Medicare to ask me to pay for the surgery. The reading of the letter seems to address expenses before a settlement or award.
    Medicare is the only place you are going to get an answer to that question. Or, you can read the federal statute at:

    https://www.law.cornell.edu/uscode/text/42/1395y

    And see what you make of it. Frankly, I can't make head or tail of federal statutes.

    Quote Quoting karl3712
    View Post
    I cannot get a straight answer from my attorney. It seems to me he is only interested in making a fast buck.
    I'm sure you are right about that.

    Quote Quoting karl3712
    View Post
    He initially said we will not give them a "Hold Harmless Agreement", now he is saying that the law requires that we give them this agreement, and when I suggested going to trial just to be safe, he came back saying that we would have to give them the "Hold Harmless" even if we go to trial. I hope this explains why I need some independent honest response from a person who has no personal interest in the case. I really appreciate all ideas and suggestions.
    "The law requires."?

    I know of no law that requires it. It's the insurance company that requires it and it really doesn't matter if it's a law or not. If the insurance company says you sign it as a condition of getting the money you sign it just like you sign the standard release of all claims.

  5. #5

    Default Re: Settlement Hold Harmless Agreement vs. Trial

    can this law be used by Medicare to ask me to pay for the surgery.
    From what I understand from Medicare, they would with estimate an amount of future expence and ad that to their payback, if any. They would not hold you to expenses in the future after the date of the settlement.

    once there is a settlement or award, Medicare is entitled to be repaid
    Your attorney would have to open a case in Medicare to alert them to the settlement amount. Your account on Medicare.gov would list or show it as an MSP case you can view and monitor. Medicare would then research which of your bills apply to your settlement injury for payback.
    This also can be expedited by a lien processor, a company that can be hired to research these bills and negotiate for a lower payback.

  6. #6
    Join Date
    Oct 2014
    Posts
    8,238

    Default Re: Settlement Hold Harmless Agreement vs. Trial

    Quote Quoting adjusterjack
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    The judgment award might or might not specify that.
    No, the judgment from a trial will not have any such statement. Why? Because once the trial is done and the judgment entered, whatever the judgment amount is will be all that the plaintiff will ever get. The defendants won't be on the hook for more. A hold harmless statement in a settlement is there to prevent the plaintiff from coming back around for more since there is no trial in that case. So after a trial verdict there is no need for a hold harmless statement even if the court would be willing to include one. The trial judgment in the case already has the same effect.

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