subject: Reasons Not To Use Your Private Health Insurance For Medical Treatment For A Maritime Work Injury [print this page] Reasons Not To Use Your Private Health Insurance For Medical Treatment For A Maritime Work Injury
One of the many difficult decisions an injured Jones Act Seaman sometimes has to make is whether or not he should use his private health insurance to pay for medical treatment relating to a work injury. Sometimes his employer will actually request or instruct the injured seaman to use private health insurance to cover medical expenses relating to a work injury. This article will address the pitfalls of using private health insurance to cover injuries which fall under the Jones Act. One initial concern with attempting to use private health insurance to cover injuries under the Jones Act relates to the language of most private health insurance policies. Many health insurance policies state that the insurance does not cover work-related injuries. If you attempt to charge work-related medical expenses to your private insurance, sometimes your employer will actually claim that you were trying to commit fraud in doing so. This is true even if your employer suggests or instructs you to use your private insurance for such medical expenses. Even if you provide a clear history to your medical providers that your injury occurred at work, and your health insurance voluntarily covers your medical treatment, sometimes you will be questioned later in your claim as to why you chose to use your private health insurance to pay for a work-related injury. Also, most private health insurance policies give your insurance company a lien for any medical expenses that they pay on your behalf. A lien allows your insurance company to receive full repayment for any medical expenses which it paid on your behalf. This repayment will come out of any money or settlement that you receive for your Jones Act claim. In other words, if you are later able to successfully resolve your Jones Act claim and you receive any type of settlement or judgment, in all likelihood your health insurance company will require that you repay any medical expenses which it paid on your behalf relating to your work injury. So instead of having your employer properly pay medical expenses for which it is responsible, sometimes you ultimately end up paying back your own private health insurance for such medical expenses. Finally, there is also a practical concern with using private health insurance to cover work-related injuries under the Jones Act. In a Jones Act claim it is always important to immediately notify your employer as well as your employer's insurance company of your work-related injury. If private health insurance is used to pay for medical treatment immediately following your injury, this can sometimes delay the proper reporting of your work injury to your employer's Jones Act insurance company. Then, when a delayed claim is filed months later, your employer's Jones Act insurance company may contest your claim or dispute that it was properly reported to them in a timely fashion. It is best to immediately report your Jones Act injury and immediately require that your employer pay for all injury related medical expenses.
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