What About My Co-Pays?

You’ve got a top offer from the insurance company, or even a jury verdict where the jury has made an award in your case.  Now, you want to know how much of that settlement or verdict you are going to net.  Once you see your bottom line, you may wonder where all the money you paid out of pocket is, such as a co-pay at the orthopedist, or a radiology bill that did not bill your health insurance so you paid it yourself before it could go to collections. In my experience, these items are generally not listed out separately on the settlement memorandum. Rather, they are included in the net going to the client.   This is one of the frequent questions I get from clients when I am going over a proposed settlement statement with them.    

The reason for this is when a settlement offer is made, or even a jury verdict, it is in a lump sum that includes past medical bills, lost wages, prescriptions, pain and suffering, any permanent impairment or other damages owed.  Once the total amount is known, deductions are taken for attorneys’ fees, expenses, and balances owed, including any amount that may need to be paid back to your health insurance.  The remaining balance is what is due to the client.  

Since any lost wages, co-pays or amounts paid by you don’t get paid out to anyone other than you, they are in a lump sum to you.  This can actually work to your advantage as generally, personal injury settlements are not taxable.  

For example, if the settlement is $10,000, generally attorneys’ fees are 1/3, plus $150 in expenses, and you have $3,000 in medical bills and $1,000 in lost wages and had to pay $100 in co-pays, but the rest of the bills were paid by your health insurance that does not have a valid reimbursement plan, the net to you would be $6,516.67.  However, that $6,516.67 would include the $1,100 you had in lost wages and the $100 in co-pays.  

It’s always good to have an experienced personal injury attorney like the ones at the Law Offices of Jason E. Taylor, PC, to make sure that you are getting any and all settlement terms explained to you in a way that you understand.



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