If you are injured in a car accident in West Virginia and receive Medicare, what are your obligations?
Medicare is a federal program that pays for certain covered health care, for persons enrolled, who are age 65 and older or persons with certain disabilities. If you are in a car accident in West Virginia or injured in any personal injury accident, where medicare has paid for your injuries new federal laws have set out obligations for the injured person and their attorney.
Previously, your attorney had a duty to contact Medicare, if Medicare paid medical bills which was caused by the negligence of someone's else and you recovered a settlement.
Now in order to ensure that Medicare can recover funds they have paid for your injures which an insurance company is responsible the government requires insurance companies to inform the government about your claim. Medicare in these situations is considered a secondary payer and liability insurance companies are required to collect and report data elements to Medicare, under Section 111 of the Mandatory Medicare Secondary Payer Reporting.
This all started on July 1, 2009, under the "Medicare, Medicaid and SCHIP Extension Act of 2007" or MMSEA, which is the date for new reporting requirements. After January 1, 2010, the new rules will apply all settlements on or after January 1, 2010.
What does this mean for a person involved in a personal injury for which a liability insurance company is responsible for your damages?
It means the liability insurance company must report items which were previously thought confidential, such as your social security number, the alleged cause of your injury, and the personal injury settlement information. This information is then disclosed by the insurance company to Medicare.
The new Mandatory Medicare Secondary Payer Reporting provisions of Section 111 can be confusing and anyone involved in a serious personal injury, for which liability insurance is responsible, will need to contact an experienced attorney who can protect your interest regarding all reporting requirements
Key Legal Takeaways & Summary
Essential West Virginia Legal Principles Established in This Case:
- •This analysis of "If you are injured in a car accident in West Virginia and receive Medicare, what are your obligations?" highlights the essential legal protections and obligations established under West Virginia civil and statutory law.
- •Under West Virginia's modified comparative negligence framework (W. Va. Code § 55-7-13a), an injured motorist may recover damages provided their degree of fault does not exceed 50%.
- •Preserving physical evidence—including vehicle electronic data recorder (EDR) logs, witness statements, and accident reconstruction data—is vital immediately following a collision.
Frequently Asked Questions
Common questions and legal analysis regarding claims under West Virginia law:
What steps should I take immediately after a motor vehicle accident in West Virginia?
Seek prompt medical attention, ensure law enforcement completes an official crash investigation report, document scene photographs, and avoid providing recorded statements to insurance adjusters before consulting counsel.
How does comparative fault affect car accident settlements in West Virginia?
West Virginia follows the 51% bar rule: if a driver is determined to be 20% at fault, their total damages are reduced by 20%. If they are found 51% or more responsible, recovery is completely barred.
Related Practice Resources & Analysis
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