Navigating a personal injury lawsuit in California can be stressful—especially when health insurance is involved. If you’re covered through Covered California or another health plan, it’s important to understand how your insurance impacts your case and your final settlement. At Hillstone Law, we help accident victims protect their rights and maximize the compensation they deserve.

Health Insurance and Personal Injury Claims in California

After an accident, your health insurance—including plans purchased through Covered California—typically pays for your medical care upfront. But that doesn’t mean the at-fault party is off the hook.

Thanks to California’s collateral source rule, the defendant cannot reduce the compensation they owe you just because your insurance covered some of your bills. In other words, your insured status cannot be used against you.

This rule ensures that the negligent party remains fully accountable for your injuries.

Understanding Subrogation

While the collateral source rule protects you, your insurance company may still seek reimbursement through a process called subrogation.

Here’s how it works:

• Your health insurer pays for your accident-related treatment.
• If you later receive a settlement, your insurer may claim a portion of it to recover those costs.

This is common with Covered California plans, as well as Medi-Cal and Medicare. Without skilled negotiation, subrogation can significantly reduce the amount you take home.

How Covered California Plans Affect Personal Injury Claims

Covered California plans vary in terms of deductibles, out-of-pocket maximums, and coverage limits, all of which can affect your personal injury claim. Some ways your plan may impact your case include:

• Immediate access to care so you can document your injuries right away
• The size of your out-of-pocket costs, which can increase your claim value
• Potential subrogation claims that reduce your net settlement

Understanding your policy details is critical—and an experienced attorney can ensure you don’t leave money on the table.

Medi-Cal and Medicare Considerations

If you’re covered by Medi-Cal or Medicare, the rules are slightly different. Both programs have strict reimbursement rights and specific procedures that must be followed. Failing to comply can create legal and financial complications, making experienced legal guidance essential.

Negotiating With Insurance Providers

Negotiating with insurance companies is often the most challenging part of a personal injury case. Skilled attorneys can:

• Challenge excessive or invalid subrogation claims
• Negotiate reductions in reimbursement demands
• Maximize the portion of the settlement that goes directly to you

At Hillstone Law, we routinely handle these negotiations to protect our clients’ best interests.

Call Hillstone Law Today

The relationship between Covered California health insurance and personal injury lawsuits is complex, but you don’t have to figure it out alone. At Hillstone Law, we fight to ensure your medical needs are met while working to secure the highest possible settlement.

📞 Call us today at (310) 595-1222 for a free consultation. Let our experienced team protect your rights, negotiate with insurers, and help you move forward with confidence.