I’m currently in the process of settling out on a worker’s comp case.

I’m currently in the process of settling out on a worker’s comp case. The attorney for the insurance co. has drafted up the compromise and settlement agreement and all we need to do is sign and return then wait 30 days to receive our check. There is one clause in there that has me concerned, my attorney has explained her position on this but without going into that I would like to know what someone else would do in my situation. The clause states this;

c. Applicant agrees that the satisfaction of any existing or future medical liens or expenses for any care and treatment to Applicant, arising out of the alledged industrial injury of 7/09/09 shall be the sole responsibility of the Applicant. This includes, but is not limited to, any leins, claims for reimbursement, recapture leins, claims for balance billing, or rights of recovery asserted by medicare, the Arizona Health Care Cost Containment System (AHCCCS) any hospital, any physician, any insurance company, any health plan, or any Employment Retirement Income Security Act (ERISA) qualified plan or program.
d. Applicant agrees to protect, indemnify and hold harmless the Defendant Employer and Defendant Insurance Company, and their predecessors and successors in interest, from any claim for un-reimbursed or under-reimbursed medical expenses or unpaid liens, including, but not limited to, recapture liens, claims for balance billing, rights of recovery, hospital liens, or any other liens arising out of the incidents occurring on 7/09/09, including any attorney’s fees incurred in defending against any claim or claims for expenses arising out of the accident occurring on 7/09/09.

Now what i would like to know is whether this is a standard clause in this type of settlement, and also in the verbage of this clause does this give the defendant and/or their attorney the ability to hold my settlement check in lieu of the possibility of any future leins or claims for unpaid bills etc.? I just wonder if this is some kind of hidden trick of semantics that could give them the power to delay the issuance of my check. I am considering asking the defendants attorney to include the following paragraph at the end of chapter d.;

“Nothing in this paragraph will delay the issuance of the settlement check in the amount of $350,000.00 once the decision becomes final (as described in paragraph 16). The defendants cannot and will not hold the applicant liable for any attorneys fees incurred prior to the decision becoming final or the issuance of the settlement check.”

I don’t mind dealing with any future claims that may arise out of this accident, I’m just concerned that the verbage in this clause will give the attorney free reign to hold me responsible for all prior fees from this case and deduct those fees from my settlement check and/or hold my settlement check past the standard 30 day period and make it impossible to ever see my money based on the possibility that some day there may be another claim that comes up?
So; 1) Is this clause something I should be concerned with?
2) Was the additional paragraph request reasonable?
3) If they refuse to add the additional paragraph, could I still sign the agreement and not be worried about getting bilked out of my settlement?

Thanks for your time and sorry for the lengthy question, I just didn’t know how else to ask it?

One thought on “I’m currently in the process of settling out on a worker’s comp case.

  1. No competent specialist in Arizona workers’ comp law will answer this question without a lot more information, but I will tell you that I have grave concerns. If you are indeed settling for such a large sum, there is a substantial chance that you are accepting responsibility for bills, liens or other claims on your settlement money, and you need to know what those things are.

    With such a large settlement, I think it makes sense for you to pay an attorney a reasonable hourly fee (I charge 250/hr) for a couple of hours of his/her time, to make sure you aren’t making a mistake. I get the impression, however, that they are concerned about medical providers and/or prior attorneys who may have a claim to part of your settlement, and they may be right!

    Thomas Stillwell
    Stillwell Law Office, PLLC
    P.O. Box 93007
    Phoenix, AZ 85070-3007

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