This is another of our favorite “it depends” questions. If your health insurance is an ERISA plan then you’ll likely have to pay at least some of the money back. Multi-state employers, through some unions, etc., usually carry ERISA plans. On the other hand, if you have a local health insurance plan then the answer is that you probably will not have to pay them back. This requires an attorney putting the proper language into your settlement documents though.
If your claim is denied and your health insurance is also denying coverage be sure that you send in a copy of your Form 61. Once the health insurance company sees that your claim is denied they are supposed to begin covering your bills. You may receive a letter from your insurance company asking for details about your workers’ compensation claim. If you do, this requires a prompt conversation with a lawyer.
