CALIFORNIA HOSPITAL LIENS: Can a hospital recover more, beyond what it agreed to accept from my private health insurance carrier, when I get a California personal injury settlement? (Also known as the " Nishihama Rule" )

No, it cannot!
 
A hospital makes bargains and contracts with different health care providers.  If your health insurance carrier covered the hospital bill in full, the hospital cannot come after more funds from you; for example, your personal injury settlement.  Why? Because the contract between your health plan is between the hospital and the health plan and has nothing to do with you. This contract takes you out of the equation, totally.  The hospital benefits under this arrangement too, because it gets cash right away from your health plan, the health plan has the hospital as a "network provider" and advertises the hospital in its own marketing brochures.  The health plan benefits as well because the hospital allows the health plan to pay much less in what was actually charged.  You see, it is a circle of benefits going on here, behind the scenes!

Here is the law on it:
 
Nishihama v City & County of San Francisco, 93 Cal.App.4th 298 (2001)  Hospital's right to recover on hospital lien does not extend beyond the amount it agreed to accept from insurance co as payment in full for services to the injured plaintiff. Cites and follows Hanif and extends it to private insurance context.


Mark C. Blane is a San Diego Auto Accident Attorney, and the managing lawyer of the Law Offices of Mark C. Blane, a San Diego, California Personal Injury Law Firm devoted to representing families of injured persons of automobile accidents. If you or someone you love, has been injured or killed in San Diego County, or Southern California, due to the negligence of another, please order your FREE copy of Mr. Blane's book, The 10 Secrets You Need To Know About Your Injury Case, BEFORE You Call A Lawyer. It is full of helpful information, insights, and secrets that will help you protect your legal rights.  It normally sells for $16.95; however, it is free to all California residents, or those injured in a California accident.