Health Insurance - Charging Fees In Excess of Hospital Services Agreement
O.C.G.A. 44-14-470 (b), provides that a hospital "shall have a lien for the reasonable charges for hospital . . . care and treatment . . . upon any and all causes of action accruing to the [injured] person to whom the care was furnished. . . ."
In Labombard v. Samaritan Health System, 275 Ariz. Adv. Rep. 28 (991 P.2d 246) is an interpleader action filed by an insurer to determine whether the hospital or the patient was entitled to funds remaining after settlement with the tortfeasor.
In Dorr v. Sacred Heart Hosp., 228 Wis. 2d 425 (597 N.W.2d 462), the tortfeasor's insurer satisfied the hospital's lien over the patient's protest upon settlement of the patient's personal injury action against the tortfeasor, and the patient then sued the hospital to recover a disputed amount.
In Nahom v. Scottsdale Mem. Hosp., 180 Ariz. 548 (885 P.2d 1113), the insured's estate sued to recoup monies the decedent's two insurers paid to the hospital in excess of the flat fee the hospital had agreed to charge under its contract with one of the insurers. the contract did not contain a coordination of benefits clause.
The court held that the hospital could not recover the excess fees because the contract stated that the hospital had agreed to accept the fixed amount "as payment in full for covered services."
In Ramsey v. Sumner, 211 Ga. App. 202, 203 (3) (438 S.E.2d 676), the hospital and the patient's attorney were competing for insurance proceeds which were insufficient to satisfy both the hospital's lien and the attorney's lien.
Construing O.C.G.A. 15-19-14 (b) and 44-14-470 (b), the court ruled simply that the attorney's lien had priority over the hospital's lien.