Mississippi Insurance Law – Part 5

Mississippi Insurance Law – Part 5 MISSISSIPPI Insurance-Related Law  — An A to Z Guide Here’s the next post sharing our 2016 update.  If you like a full copy or have any questions, please email or call. License Suspension Upon the request of a plaintiff or his attorney in a case involving an automobile collision, a losing defendant’s license will be suspended if a judgment is not paid within 60 days and the plaintiff’s attorney requests that it be suspended.  Miss. Code Ann. § 63-15-25 through 63-15-35.  The statutes permit the lifting of the suspension for agreed upon installment payments.  The statutes only require the satisfaction of a judgment up to the minimum insurance limits required by law. Liquor Liability Mississippi has a statute which provides immunity from liability of those who lawfully sell or supply intoxicating beverages by permit.  However, this liability limitation does not extend to the holder of an alcoholic beverage permit, his agent, or employee who sells to a visibly intoxicated person.  Miss. Code Ann. § 67-3-73. Social hosts are also immune from liability for serving or furnishing alcoholic beverages to persons who may lawfully consume such beverages.  Further a social host is not liable for those that consume alcohol on his premises and in his absence.   These immunities do not apply if alcohol consumption is forced by the host or he falsely represents that the beverage contains no alcohol.  Miss. Code Ann. § 67-3-73. An adult is prohibited from permitting a party to take place at their home if they are aware that minors are obtaining or consuming alcohol.  Miss. Code Ann. § 97-5-49 Liens Medicaid Medicaid has a statutory right of recovery from the beneficiary and from third persons or entities that a beneficiary has a right to sue.  Miss. Code Ann. § 43-13-125(1) and § 43-13-305.  Effective 2014, the Mississippi Division of Medicaid has contracted with Health Management Systems, Inc. (HMS) to be the primary contact for all casualty recovery inquiries.  Contact information:  HMS Mississippi Casualty Recovery, P.O. Box 1350, Jackson, MS 39201-9820; 855-547-4984; missubro@hms.com. Medicare Medicare claims to have a superior right of reimbursement, which may be helpful to think of as a “super lien.”  Medicare is controlled by federal law.  See 42 U.S.C. § 1395y(b).  This means that Medicare is not required to notify anyone of its right to reimbursement, nor is it required to make a request for reimbursement in order to enforce its right to recovery.  Instead, the parties to a liability claim must notify Medicare of the claim, take action to determine the amount of the reimbursement and make payment accordingly.  This includes reimbursement for past treatment as well as protection of Medicare’s interests when future treatment will be necessary. the amount of the reimbursement and Hospital/Medical Unlike some other states, Mississippi has no general statutory provision for a “hospital lien,” “physician lien,” or “medical lien,” nor does there appear to be any case law creating a medical provider’s equitable lien on insurance benefits because of medical services rendered.  Memorial Hospital at Gulfport v. Guardianship of Proulx, No. 2012-CA-01714-SCT (Miss. September 12, 2013).   See also Assignments.  Mississippi law only permits a transfer of benefits for medical costs by assignment. In 2013, Mississippi created a lien in favor of providers of burn care.  See Miss. Code Ann. § 85-7-301, et seq.  There are specific procedures that must be followed regarding notice of such lien.   ERISA In some cases, payment of medical bills or other benefits may have come from an insurance plan subject to the Employee Retirement Income Security Act of 1974 (ERISA).  Although not a “lien,” most insurance plans have a contractual provision providing that they have a right to repayment or subrogation should the insured receive money from a tort settlement or judgment. ERISA is codified at 29 U.S.C. §1001 et seq. and has broad application to most every conceivable employer sponsored health insurance plan with certain exceptions for plans described in §410 (c)(1)(A-D) (church plans, government plans, and trade association plans) and those exemption by the “safe harbor” provisions prescribed by the Secretary of Labor.  See 29 C.F.R. § 2510.3-1(j) (1993). ERISA in and of itself does not have a provision requiring subrogation or giving an insurance company a lien on settlement/judgment proceeds.  Typically the right of recovery for an ERISA plan is governed by the insurance contract.  In  Yerby v. United Healthcare, 846 So .2d 179 (Miss. 2002), the Mississippi Supreme Court held that the made whole rule is not the default rule in an ERISA plan.  The Fifth Circuit has likewise rejected the made whole rule where it was not included in the ERISA plan, and held that a clear and unambiguous subrogation/reimbursement provision entitles an ERISA plan to the full amount of medical benefits paid on the insured’s beha

Source: Holcomb Dunbar Mississippi Insurance Law – Part 5 – Holcomb Dunbar

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