MSA Amount is More Than the Insurance Company Approved

[otk]

My workers compensation claim was made in the State of: MI. my MSA came back from CMS approved, but it is way higher than the insurance company proposed. what happens next??? and also the approval took almost 3 years to get. And now that we have it, we are supposed to be settling part 2 redemption and because it was so high the insurance company is playing games. REALLY FRUSTRATING. anyone with some suggestions would be appreciated......

[otk]

My workers compensation claim was made in the State of: mi. Has anyone's MSA, came back higher and if so how has it handled????

[airdale]

My workers compensation claim was made in the State of: mi. Has anyone's MSA, came back higher and if so how has it handled????

Yes many of us have had shocking higher ones....

Mine was guessed at 75k....ended up at 152k.....Wow was I shocked!

[otk]

yeah, they said mine was 23k and came back at 458k. insurance company tried to sneak it through CMS at a low ball figure....

[controlfitter]

yea mine was higher im sure the ic tries to pull a sneak medicare reviews them. they even game an itemized finding of how the money upgrade was figured out

[otk]

My workers compensation claim was made in the State of: MI. if the insurance company doesn't fund the CMS approved MSA, what happens? does MEDICARE keep covering you until the MSA is funded ???

[tony]

My workers compensation claim was made in the State of: MI. if the insurance company doesn't fund the CMS approved MSA, what happens? does MEDICARE keep covering you until the MSA is funded ???

Your case doesn't settle, the insurance continues to pay weekly benefits and medical until you either recover 100%, return to work or die.
They could settle the indemnity side and leave the medical open, that probably won't happen.

Medicare will not cover any medical associated with a work related injury until there is an MSA setup and exhausted.

Tony

[otk]

HI Tony, I did settle the wage loss portion, but it was a two part redemption. they held a portion of my money back, until they got the CMS approval. Now that we have the MSA approved, they don't want to fund it because it came back a lot higher than they proposed. So will Medicare keep covering me until the MSA is funded. They also are playing games with the money they held back.........

[complwyr]

No, because until you settle the medical on your claim, the comp carrier is still on the hook for it. Which means that Medicare is not.

And it means that if Medicare pays any meds on your comp injury before you settle the medical, then someone---possibly you personally----- will have to reimburse Medicare out of pocket.

[otk]

HI complwyr, Why would you say me. its not my fault the insurance company took almost three years to get the paperwork to CMS. We protected MEDICARE in my settlement proposal, that the insurance company agreed to also.