About a million issues can arise when attempting to settle your lawsuit. You should not try to do it yourself. Just, by way of example, below are some that mandate that you need an attorney when settling a lawsuit.
MEDICARE SET ASIDE ISSUE IF APPLICABLE
I understand and agree that Medicare may deny payment of my future medical care for the injuries related to the Action if I do not consider Medicare’s interests by setting aside a sufficient amount of money, called an allocation, to pay for such Medical care.
I suffered personal physical injuries and damages were sought in the Action for said injuries, I have received money damages for these injuries; and, at least a portion of my money damages was, or may have been, paid to me for my future medical costs related to the Action.
I have been informed by my attorney of my potential obligation to consider Medicare’s interests as they relate to my future medical care that may be needed due to this claim. They have explained that the treatment of these injuries may be covered by Medicare and therefore, I may need to consider the use of a Medicare Set Aside.
I agree and understand that Medicare is always secondary to all forms of insurance including liability insurance, self-insurance, no-fault insurance, and workers’ compensation coverage. I agree and understand that Medicare does not allow the cost of future injury-related medical care to be shifted to the Medicare system when there is a primary payer such as liability insurance, self-insurance, no-fault insurance, and workers’ compensation coverage.
I agree and understand that Medicare considers a portion of my money damages for future medical care that is Medicare-covered. I agree and understand that Medicare may require me to use the portion of my money damages that were paid to me for future medical care that is Medicare-covered to actually pay for such care that would otherwise be paid for by Medicare.
I agree and understand that Medicare may deny payment of my future medical care for the injuries related to the Action if I do not consider Medicare’s interests by setting aside a sufficient amount of money, called an allocation, to pay for such Medical care. I agree and understand that a denial of Medicare payment or coverage would not be in my best interests and could result in substantial harm to me.
I am fully satisfied with the adequacy of all the information received from the Law Firm and acknowledge and confirm that the Law Firm is in no way responsible for my decision at the time of signing this document nor at any time in the future; I also hold the Law Firm harmless from any and all harm or damages that might result from my decision to not consider Medicare’s interests.
By my signature below: I confirm the above; acknowledge the same; and, accept the full consequences and potential harm of my decision to accept my settlement/judgment/award monies without setting aside a sufficient amount to pay for any future Medicare-covered medical care related to the Action.
RECEIPT OF MEDICAL RECORD ACKNOWLEDGEMENT
The undersigned hereby acknowledges receipt of all medical records and medical equipment in the possession of Massey and Duffy, P.A., as of the date of signing below. It is understood that no copies of these records are being retained by the firm and the records would have to be provided to the firm in the event of any future contact.
LIEN PROTECTION AND HOLD HARMLESS RECORD ACKNOWLEDGEMENT
The clients agree to hold harmless the law firm of Massey and Duffy, P.A. any unpaid and disclosed liens to which the law firm is not aware of by virtue of any contractual relationship and agree, as additional consideration and inducement for this compromise and settlement, that the client shall satisfy all past, present, pending, existing, potential and future liens or claims of liens and/or subrogation claims for damages arising out of the incident complained of, or such payments or benefits made hereafter, against the released parties or the settlement proceeds out of such proceeds upon their receipt.
NO LIEN REPRESENTATION
The client agrees that it has not been notified of any liens on his case, from Shands, any medical provider, any insurance company, or otherwise. The client has not informed the Firm of any liens on his file for any medical claims.
NO LIEN/MEDICAL BILL RESOLUTION
The client agrees that the Firm will not be representing the client for the purposes of resolving any medical bills or other costs that may (or may not) be associated with the client. After the funds are distributed to the client, the Firm’s representation will cease.
The Claimant acknowledges that his/her attorney has specifically advised and recommended prior to the settlement, that he/she consider taking funds in an annuity such that the money would be paid monthly in a sum certain and the attorney further suggested that the Claimant consult an accountant to maximize certain tax advantages of such an annuity.