Insurance Settlement to Native Isn’t Up for Grabs

(CN) - A hospital that treated a Native American woman pro bono, as required under federal law, cannot stake a claim to the money she wins from her insurer, the 9th Circuit ruled Thursday.

Under the Indian Health Care Improvement Act, the Alaska Native Tribal Health Consortium dba Alaska Native Medical Center did not charge Adrienne Blatchford, a Native American, for "extensive health service" when she sustained injuries in a car accident.

If Blatchford received any money from third parties, however, the consortium reserved the right to get reimbursed through a lien.

After Blatchford's insurer paid a "substantial settlement," her lawyer put part of that money aside for the consortium.

Blatchford balked, but an Alaskan federal said the consortium had a valid lien.

The federal appeals court sitting in Anchorage, Alaska, reversed that decision Friday, finding that the lower court and hospital misconstrued the law.

"That statute provides a right of recovery only against third parties," Judge Susan Graber wrote for the three-judge panel (emphasis in original).

"That wording presupposes that the provider stands in the shoes of the individual who, naturally enough, would not be receiving reimbursement or indemnification from herself," she added.

To enforce its rights with respect to potential third parties, a provider has just two options: join the individual's action or file its own action.

"The ordinary workings of this statute are uncomplicated," Graber wrote. "Because a Native American need not pay for health care services from eligible providers, she may have a diminished incentive (if any incentive at all) to seek remuneration from third parties for the provider's cost to deliver care." (Parentheses in original.)

In this case, the consortium is fighting the protected individual, the ruling states.

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