Success in Reducing Difficult Self-Funded ERISA Plan Lien
Medical malpractice cases where the injuries may alter their life but not necessarily result in constant treatment are difficult to prove the future medicals and distinguish pain and suffering. Recently, one of our firms represented a Pennsylvania man who suffered from an MRSA infection due to medical malpractice. As a result, he totaled $661,769.86 in a Self-Funded ERISA plan lien.
This being a self-funded ERISA plan, the law and plan language would be difficult to argue. The right to full reimbursement was what the ERISA plan wanted regardless of the details of the case. The lien outweighed any recovery that the client would receive. Christina Sanalitro, Senior Lien Negotiator at MASSIVE, was able to negotiate and prove the future medicals and pain and suffering were worth validating a recovery. MASSIVE reduced the ERISA plan lien down to $317,121.80…a 52% reduction!
“ERISA plans in general are complicated to negotiate as they all feel they are entitled to full reimbursement regardless of the case details. We were able to prove them wrong, that circumstances do matter.” said Christina. “In this case we were able to establish the pain and suffering with the permanency of the injuries were warranted and needed to be compensated. My knowledge and experience reviewing ERISA plans helped to establish both and we were able to resolve the lien equitably and in favor of the client. The law firm and client were extremely pleased with the outcome.”