Can My Private Health Insurance Be Used Under the Jones Act?

If you are an offshore maritime worker and you suffercompany has a lien or right to be repaid any money
an injury at work, very often you will be faced with thethat they pay for medical treatment in the event that
decision of whether or not you should use your privateyou recover money from a third party. In other words,
health insurance to pay for medical treatment relatedeven if your health insurance company does pay for
to your work injury. The Jones Act will typically applymedical treatment relating to your injury, when you try
to your case, and there are at least three importantto resolve your claim or you present your claim in
reasons that you should not use your own privatecourt, your health insurance company will require that
insurance to pay for medical treatment relating to ayou repay them for any medical expenses which they
maritime injury.covered. Sometimes this lien can make it difficult to
One concern with attempting to use your own privateresolve your Jones Act claim with your employer
insurance to pay for a work-related maritime injurysince you essentially owe your own insurance
relates to the language of your insurance policy. Manycompany money out of any potential settlement that
private health insurance policies contain language whichyou may receive.
states that the policy does not provide coverage for aOne other concern with using your private health
work-related injury. Very often maritime employers willinsurance to pay for medical treatment relating to a
request or even instruct an injured employee to useJones Act injury is a practical effect that using your
their own private health insurance to pay for medicalprivate insurance has upon your claim. Many Jones
treatment relating to a work injury. If the employeeAct employers will have the injured employee use his
does not fully describe to his doctors that his injuryprivate insurance for months and months of medical
occurred at work, sometimes the employer will latertreatment following the original injury. This can
claim that the employee was essentially committingsometimes delay the official filing of a claim under the
fraud by using his private health insurance to pay for aemployer's Jones Act insurance. Even though the
work-related injury. In short, your employer may try toinjured Jones Act employee has done nothing wrong,
accuse you of trying to cheat your own private healthmany times it is difficult to move a claim forward if the
insurance if you try to obtain medical treatment for aemployer's insurance company was not made aware
work-related injury through your private insurance.of the claim until months and months later. It is always
Many employers will do this even if the employer itselfbest to immediately report any type of Jones Act
requested for you to use your own private healthinjury and also require that your employer pay for all
insurance!medical expenses rather than putting these expenses
Also, most health insurance companies have languageon your own insurance.
in your insurance policy which states that the insurance