Third Party Liability

All work-related injuries and others responsible for your injury need to be documented. Under certain circumstances, others may be liable for medical expenses you incur.

Kaiser Permanente will provide you with services even if you were injured through the fault of someone else. If you collect any money from the other person or from his/her insurance company, you will be required to reimburse Kaiser Permanente (or its designee) at non-member rates for medical care Kaiser Permanente provided you for that injury or illness, up to the amount you (or your estate, parent, or court-appointed guardian) receive from the settlement or judgment. Kaiser Permanente shall have a lien on the settlement or judgment for the purpose of that reimbursement.

Payment will be made for covered emergency care services received from out-of-plan providers even if you were injured through the fault of someone else. If you collect any money from the other person or from his or her insurance company, you will be required to reimburse Kaiser Permanente (or its designee) for those payments Kaiser Permanente made for medical care provided to you for that injury or illness, up to the amount you received from the settlement or judgment. Kaiser Permanente shall have a lien on the settlement or judgment for the purpose of that reimbursement.

At Kaiser Permanente’s request, you shall execute lien forms directing your attorney or the other person to make payments directly to Kaiser Permanente from the proceeds of the settlement or judgment. If Kaiser Permanente institutes legal action to enforce its lien, the party that substantially prevails shall be reimbursed for the reasonable costs of collection, including attorney fees, by the other party(s).

This provision applies even if the total settlement or judgment you receive is less than your action damages. It is your responsibility to notify Kaiser Permanente of any actual or potential claim or legal action you anticipate bringing or have brought against the other person within 30 days from the date of filing a claim or legal action against the other person.