Suppose you have $ 5,000.00 in medical bills which were partly paid by your medical payments coverage and partially paid by your health insurer. Do you have to pay them back? Because you paid premiums for insurance and not a loan, wouldn't you expect that you would not have to reimburse your insurers? In an ideal and fair world such would be the case. However, the reality is you may have to reimburse your medical payments coverage provider or your health insurance company regardless of how fair it might be.

• Medical Payments and Reimbursement Rights:
  There are circumstances when you would have to reimburse for payments made under the medical payments coverage provisions of your policy. It depends on several things, including whether the policy contains a provision for reimbursement as opposed to an assignment of rights, whether you have been "made whole" by what you received from the at-fault parties insurance company, and whether you and your insurance company comply with Georgia laws regarding notice. The "made whole" doctrine is a legal term of art and not easily defined or determined. The statutory notice requirements involve notifying your insurer by certified mail within 10 days of settlement of your intent to settle and the insurer responding in a timely manner in the same fashion. It is a complicated issue and if your medical expenses are substantial, you need to seek legal advice regarding how best to protect yourself from reimbursement provisions in your policy.
• Do I have to reimburse my health insurer if I obtain compensation from the at-fault party?
  The short answer is maybe. The made-whole doctrine applies for most health insurers. Unless you are made whole by the payment from the third-party then you would not have to reimburse your health insurer. The question is how do you determine whether you have been made whole. The concept has not been well defined by our courts and you should seek legal advice to protect yourself in the event your insurer has paid medical bills on your behalf. There is a group of insurers who are covered by ERISA and this area of law regarding reimbursement is in a state of evolution. The best advice is to seek legal counsel to protect your rights.
• Misceallaneous:
  There are other types of "insurers" who have reimbursement rights and/or subrogation rights. If your medical bills are paid by Medicare or Medicaid, they have a statutory subrogation right and must be paid back or you may be subject to a lawsuit.