Hospital Liens vs. Health Insurer Claims in Connecticut

By the FigureMyTax Editorial Team · How we calculate

A Connecticut hospital or ambulance lien is on the proceeds of the liability policy, is effective only after written notice to the insurer before payment, and is limited to the actual cost of services. A health insurer's repayment claim is largely barred.

Who has the lien

General Statutes 49-73(a) gives a lien to a tax-exempt hospital, an ambulance owner or operator, or a hospital owned and operated by a municipality or the state that furnished medical services or materials to a patient injured by an accident not covered by workers' compensation. It is a lien on the proceeds of any accident and liability insurance policy issued by a company authorized to do business in the state, to the extent of the actual cost of the services and materials.

Notice is required

The lien works only if, after services begin and before the insurer pays, the provider serves written notice by registered or certified mail on the insurer at its home or branch office, or on the Insurance Commissioner if the insurer is out of state. The notice is in duplicate and states the injured person's name, the insurer, the amount spent and an estimate of the amount to be spent.

Payment and disputes

When the insurer's liability has been fixed, it pays the hospital directly the amount due, if all interested parties agree on the amount (49-73(b)). If they do not agree, either side may bring an interpleader action in the judicial district where the provider is located. We found no percentage cap in the statute.

Private providers

A provider that is not a tax-exempt, state or municipal hospital or an ambulance operator does not have this statutory lien. It may still bill you and may have contractual rights, so ask for an itemized bill and any lien paperwork.

How an insurer's claim differs

A health insurer's claim is not created by this section. Under 52-225c a collateral source insurer is generally not entitled to recover from your claim unless another law provides otherwise; see our collateral source post. Medicaid and Medicare follow their own rules; see the Medicare and Medicaid post.

Run the numbers

Enter the hospital's claim, and whether it served timely notice, in the Connecticut medical lien calculator.

This is general information, not legal advice, and the state comparisons above are illustrative, not an exhaustive survey. Confirm how Connecticut's rules apply to your specific case with a licensed Connecticut attorney.