This case involved a self-funded ERISA plan participant who was injured in a motor vehicle accident. The plaintiff was injured when the car in which he was riding was rear-ended by the tortfeasor. The plaintiff incurred significant injuries which resulted in a healthcare subrogation claim, in the amount of $26,669.18, being asserted by the self-funded ERISA plan. The plaintiff’s attorney engaged Synergy Lien Resolution Services to resolve the subrogation/reimbursement claim that was being prosecuted by The Rawlings Company on behalf of Aetna and the employer group. Rawlings is a third party recovery vendor for Aetna, but despite this status they attempted to avoid dealing directly with Synergy by advising plaintiff’s counsel that they “limited communication” with lien resolution groups and offered a nominal reduction. Wise plaintiff’s counsel did not fall for this ruse. Synergy then negotiated directly with the Plan Administrator and within three (3) weeks had secured a reduction of 50% from Plan Administrator. This was a savings of $13,334.59 to the injured plaintiff.
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