Handling ERISA (Employee Retirement Income Security Act) liens can be a challenging process, especially when faced with lien amounts that threaten to consume the majority of the settlement paired with the plan’s strict reimbursement language. In this case, Lucia Giglia tackled a massive $2,081,777.76 ERISA lien with a plan asserting full reimbursement rights and successfully reduced it to $0.00.
Here’s how she did it.
The Initial ERISA Lien Investigation
When the case was referred to Precision Resolution, the ERISA lien had already been reported by plaintiff’s counsel and had an interim lien amount of $1,470,102.63.
However, upon Lucia’s request to the recovery contractor for an itemized breakdown, she found the ledger to be incomplete, making it impossible to assess the accuracy of the lien amount.
Uncovering Additional Charges
Once the full itemized ledger was received, Lucia discovered that the lien had increased to $2,081,777.76—over $600,000 more than originally reported. While it is not uncommon for lien amounts to increase over the course of litigation, especially in instances in which the plaintiff is still being treated, it is critical to review the itemization for accuracy in the treatments billed. In instances of prolonged litigation, plaintiffs with comorbidities, or both, it is not uncommon for recovery contractors to include claims unrelated to the cause of action in the lien itemization.
Here, Lucia identified several issues with the increased lien amount:
- Claims dated before the Date of Incident (DOI)
- Medical charges unrelated to the liability case
- Lack of clarity on which charges were directly associated with the case
The Dispute Process: Challenging Unrelated Claims
The removal of unrelated claims from a lien amount is not the only strategy for reduction of the lien, but, in many instances, it can offer the clearest path to a reduced amount.
Lucia went to work reviewing medical records and extracting specific admissions, discharge summaries, and physicians’ notes to establish the basis of her dispute of claims.
As a result, the lien was reduced to $1,189,123.86, marking an initial savings of nearly $900,000. However, Precision Resolution’s job was not complete. Many claims that Lucia determined to be unrelated remained on the itemization.
Round Two: Pushing Back Against Unjustified Charges
We challenged the remaining unrelated claims again, but the recovery contractor refused to remove them, alleging that medical coding classifications linked them to the case.
Not willing to accept unjustified charges, Lucia continued to demand the removal of all unrelated claims.
The Breakthrough: Requesting a Complete Lien Waiver
With the contractor unable to confirm the validity of the remaining charges, we took a bold approach:
- We requested that they reduce the lien to $0.00.
- We asked them to officially close their file.
- We provided strong legal reasoning for dismissing the lien entirely.
The Final Victory
As a result of Precision’s persistence and expertise in ERISA lien resolution, the contractor complied with our request and closed the file. The final lien amount? $0.00.
Key Takeaways for Law Firms & Beneficiaries
This case highlights the importance of thorough lien investigation and aggressive dispute resolution when dealing with ERISA liens. Here are some critical lessons:
- Always request a complete ledger—an incomplete itemization can hide unrelated claims.
- Challenge unjustified medical codes—coding errors can inflate liens with unrelated charges.
- Do not accept partial reductions if unrelated claims remain—push for full removal.
Putting an Additional $2 Million into the Plaintiff’s Pockets
Successfully navigating ERISA liens requires a deep understanding of plan language, medical coding, and dispute resolution strategies. Precision’s ability to analyze, challenge, and persistently negotiate resulted in a complete lien dismissal, saving the plaintiff over $2 million.
If you’re dealing with a complex ERISA lien and need expert assistance, contact Precision today to discuss how we can help you achieve the best possible outcome.
Precision Resolution offers premier outsourced lien resolution services for attorneys aiming to enhance client services, achieve optimal case outcomes, and maximize settlements for plaintiffs.
About the Author
Lucia Giglia is a highly dedicated Case Manager at Precision Resolution, with 10+ years of experience in the legal field. She brings a wealth of knowledge and expertise to her role, facilitating the smooth and efficient management of complex legal cases. To contact Lucia, email her at giglia@precisionlienresolution.com.