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If you have been injured in a motor vehicle accident “that is attributed to the negligence of another person” and go to a hospital emergency room, you may get more than you bargained for.

You will soon realize that the hospital emergency room intentionally does not file on your health insurance.

Instead, according to Chapter 55 of the Texas Property Code, the hospital can file a “lien” in the county the accident occurred in.

Essentially the lien notifies the public that it is owed money and gives hospitals and emergency care providers the right to be paid first when settling from a negligent third-party.

Let’s look a little deeper into how exactly a hospital lien works.

Common Practice

It is very common for a hospital or medical service provider to refuse to file on your health insurance if they know the service was due to a car accident.

Also, health insurance companies usually refuse to pay for emergency medical expenses if they know that they were due to a negligent third-party who has auto insurance available.

In situations such as that, the hospital will usually count on their lien to claim they are owed a much higher amount for their services than they would be owed if they filed on the patient’s health insurance.

This also gives hospitals the opportunity to try and charge you for the exorbitant rates, which are called the “chargemaster rates” in the hospital industry.

If the hospital has a lien on file, the negligent third-party’s insurance won’t pay the proceeds from the settlement and you will end up paying way more for your services than you should and your settlement will be greatly reduced.

Making sure you understand the legal requirements of a lien can help you be prepared the next time you are in an accident and protect you from paying more than you should.

Validation Of A Lien


In order for hospital lien to be valid, the injured person must be admitted and treated within 72 hours or 3 days after the accident.

If treatment occurred after 72 hours from the time of the accident or if a doctor did not admit you to the hospital, the hospital cannot file a lien for those services and it becomes invalid.


A lien can attach to a cause of action for damages, judgment from a Texas court, the proceeds of a settlement, and the decision from a public agency.

This essentially means that a lien can attach to your personal injury whether it goes to trial or settles.

Although, if you receive a settlement for the claim before the hospital files a lien, the lien is invalid and has no effect.

Texas auto drivers are only required to have liability insurance in the amount of $30,000.

Often times a hospital will attempt to assert their lien against your first-party liability insurance such as uninsured, underinsured, and personal injury protection.

Chapter 55 of the Texas Property Code does not allow the liens to attach to first-party insurance.

As a consequence, hospitals sometimes require a sweeping assignment of benefits to be executed by you before treatment in order to “capture” proceeds from a first party policy.


The law states that a lien can only be applied to services received in the first 100 days of hospitalization.

Any treatment beyond this cannot be included in the lien.

Section 55.004 of the statute states that a lien “may also include the amount of a physician’s reasonable and necessary charges for emergency hospital care services provided to the injured individual during the first seven days of the injured individual’s hospitalization.”

This is directed at those ER doctors who typically issue a charge separate from the hospital.

The hospital can actually act on the physician’s behalf in securing and collecting the lien.

Excessive Rates

If the charges against you are unreasonable and excessive, then the lien may be fraudulent you could get the lien released and be able to collect the third parties’ liability insurance to which you are entitled.

If you cannot get the lien released, it will at least be reduced.

If you received services from an ambulance in the first 72 hours after your injury, the lien amount cannot exceed $1000.

In Conclusion

Hospital liens can easily put an innocent patient in a very bad financial situation.

Many people become subject to them without knowing all the many factors that affect them and what validates them.

It is a good idea to become familiar with the laws behind them to protect yourself against fraud and paying much more than you ever should for emergency services.

If you’ve been a victim of the conduct described in this article, get yourself a seasoned personal injury lawyer who is familiar with liens before it is too late.