What is a Hospital Lien?

Hospital liensA hospital lien is a special right granted to hospitals and emergency services providers by Statute enabling them to receive payment from the first monies recovered from a negligent third-party by the injured victim. The phrase: “hospital lien” is actually short for “hospital and emergency services lien.” It is a right that attaches automatically and is often accompanied by written notice of a hospital lien although this is not required. The lien applies only in emergency situations and to reasonable and necessary medical care provided as a result of the emergency for a set time period.

When the Hospital Lien Attaches

Under Texas Property Code 55.002(a), hospitals are automatically granted a lien (right of recovery) against “a cause of action or claim of an individual who receives hospital services for injuries caused by an accident that is attributed to the negligence of another person.”  In simple language, if you are injured due to the negligence of another such that you may bring a claim against them to recover for damages done, the hospital lien for the related care attaches to your claim. For the lien to attach, the patient must be admitted to the hospital for emergency medical services within 72 hours of the event necessitating the care. Emergency medical services are defined as “services used to respond to an individual’s perceived need for immediate medical care and to prevent death or aggravation of physiological or psychological illness or injury.”  So long as the provider has a reasonable belief that the person needs immediate medical care and provides care in accordance, the lien attaches.  The lien extends to both the admitting hospital and a hospital to which the individual is transferred for treatment of the same injury.  A similar emergency medical services lien is granted to providers of emergency services such as EMS or emergency doctors in counties with less than 800,000 residents.

To What the Hospital Lien Attaches

A hospital lien attaches to any personal injury cause of action itself as well as the settlement or judgment that results therefrom.  See Texas Property Code 55.003. It does not attach to workers compensation benefits or the injured victims own non-public liability insurance policy.  This has been held to mean that the lien does not attach to injured persons own uninsured/under-insured motorist insurance policy because it is not “public liability insurance.” It also does not apply in certain instances with railroad employers.

Amount of the Hospital Lien

A Hospital Lien a is for the first 100 days of emergency medical care provided by the initial hospital or a hospital to which the patient is transferred for care. The amount covered is only the reasonable and necessary charges for the services–it cannot exceed a reasonable rate.   “Emergency Medical Services Liens” are limited to a maximum of $1,000.00 and only cover the emergency physicians charges for the first seven days of emergency care.

Perfecting the Hospital Lien

In order to enforce the lien , it must be “perfected.”  The lien holder is required to send written notice of the lien to the patient as well as file a notice of lien with the county clerk where the services were performed.  The notice further must be filed before the money is paid to the injured party.  Thus, if after a car accident another driver’s insurance pays the injured victim before a lien is filed, the hospital has no claim against the insurance company.

Who is Affected?

Once a lien is “perfected,” everyone automatically has notice of it for purposes of the law.  This means that insurance companies paying settlements and lawyers collecting and distributing settlement funds for injured victims must check with the county clerk to see if any notice of a Hospital Lien has been filed. If they fail to locate and honor a perfected lien, the emergency services provider now has a direct cause of action against them for paying out funds without settling the lien first.  Thus, if your lawyer has notice of a hospital lien, he must negotiate and settle with them or he could be sued directly by the emergency services provider in question. The provider also retains the right to sue the injured victim as well.

What if There is No Hospital Lien Filed?

Whether there is a lien or not, you still have an obligation to pay the hospital’s bills. If you fail to do so, they have four years from the date the services were provided to sue you to collect on the bills. The Texas Hospital Lien Law simply extends the recourse that a hospital may seek to the tortfeasor, his insurance company and/or representatives and your attorney if any of them fail to honor the lien after notice is perfected.

Every case differs on its own facts. For more information about your rights, you should consult a personal injury attorney about your case specifically.


Paul Cannon

Paul Cannon has practiced personal injury trial law since 1995. He is Board Certified in Personal Injury Trial Law by the Texas Board of Legal Specialization since 2005. He has earned recognition as a Super Lawyer by Thompson Reuters in 2017-2019, and as a Top 100 Trial Lawyer by the National Trial Lawyers Association in 2017. He is a Shareholder, trial lawyer and online marketing manager at Simmons and Fletcher, P.C. His legal writings have been published by the Texas Bar Journal, Business.com, Lawyer.com HG Legal Resources, Lawfirms.com, and others. He has been asked to give educational talks and media interviews regarding personal injury law issues..