§ 8.01-27.4.Civil recovery for professional services.
Chapter 3. Actions · Article 2. Actions on Contracts Generally · Last amended 2005 · Last verified July 16, 2026
In one sentenceSection 8.01-27.4 lets a licensed professional recover the amount of an insurance payment, plus a penalty of the lesser of $250 or three times that payment, from a patient who receives payment from their insurer for the professional’s services but fails to forward it within thirty days, provided the professional sent an invoice beforehand.
Full Text of § 8.01-27.4
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In the event any insured or enrollee of an accident and sickness insurance policy, health services plan or health maintenance organization receives payment from the insurance company, health services plan or health maintenance
organization licensed under Title 38.2, pursuant to a claim that involves the provision of services to the insured or enrollee by a professional licensed under Title 54.1, and within 30 days of receipt of the payment does not forward the payment with the necessary endorsement to the professional for application towards the unpaid balance on the professional services subject to the claim, the professional may in a civil action brought by the filing of a warrant in debt recover from the insured or enrollee the lesser of $250 or three times the amount of the payment, together with the amount of the payment. The amount recovered as authorized by this section shall be in addition to the amounts authorized for recovery under § 8.01-27.1. No action may be initiated under this section unless the professional, prior to receipt of payment by the insured or enrollee, forwards to the insured or enrollee via first class mail an invoice for services rendered.
Plain-English Summary
Section 8.01-27.4 addresses what happens when an insurer pays a patient directly for services a licensed professional provided. It covers an insured or enrollee under an accident and sickness insurance policy, health services plan, or health maintenance organization licensed under Title 38.2, who receives payment on a claim involving services from a professional licensed under Title 54.1.
If the patient does not forward that payment, endorsed over, to the professional within thirty days of receiving it, the professional may sue by filing a warrant in debt. The professional can recover the amount of the payment itself, plus a penalty of the lesser of $250 or three times that payment — a recovery that comes in addition to anything available under Section 8.01-27.1.
The remedy comes with a condition: the professional must have mailed the patient an invoice for the services, by first-class mail, before the patient received the insurance payment. Without an invoice sent in advance, no action can be brought under this section.
Frequently Asked Questions
When can a professional sue a patient under Section 8.01-27.4?
When the patient received an insurance payment for the professional’s services and did not forward it, endorsed over, to the professional within thirty days of receiving it.
What can the professional recover in this kind of action?
The amount of the payment itself, plus a penalty of the lesser of $250 or three times that payment, on top of anything recoverable under Section 8.01-27.1.
What must the professional do before the patient receives the insurance payment?
Mail the patient an invoice for the services rendered, by first-class mail, before the patient receives payment. Without that advance invoice, the professional cannot bring an action under this section.
What kind of professionals does Section 8.01-27.4 cover?
Any professional licensed under Title 54.1 whose services were the subject of a claim paid by an accident and sickness insurer, health services plan, or health maintenance organization licensed under Title 38.2.
What form must the professional’s lawsuit take?
A civil action brought by filing a warrant in debt.
Amendment History
2004, c. 909; 2005, c. 141.
Source & verification. Section text and amendment history are
reproduced verbatim from the Code of Virginia, published by the
Code of Virginia, Virginia Division of Legislative Automated Systems. Last verified July 16, 2026.
· Official source
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