They will only get what he is insured up to. If the bill is 200K and he is only insured for 100K they will settle for the 100K. In order for them to get more than you are insured for they can’t take any money from the insurance company. They would have to sue you directly and chances are you will file for bankruptcy and they wont get much. In order to get the insurance money they have to agree that is all they can get and that the case is settled. They can’t take the insurance money and then go after you for more.