Subrogation (Did you get Medical Care Using your Health Insurance?)


If you are a person who had a minor collision with minimal injuries that you recover from quickly, you may be contemplating settling your claim on your own with the other driver’s car insurance company (or possibly your own if the other driver did not have insurance). If this is the case, make sure you are aware of your responsibilities where you have gotten bills paid by a subrogation interest.

Health insurers (including Medicare and Medicaid) are probably the best example of a subrogation interests, though there are other payors of benefits on your behalf that can have them as well (such as a worker’s compensation insurer). The idea is that if an insurer pays health care bills that are the result of you being injured by a negligent third party, and you make a recovery from that third party (settlement), it would be a double (unjust) recovery for you if those insurers did not get paid back because they suffered injury in the form of monetary loss because of that third party’s (also known as a tortfeasor in personal injury law) negligence as well.

For this reason most insurance contracts have provisions in them where you agree to reimburse your health insurer for the amounts they have paid if you reach a settlement with the third party’s insurer. Because of this, you need to make sure you know how much you have to pay back to your insurer BEFORE you agree to any settlement. You should be able to contact your health insurer and request a payout of bills they have paid on your behalf to help in your own evaluation of your claim’s value.

And don’t forget to check your car’s insurance to see if you have Medical Payments Coverage (usually in the amount of $5,000). Assuming you do (most people do), you should be aware you do NOT have to pay back those monies because that is a specific benefit you are already paying for in your policy.

Also, remember, if you have been seriously injured you should be calling us to discuss whether it would be better for you to be protected (personal injury cases can be very complex) by having an attorney represent you. Please call our office for a free initial consultation. The Webster Law Firm, LLC (719) 633-6620.