Subrogation rights essentially allow healthcare providers and workers’ compensation carriers to recover some of the money they have expended on your behalf while your claim was pending. Whether they are entitled to the money they wish to have reimbursed is a case-by-case issue and some companies may seek subrogation that they are not entitled to. If you are being asked to reimburse subrogation, contact an attorney immediately.
Generally, when you are injured in an accident, your health insurer will pay for the costs of treating your injuries and any emergency attention you receive. However, once done, your insurer may contact you to further discuss how your injuries occurred and determine if some other entity is responsible for your injuries and can thereby relieve some of their financial responsibility.
They may then attempt to recover some of their expenses by collecting a portion of your settlement or judgment.
In most cases, if you singed an insurance agreement or started using your insurance coverage, you probably also signed a contract allowing your insurance company to seek repayment form you for the bills from an at fault third party. That is subrogation.
In instances of subrogation, it is important to remember that the insurer can only collect the actual amount they would have paid for your injuries. It is not uncommon for healthcare providers to charge higher fees than what would actually be accepted by an insurer.
Think of past insurance claims. You may have had a procedure for which the cost listed was $3,000; however, the amount paid by the insurer after negotiations was only $2,000. In a case of subrogation, your insurer would only be able to pursue a $2,000 reimbursement.
Having an experienced attorney is essential when dealing with a subrogation action. Not only can your attorney help you calculate what an insurer would have paid for a procedure, they can also help negotiate a reduced amount to be reimbursed back to the insurer.
Further, if an insurance company seeks reimbursement which they are not entitled to, your attorney will have the resources and knowledge to challenge their claim for compensation.
Thomas J. Henry Injury Attorneys is a personal injury law firm with offices in Corpus Christi, Texas, San Antonio, Texas and Houston, Texas representing accident victims nationwide. Our priority is to provide our clients with the best legal representation. Our experienced trial attorneys are committed to defending your rights in personal injury matters including defective products, recalled drugs, child injuries, and auto accidents.
If you or someone you love has been injured in an accident, contact our offices immediately – we are available 24/7, nights and weekends.