You’ve been severely injured in an accident caused by a negligent party, and as a result of your personal injury claim, you have recovered compensation for your damages, including for medical costs. Soon after receiving your settlement, your health insurance provider may make a claim for part of your settlement to recoup for the various medical expenses it paid on your behalf.
Usually this right by the insurance company to be reimbursed for these payments is built into the contract you agreed to when you signed up for coverage. The language of these contracts will oftentimes allow the insurance company to seek repayment if your injuries were caused by a negligent third party. In the case of government-provided healthcare benefits, such as Medicaid or Medicare, reimbursement of payments are generally pursued due to provisions found in the laws that allow for these benefits to exist.
In many situations, these health insurance providers will place a lien on the results of your personal injury claim or lawsuit. Before you can receive your recovery from your case, the lien placed by the insurance company has to be paid.
The claim of reimbursement is through the concept of subrogation. Subrogation by definition is the act of a party stepping into the shoes of another. Subrogation allows a collateral source (in this case, an insurance company) to make any claim against a third party that the insured party could have. Insurance companies take the place of the insured party to recoup a monetary amount and relieve some of their financial costs.
When an insurance company exercises their right to subrogation, they are entitled to recover the actual amount they paid to cover your medical costs. Although a treatment may cost $5,000, if your insurance company paid $4,500 for the treatment, you will only have to repay the insurer $4,500.
There are many reasons why you should hire an attorney to handle an injury claim. One overlooked benefit is that an experienced attorney can negotiate with your insurance company on how much of your paid medical costs need to be reimbursed. In some cases, an attorney can work with the insurance company and reduce the amount that needs to be repaid. Additionally, your lawyer should be cognizant of the subrogation interests of your health insurance company and work tirelessly to maximize the recovery amount in your claim.
If you or a loved one have been hurt in an accident, contact Thomas J. Henry today. Our experienced injury attorneys are available 24/7, nights and weekends to evaluate your injury claim. Subrogation rights and medical liens can be confusing and difficult to navigate. You need a lawyer that will represent you and protect your rights as an injured victim from the beginning of your case until the end and fight for the compensation you deserve. Call our law offices today to speak with an attorney and receive a free case review.