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Health Insurance Claims on Personal Injury Settlements

July 29, 2022

Personal injury claims can be difficult to win, and even if you win, several parties will often fight to get their piece of the pie. On this list of people trying to take some of your settlement are insurers and health care providers. If you are concerned that you may lose more of your settlement than is reasonable, it can be helpful to understand how health insurance companies make claims on personal injury settlements.

Here is more information about the process.

Health Insurance Claims on Personal Injury Settlements

Health Insurance Companies Can Make Claims on Your Settlement

If you sought health care services using a health insurance policy that you hold, your health insurance company may seek to recover a portion of your settlement as reimbursement for the claims they paid out. The insurers achieve this through a process called subrogation.

Subrogation

The purpose of subrogation is to enforce the idea that health insurers exist to provide a safety net for if you are injured or get sick, but when your illness or injury is caused by a third party, the at-fault party should be held liable for your injuries instead. While your health insurance company may pay for medical costs associated with the injury at first, this is only because liability is not clear until a verdict or settlement has been reached.

Once it is clear that someone else was liable for your injuries, your insurance company will initiate the subrogation process to recover costs associated with the treatment of your accident-related injuries.

A Subrogation Letter Will be Dispersed

Following an accident, you are usually sent a letter from your health insurance company. The letter will primarily ask you for more information about the accident you were in. For example, subrogation letters may question whether the accident was work-related or if another party was involved in any way. They also seek to find out whether the at-fault party has an insurance adjuster who can be contacted.

Subrogation letters should ask you if you have also retained the services of a Denver personal injury attorney. If you have, they will request that attorney’s contact information so they can reach out. Finally, insurers will pretty much always remind you that the policy you signed offers them the right to claim full reimbursement from any personal injury settlement you recover. This is the case whether your case is settled outside of court or through a verdict.

Subrogation is Not Always Allowed

Some states bar health insurance companies from engaging in subrogation. In order to find out whether this applies in your state, get in touch with an attorney. They will certainly be familiar with local laws. If subrogation is not allowed, a lawyer can help you fight claims made by the insurance carriers.

Maximize Your Portion of Your Settlement

Insurance companies may attempt to recover more of your settlement than they are due through subrogation. To ensure that everything is fair, you need the assistance of an experienced accident attorney. To get in touch with one, contact The Fang Law Firm using the contact form featured on this page.