What Is Subrogation in Personal Injury Claims?

What is Subrogation?

Navigating a personal injury claim can be confusing as you may encounter terms that you are unfamiliar with such as “subrogation”.

What is subrogation? Subrogation is a legal term that can arise in almost any type of personal injury claim. It describes how an insurance company or an entity that pays medical expense on behalf of an injured person has a right to be reimbursed for any payments made, should another party be found at fault for their injuries. The precise nature of your subrogation agreement is found in your insurance contracts. 

How does subrogation work?

Someone who is injured through no fault of their own is often confused about who should be paying their injury-related treatment. When you seek medical care, it is important to submit your bills to either your health insurance or your medical payment coverage under your automobile policy. 

One reason it is beneficial to have your health insurance pay is that you get to maximize any recovery you receive in settlement. Often health insurance companies receive contractual discounts from medical providers and this discount is passed on to you.

Despite health insurance paying a contractual rate, you can still claim the reasonable rate billed from the at fault party in settlement. In fact, courts have determined through the collateral source rule that evidence of having health insurance is inadmissible in trial. This means that an at-fault driver does not get to use your health or automobile insurance against you.  

Another reason it is important for health insurance to pay is because the party that is responsible for your injuries will not pay you medical bills while you are treating. Payment will only be made at the time of settlement and this can take months or even years to be resolved. This means that any unpaid medical bills can be placed into collections, negatively affecting your credit.

It is important to note that subrogation can apply to not only your health insurance or automobile medical coverage but also to federal entities such as Medicare, the VA, or even workers compensation. Anyone that makes payments on your behalf where a third party is at fault has a right to be compensated. 

How Can My Attorney Help with Subrogation?

There are many rules that can surround the variety of subrogation claims you will find in personal injury. Rules that can change between a private health insurance, state health insurance, self-funded insurance plans or even employee benefit plans. These complicated rules can also apply to federal entities with subrogation claims and medical coverage policies under automobile insurance. 

There are also different rules associated to dog bites, pedestrian-vs-auto accidents and uninsured/underinsured motorists claims. In these instances, there are often times medical policies that will help pay for treatment and special reductions in the final settlement for attorney-represented cases.

It is important to hire an attorney that is well-versed in this area as they can navigate these claims and lessen the impact your bills leave on your settlement.

How Can Washington Law Center Help?

We work for you. We will always give you our best opinion but will follow your direction on which way you chose to proceed with your case. Please call the experienced attorneys at Washington Law Center for a free case review.