When you file a personal injury claim, you may hear many unfamiliar legal terms. Many of these terms could significantly impact how much money you receive for your injury claim. Subrogation is one of those terms.
Seeking Compensation for Injuries After an Accident
After certain accidents, you may file a claim with another party’s insurance company. For example, if another driver caused your car crash, you would file a claim with the driver’s auto insurance company.
The purpose of an insurance claim is to seek reimbursement for the damages caused by the at-fault party, including medical bills, lost income, and pain and suffering. The insurance company will pay you for your damages if its insured caused the accident. However, you have the burden of proving fault, causation, and liability before you receive any money.
Defining the Term “Subrogation”
Subrogation is when one party stands in the place of another party. Health insurance and automobile insurance companies often file subrogation claims. They will typically demand reimbursement for any bills they paid related to an accident case.
For example, suppose you file a claim with your health insurance provider for hospital bills after an auto accident. Suppose your health insurance company pays those bills. It will expect reimbursement if you receive a settlement from the at-fault driver. Subrogation may also apply when your insurance company pays to repair the property damage to your vehicle after a car accident.
Your health and auto insurance companies will pay expenses according to the terms of your insurance coverage. However, they are not legally responsible for paying damages caused by the at-fault party. Therefore, your insurance company will seek reimbursement for money it pays you after an accident by filing a subrogation claim (assuming someone else is at fault).
Subrogation may apply in any personal injury case. It is based on the concept that an injured person is not entitled to double recovery for damages. In other words, you should not receive compensation for medical bills from the at-fault party if your health insurance company paid those bills.
How Do Insurance Subrogation Claims Work?
Most insurance policies contain subrogation clauses. The clauses state that if the company pays expenses for another party’s financial responsibility, the company has the right to subrogation (reimbursement for the payments it made).
Furthermore, the clauses state that you agree to cooperate with any subrogation attempts. Therefore, you cannot waive your right to compensation for damages if the other party is legally liable for those damages. If you refuse to pursue the personal injury claim, your insurance provider could likely pursue the subrogation claim directly against the at-fault party and their insurance provider.
Do Subrogation Claims Include State Assistance Benefits?
Subrogation still applies if you receive benefits under state law, such as Medicaid. The same is true for benefits under a federal program like Medicare. The government agencies or the insurance carriers may pursue subrogation rights against the at-fault party if the insurer pays bills that pertain to your accident or personal injury claim.
How Does Subrogation Affect Your Personal Injury Recovery?
Any settlement you receive from the insurance company, the at-fault party, or a jury trial is subject to subrogation claims. Therefore, if your insurance company asserts its subrogation rights, your personal injury lawyer must reimburse your insurance provider for the amount it paid related to the accident case.
Inserting a waiver of subrogation clause into a settlement agreement may not be legal. Furthermore, it could cause problems with your insurance provider. For example, your insurance provider could cancel your insurance coverage for breach of contract.
Your personal injury attorney can attempt to negotiate a lower amount to settle the subrogation claim. Some insurance companies are willing to lower the amount they accept to satisfy their subrogation claim. They may be more willing if the money you receive does not compensate you for all damages.
For example, let’s assume the at-fault driver has minimum automobile insurance coverage. If so, you may receive less than your personal injury claim is worth. Even if you file a claim with your underinsured motorist coverage, both amounts may not cover all damages.
In that event, your health insurance company may negotiate a lower payment for the subrogation claim. That allows you to keep more of the settlement proceeds to compensate you for your losses.
Contact an Atlanta Personal Injury Lawyer for Help
If you have questions about your personal injury claim, contact an Atlanta personal injury lawyer for help. They can help you understand whether subrogation will apply in your case. They may be able to negotiate with any parties claiming subrogation to reduce the amount you owe. They can also negotiate with the at-fault party’s insurance company to ensure you receive maximum compensation for your claim.