Subrogation is the contractual right of an insurance company to recoup any money it paid on your behalf following an accident caused by another person.
You are hurt in an accident, have to go to the emergency room, and are admitted to the hospital for several weeks. You then have a few months of follow-up appointments and physical therapy. After deductibles and copays, your health insurance company pays all of your medical bills. After you recover from the accident, you settle your injury case with the at-fault party’s insurance company. If you receive a settlement or verdict as a result of the accident, you will owe the health insurance company the amount they paid.
Your insurance policy contains a subrogation clause which allows the health insurance company to recover the medical bills it paid on your behalf. The right of subrogation exists regardless of whether you have private insurance such as Blue Cross Blue Shield or Tenncare or Medicare.
Here is an example: You are in a car accident caused by a negligent driver. Your medical expenses from the accident come to $100,000. Your health insurance that covers this entire amount. You later sue the negligent driver in court and win a $150,000 judgment. Your health insurer then asserts its subrogation rights, meaning it is entitled to $100,000 as reimbursement for the prior payment of your medical bills. As a result, you only get $50,000.
Subrogation is complex, and an experienced lawyer can often negotiate a substantial reduction in the amount that has to be repaid to insurance companies. The personal injury lawyers here at Herndon, Coleman, Brading, and McKee have decades of experience negotiating with insurance companies. Successful negotiations with the insurance company can mean considerably more money is left to go in your pocket.
If you would like to discuss your injury case with one of our experienced personal injury lawyers, please contact us online or call us at 423-434-4700 for a consultation. In injury and wrongful death cases, we work on a contingency fee basis which means we only get paid if we recover money for you.