How Health Insurance Claims for Personal Injury Settlements Work?

Your lawyer will tell you that your health insurance company will try to recover the money it gave you for your injuries once you receive your personal injury settlement.

You’ll notice that you have many more ‘instant friends’ once you file a personal injury claim. Your personal injury lawyer in Sherwood Park will tell you to take this with a grain of salt because most of them are trying to get their hands on some of your personal injury settlement money.

Your personal injury lawyer will tell you that your health insurance company will be one of the ‘instant friends’ on the list of ‘instant friends’ who want your settlement money. This is especially true if it has already paid you for your personal injury settlement. Keep in mind that all of these friends must be paid and that the funds will come from your personal injury settlement.

Subrogation process works

The term subrogation may sound familiar to you. If it does, know that it applies to health insurance carrier claims regarding personal injury settlements. Another fact to know is that subrogation claims are different from reimbursement claims. However, they are considered to be the same from the standpoint of resolving the claims on your settlement.

Have you heard of subrogation notice letters?

Your health insurance company will send you a letter once you’ve been involved in a personal injury accident. It will ask for many details. Some of these will include questions that inquire about the nature of the accident. Did it happen on the job? What was the nature of the accident, and who is the insurance adjuster for the defendant?

The letter will ask you if you have hired a personal injury lawyer. You’ll be asked to provide his or her contact information if you have indeed hired a lawyer. You’ll be informed that the insurance company has every legal right to be reimbursed once you receive your settlement.

Why subrogation?

It’s your health insurance company’s job to protect you financially if you are ever injured or if you get sick. However, it’s the job of the defendant to pay for the damages and injuries that resulted from your personal injury case.

Get a copy of the policy: Ask your health insurance company for a copy of your insurance policy. You have a legal right to ask for this. Read the policy terms and conditions carefully to see if it allows for subrogation. If it does not then federal law may prohibit it from subrogating against your claim.

Look into state laws: The state that you live in may have laws that make it illegal for health insurance carriers to subrogate. Call your state’s insurance department to see if this is the case.

Does your employer self-insure medical claims?

Federal law may come before state law if your employer has self-insurance. This may be the case when it comes to subrogation.

Ask for unrelated claims to be eliminated: Your carrier may not subrogate for expenses that are not related to your personal injury accident. Be sure to ask that these claims be eliminated.

Ask your personal injury lawyer to reduce his or her fees: You are entitled to ask your attorney for a fee reduction if your insurance company subrogates. Be sure to ask your lawyer for one.

Subrogation is a complex concept: As is evident, subrogation is not an easy concept. Be sure to hire a good personal injury lawyer who will guide you through the subrogation process and help you keep as much of your settlement money as possible.