Health insurance subrogation is a complex issue most people know little or nothing about. Most health insurance is provided via a policy, which is a complex contract. Many (but not all) health insurance policies contain what is commonly referred to as a “subrogation” clause. Subrogation means that when you are injured and incur expenses for medical treatment which are then paid by your health insurance company, you health insurance company is typically (but not always) entitled to be reimbursed some or all of the amount its has paid on your bills from whatever amount you may recover in a claim against the person or entity responsible for your injuries.
In order to determine whether your health insurance company is entitled to “subrogation,” you have to obtain a copy of the policy, or contract. Many (but not all) subrogation clauses require your health insurance company to reduce the amount of its claim to account for a fair share of any attorneys fees or costs incurred in pursuing recovery of medical expenses from an at-fault party. The general rule of thumb is that subrogation clauses are just like other contract provisions and will be enforced as written. Not all policies contain a subrogation clause. Not all subrogation clauses are identical.
The best way to know what your health insurance company’s subrogation rights may be is to consult with a lawyer. Call 803.765.2383 to speak with one of the attorneys at Leventis & Ransom to find out more about your legal rights.