Did You Get a Subrogation Notice from Your Health Insurance Company?

The National Safety Council noted that in 2022, the average motor vehicle disabling accident cost $162,000, accounting for wage and productivity loss, medical expenses, and other costs. For many victims, most of that cost is medical.
Health insurance companies may pay for these losses as outlined in your policy. In situations where that injury is another person’s fault, the health insurance company may wish to pursue compensation for their costs from the at-fault party. They do this through subrogation.

What does it mean when you receive a subrogation notice from your health insurance company?

What Is Subrogation?

Subrogation is the process insurance companies take to obtain compensation for paid claims from the responsible party. In situations where a health insurance company pays for a victim’s hospitalization, medical visits, or other care, and that cost relates to a negligence-related accident, the insurance company may pursue the at-fault party for the losses they paid.

Consider an example:

• A driver runs a red light, hitting a motorcycle rider. The motorcycle rider goes to the hospital to receive medical care.
• The motorcycle rider’s health insurance covers the costs associated with the emergency and all follow-up care.
• The driver is found at fault for the accident. This means the driver is responsible for the losses the motorcycle rider experiences.
• The health insurance company initiates the subrogation process to pursue the money it paid for the motorcycle rider’s care from the at-fault party.

A part of that process is to contact you, the victim, to alert you of their intentions to seek compensation for the accident. They are not demanding that you pay these costs. They want the at-fault party to pay what they owe.

What Happens If the Victim Does Not Present a Claim?

In some situations, victims of accidents may not think to seek a claim against the at-fault party. If your health insurance covers the costs, you may not have substantial losses from the accident.
In this situation, the health insurance company still has the right to seek compensation from the at-fault party. They can pursue that loss through a subrogation claim, whether or not the victim files a claim.
As the victim, you are still liable for any co-pays and associated costs for your hospital visit or medical care, as outlined by your health insurance policy. You are also responsible for your health insurance deductible, which may be higher than your car insurance PIP deductible. In these situations, victims end up paying substantially for losses they do not owe.

How Does Subrogation Impact the Victim?

One of the concerns victims have after receiving a subrogation claim is that the health insurance company’s action may impact them. Depending on the situation, it could.
The subrogation process is important. It creates a way for the health insurance company to pay for the medical costs you have now, at the time of the accident, without delay. This ensures you continue to get care. The health insurance company has the legal right to seek a claim.

Consider the following factors:

• What you receive from the claim: If you file a claim against the at-fault party, your compensation is lessened by the amount the health insurance company paid for your care. Most often, you do not receive those funds. The subrogation effort enables health insurance companies to obtain those funds.
• Your out-of-pocket expenses: You may have paid a copay at the time of receiving care (or it was billed to you). You may also have to pay a deductible for your health insurance for the year before your health insurance kicks in. Any of these out-of-pocket costs you have could be a part of your claim against the at-fault party.

The health insurance subrogation process does not eliminate your ability to seek compensation. It enables the health insurance company to seek compensation they are rightfully owed (and only that amount). This, in turn, helps keep your health insurance rates low.

How a Personal Injury Attorney Can Help You Recover Your Losses

If you received a subrogation notice, that typically means the health insurance company believes someone else is responsible for the losses you have, including your accident. This may be the case, for example, if you report that the incident was due to an accident, such as a fall at work or a car accident. This is a good indication that you should contact our Miami car accident attorneys for guidance.

Our personal injury attorney in Florida will help you in several ways, including determining what all of your losses are. This may include:

• Medical expenses you paid out of pocket
• Pain and suffering
• Lost wages from being unable to work
• Future medical expenses resulting from the accident or complications
• Future pain and suffering
• Emotional trauma and losses related to anxiety and stress

In situations where there is a likelihood that someone else is responsible for your accident and injuries, it is critical to arm yourself with a legal team that can guide and support you in the full recovery of your losses. Set up a free consultation with our team to discuss your case with us at length. Let us help you navigate what comes next.

Contact Abogadas305 for a Free Consultation and Help with Your Subrogation Letter

It can be unnerving to receive a subrogation letter from your health insurance provider, especially when it may seem like they are asking for money. Let us help you understand what is happening and why. A free consultation takes a few minutes and can offer peace of mind.

📞 Call us at 1-877-305-3055 or fill out our online contact form to schedule your free consultation with us now. Let our Miami personal injury legal team take a closer look at what the health insurance company is claiming and what that means for the recovery of compensation you are owed. Trust that Abogadas305 is ready to guide you. We know how to handle the insurance company on your behalf.