Connection Between Personal Injury Settlements And Health Insurance Claims

Once your personal injury claim has been settled, you may be surprised to discover how many parties push to cut off a slice of that settlement for themselves. Even more surprising may be that one of these parties is your health insurance provider.

Understanding Subrogation

Subrogation will be a term you are likely to come across as you look into your health insurance provider’s right to make a claim on your settlement. At first glance, a subrogation claim may seem synonymous to a reimbursement claim, but in actuality, the two are wildly different. The ultimate outcome will be the same with the loss of part of your settlement, but the nature of the two claims are nothing alike. So let’s dive into the differences.

Receiving A Subrogation Notice

Following your involvement in an accident, a letter is likely to appear on your doorstep. The envelope will be sent to you by your health insurance company and will serve to inquire about the details surrounding the accident, i.e. whether it was work-related, if there were more than two parties involved, and what the name of the liable party’s insurance adjuster is.

You will also be asked about your personal injury lawyer in Cornwall and whether you have even hired one. If you have, they will request contact details. The letter will then close with a reminder of the section in your insurance policy which states your insurance carrier’s right to a full reimbursement once your claim has been settled, be it through the verdict of a jury or a pre-trial settlement.

Why We Have Subrogation

A health insurance plan contains a subrogation clause for a reason. When you sustain an injury or fall ill, your health insurance is there to protect you and support you financially. Even when a third party is responsible for your injuries, your plan will kick in and take of your medical expenses while you build a case and file a claim against the liable party. However, once a settlement has been made, your health insurance carrier is going to determine that it should be the liable party who compensates you through their own liability policy. And because of this, they will want to be reimbursed for the money they forwarded to cover your medical expenses.

Why You Should Request A Copy of Your Policy

Obtaining a copy of your own health insurance plan policy is not as straightforward as you may think. It requires you to contact the plan administrator, who can be found in the summary plan booklet containing all the benefits plans available. That is why you need to have a good lawyer in your corner to take care of the intricacies in the case.