What is Subrogation?April 15, 2019
When you have been injured in an accident and your health insurance company pays out money on your behalf so you can get the treatment you need for your injuries, something called subrogation will occur in your case.
Subrogation means that one person or party (your health insurer) stands in the shoes of another (you). If your insurer has a right to subrogation, your insurer is permitted to collect the money that it paid out for your accident related medical care from your settlement or judgment. In short, your health insurance company has a right to be reimbursed. If you have health insurance of any type and you plan to use or are using it for care related to your case, the question you should be asking yourself is, “Does my health insurance company have a right to be paid back out of my settlement; and if so, should the insurer be paid back in full, in part, or even at all?” Without proper representation, the insurer will not tell you. The insurer will simply demand reimbursement in full, which may be against Colorado and/or Federal Law.
Here is an example, Sarah was injured in a motor vehicle collision. She has health insurance, and her health insurance paid for the medical treatment that she received as a result of the motor vehicle collision. Sarah receives a settlement from the at-fault party’s insurance company. Once she settles, her health insurance claims may be entitled to a portion of her settlement in the amount her medical insurance paid for her treatment. Sarah’s health insurance is claiming a right to subrogation and is demanding reimbursement. Sarah needs to know how much her insurer should be paid. Only an experienced attorney who understands complex and ever changing subrogation and insurance law can determine how much that health insurer should be paid back, if anything.