When you are injured in an accident or because of another party’s wrongdoing, you can file a personal injury claim seeking compensation for damages. Economic damages include medical bills, out-of-pocket expenses, lost wages, and other expenses. Non-economic damages include emotional distress, pain, and suffering.
Injured parties often incur significant medical bills. Your health insurance company may pay medical costs for your personal injury. However, the company may file a claim for reimbursement of the money they paid. These claims are called subrogation claims.
How Does a Subrogation Claim Work in Lafayette, LA?
As you incur medical bills after an accident or injury, you are responsible for paying the medical bills. Even though someone else is responsible for causing your injuries, you are liable for paying the bills. When you file a personal injury claim, you can seek reimbursement for the costs of the medical care.
Health insurance may cover your medical costs. If so, they may file a subrogation claim. Subrogation allows the insurance company to assume your legal rights to pursue a claim for medical bills against the party who caused your injuries. The company has the right to sue the at-fault party for reimbursement of the medical bills it paid.
However, if you are pursuing a personal injury claim, your health insurance company probably will not pursue a claim. Instead, it will send a notice asserting the subrogation claim. When you receive funds for your personal injury claim, you must pay the subrogation claim before receiving any funds.
For example, suppose your health insurance company paid $40,000 in medical bills for a car accident. You receive $220,000 as a personal injury settlement. You are required to pay $40,000 from your settlement to your health insurance company.
Why Does Louisiana Allow Subrogation Claims in Personal Injury Cases?
Most insurance policies contain a subrogation clause. The subrogation clause gives the company the right to file a claim against the proceeds of a personal injury claim. The clause may also give the company the right to pursue a claim on your behalf if you do not do so.
When you sign the insurance contract, you agree to the terms and conditions, including the subrogation clause. Therefore, the rights are controlled by contract law.
Furthermore, subrogation claims prevent injured victims from double recovery for the same damages. If you receive reimbursement for medical bills already paid by an insurance company, you will benefit twice from the same loss. Damages are intended to reimburse you for losses, not benefit you by allowing “double dipping.”
Does Subrogation Apply to Medicaid and Other Government Health Insurance Plans?
Subrogation applies to government health insurance benefits, including Medicaid and Medicare. You could lose your benefits if you do not pay subrogation claims for government health insurance programs.
Negotiating Payoffs for Subrogation Claims in a Louisiana Personal Injury Case
Health insurance companies may have the right to file a subrogation claim against your personal injury proceeds. You will likely receive a statement notifying you of the claim amount. However, a skilled Lafayette personal injury lawyer negotiates the claim with the health insurance company.
A health insurance company is not required to accept a lower payoff for a subrogation claim. That does not mean the company will not negotiate a reduced amount to satisfy the claim.
For example, your attorney may explain that the personal injury settlement does not cover all damages in your case. However, that was the maximum amount available for your claim because of insurance policy limits. Your attorney proposes a payment lower than the amount of the claim. The company and your attorney may negotiate back and forth to agree upon an amount to resolve the subrogation claim.
Experienced personal injury attorneys are skilled in negotiating subrogation claims. While receiving your personal injury settlement may take additional time, it may be worth waiting if you receive more money for your claim.
Protecting Your Rights When Dealing With Subrogation Claims
You might not be able to prevent your health insurance provider from filing a subrogation claim, but you should take steps to protect your rights.
First, keep copies of all medical bills related to your treatment. The bills should show the amount charged for the provider’s services. If the insurance company paid the bill, it should be shown in the statement.
Any discounts negotiated with the insurance company should also be shown. This information will become important when your attorney negotiates a settlement for your personal injury claim.
Your attorney’s office compares the amounts claimed by your insurance provider with the medical bills. This step ensures that the amount claimed by your health insurance company does not exceed the amount they paid.
Get Help With a Lafayette Personal Injury Case
Did someone cause your injuries? If so, you could be entitled to compensation for your damages. Call Kenny Habetz Injury Law for a free consultation at (337) 399-9000 with an experienced Lafayette personal injury lawyer.