If it feels like you can get lost in legal jargon, there is a reason — you can! Unless you have a law degree or someone on your side in a personal injury case, it can get extremely complex quickly. If you have ever been accidentally injured or had to have emergency treatment, you know that it is never cheap.
If your injury is due to someone else’s negligence, there is no reason why you should be left on the hook paying for it. If you submitted your bills to your health insurance carrier and they ask you more about the incident, it might be that they are trying to discern who is at fault and if they have to pay.
There are times when an injury happens due to someone else’s fault. You pay your health insurance premiums to ensure that you are taken care of if something happens, but what happens if the incident isn’t an accident that was caused by something you did? What if the accident was someone else’s fault? Is your insurance carrier responsible for paying, or is someone else?
A personal injury attorney Boston will tell you that if you are getting a notice that your medical insurance carrier needs more information to cover a bill, then it is likely they believe that someone else might be at fault for your injuries and the related medical costs. There are also times when they might believe that they are only partially responsible and may be looking for someone else to shoulder the cost. What this means for you personally is that two entities are trying to determine who has to pay the bills.
How does subrogation affect the individual?
If you are injured in an accident that might be someone else’s fault, you might hear the term “subrogation.” Subrogation means that one party takes the place of another. So what does that mean regarding insurance? Subrogation issues arise when there is a third party that is at fault for an injury or claim. Therefore, the claim might not be the problem of the person’s insurance carrier.
In a subrogation claim, the innocent party might be left paying, (which is sometimes referred to as the “collateral source,”) in the place of the injured party. For practical terms, that means that the collateral source, who is making the subrogation claim, is not entitled to any greater rights than the person who was initially entitled to the benefits that would have been paid out. Once more, the injured party may be able to recover from the collateral source provider, if the case is proven.
What is a collateral source?
A collateral source is typically a private entity, such as a private insurance carrier or a governmental agency, which stands in place of the injured person to collect for damages that they already paid out. Subrogation issues revolve around the repayment of collateral payments made to the injured party. It ensures that the injured individual isn’t privy to “double recovery,” where two agencies would provide assistance and payment for the same person or injury.
Settlement and subrogation
When there is a settlement of a lawsuit with a third party, subrogation can get very complex. There are times when the collateral source provider and the injured party might be capable of settling portions of the claim at an at-fault basis. A settlement might, however, limit the insured’s right to receive compensation for their injuries going forward. If someone wants to ensure that they can receive ongoing benefits, it is important to provide notice to the party that doesn’t settle, that there is a settlement pending.
Although each state varies when it comes to subrogation issues, if you are injured and are being bombarded with subrogation notices, then you should not only know what is allowed in your state, but also what your rights are so that you aren’t left without any recourse.