Millions Recovered For Past Clients

Subrogation: The Risk of Health Insurance Liens

On Behalf of | Jan 3, 2022 | Auto Accidents

What is subrogation?

At Curt Hamilton Injury Law, we deal with many challenges which are often difficult and understand. Subrogation plays a role in every single personal injury case. However, few of our clients know what it is or why it is important. Clients are always understandably frustrated to learn they owe money back to their multi-billion-dollar health insurance company. They have paid for the right to use this coverage and feel robbed to be charged to use their benefits.

So, why do clients owe money back to their health insurance company for using the coverage they purchased? Here is how it works.

Health insurance policies include a subrogation clause. This allows insurers to seek reimbursement for every dollar paid toward medical expenses caused by someone else’s negligence. By accepting the policy, you are likely unknowingly agreeing to these terms. This is true whether you have insurance through your employer, a private plan, Medicare, or Medicaid. If you receive compensation for your injury then you owe your health insurance company reimbursement.

Simple subrogation example.

For example, let’s say our client suffers a broken leg in a car wreck. They accumulate $50,000.00 in medical expenses as they recover from their injury. The client’s health insurance promptly pays these medical expenses. Our firm eventually resolves your case for $200,00.00, which includes the client’s medical expenses, lost wages, and pain and suffering. At this point, the client has received the medical expenses from their health insurance and the at-fault party’s insurance.

This is where the problem lies. The client has doubled-dipped and violated the health insurance contract. This triggers a subrogation claim which exposes our client to possibly being sued by their own health insurance company.  The health insurance company can then collect reimbursement from the client for the full amount of the medical expenses. That is subrogation.

Complex subrogation example.

Unfortunately, subrogation is often far more complex when the medical expenses exceed the amount of liability insurance available to recover. Assume our client’s leg was broken by someone with state minimum coverage, which is $25,000.00 in Kentucky and Indiana. What then?

The severity of the injury and the bills have not changed. The health insurance has still paid $50,000.00 and still has a right of subrogation for the entire amount. The health insurance company could take the whole $25,000.00! There is no justice in this result, and this is where experienced lawyers and persistence kick into full effect.

Our lawyers search for underinsured motorist coverage (UIM) for our clients. After enduring the long battle to reach a fair settlement or verdict, the war is not over. The lawyers at Curt Hamilton Injury Law then negotiate with the health insurance company to reduce their subrogation claim. This maximizes the amount of money our landing in our client’s hands.

A lawyer unaware of how to negotiate a subrogation lien may cost a trusting client money. The lawyers at Curt Hamilton Injury Law are well versed in subrogation law. We would be honored to be trusted with your case and to put our experience to work for you.

Recent subrogation success.

Recently, Curt Hamilton resolved a case with a significant subrogation lien. Our client underwent two surgeries while accumulated $93,000.00 in medical expenses and lost full use of their wrist or thumb. The young defendant’s vehicle only carried $50,000.00 in liability coverage and the client had $25,000.00 in UIM benefits.

After collecting the $75,000.00 of total available coverage, the client was facing a heft subrogation claim from their health insurance. After months of negotiation, Curt drastically reduced the subrogation claim. As a result, our client received over $10,000.00 more in their pocket than they would have without our firm’s help. At the end of the fight, it was a success, and the fight was well worth our client.

Hurt? Call Curt! We can help negotiate your liens.

Subrogation can become far more complex than the situation detailed above. Contact the attorneys at Curt Hamilton Injury Law to help handle your case and subrogation liens. Our lawyers also co-counsel with fellow attorneys dealing with complex subrogation issues.