Health Insurance Subrogation: Adding Insult to Injury

Date Added: January 14, 2011

Author: Ethan Luke

Personal injury victims are often shocked to learn that a portion of their personal injury recovery may have to be paid to their health insurance company as reimbursement for accident related medical charges that were paid by the health insurance company. The right of a health insurance company to recover payments made for accident-related health expenses is called the right of “subrogation.”

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Until recently, the Texas “made whole” doctrine protected injury victims by providing that they should get paid first and be “made whole” before having to reimburse their health insurance companies. After all, why should a health insurance company get their payments back? They were paid a premium to provide the medical coverage.

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Unfortunately, as a result of intense political pressure from health insurance companies, recent Texas court decisions have seriously undermined the long-standing “made whole” doctrine. Under current case law, health insurance companies now argue that they are entitled to be reimbursed from the first money recovered, and that they no longer have to wait until the victim has first been “made whole.”

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This can lead to horribly inequitable results. Take for example the situation of the accident victim with $25,000 in medical bills as a result of auto accident that was caused by a drunk driver with only $25,000 in liability insurance. The victim’s health insurance company, which has been charging exorbitant health insurance premiums, will claim that it is entitled to the entire liability policy proceeds, leaving the accident victim with nothing for her injuries.

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For this reason, it is extremely important for injury victims to have a personal injury attorney who is very knowledgeable in the area of personal injury subrogation law. I recommend a board certified personal injury trial attorney because they have special skill and competence in personal injury trial law including the area of personal injury subrogation law. Despite recent court decisions, a board certified personal injury attorney often can greatly reduce or even eliminate a health insurance company’s subrogation claim. And that means more money in the injury victim’s pocket, where it belongs.

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So how does one go about finding a board certified personal injury trial attorney? One way is to visit http://www.tbls.org/Directory/Attorney.aspx. The website will give you a list of the attorneys in your area who are board-certified. You are also welcome to call the Neese Law Firm at 713.355.1200 or 888.99.NEESE, and if we cannot help you with your particular legal issue, we will do our best to point you in the right direction and get you to a personal injury attorney who can help you.

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John Neese Personal Injury Attorney – Neese Law Firm, P.C. represents plaintiffs in all types of personal injury and business litigation cases worldwide.

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