Know About The Subrogation Process In Healthcare Insurance Claims

Many individuals are surprised to find that they are not the only ones trying to reap the monetary benefits of their personal injury claims. In other words, they are trying to get a portion of your settlement. Ironically, the biggest offender is oftentimes the company that pays your claim or your healthcare insurer. If you’ve hired an experience personal injury attorney, they will file the claim for you. But make no mistake about it, the money appropriated to satisfy your personal injury claim will be deducted from your settlement. This is one of the reasons that you should talk with your personal injury lawyer in Lindsay and know the facts.

Healthcare Insurance Claims or Subrogation Claims

When discussing personal injury settlements and the healthcare insurer’s claims to them, you’ll often hear the terms “subrogation” or the “subrogation process.” For all intents and purposes, reimbursement claims differ from subrogation. But for the purpose of resolving claims on personal injury settlements, the results are the same. Therefore, for the balance of this content, healthcare plan claims will be referred to as subrogation claims.

Subrogation Letters from the Healthcare Insurer

If you recently were involved in some type of accident, your healthcare insurer will send you a letter inquiring about the details of your accident. You’ll be asked questions such as “Was a 3rd party involved?”, “Was it a work-related accident?”, or “What is the name of the at-fault party’s insurance adjuster?”, and so on. You’ll also be asked to provide specific information such as whether or not you’ve hired an attorney and their contact information. The form or letter will also contain a reminder about how the insurer has full reimbursement rights to any settlement that you receive.

What’s the Purpose of the Subrogation Letter?

The basis or reason for a subrogation letter (as well as putting a subrogation clause in your healthcare insurance policy) is that this insurance is supposed to protect you when you get ill or injured in some type of accident. So if you sustain injuries from a 3rd party, your healthcare insurance will cover you initially because the issues regarding damages and liability in your personal injury claim haven’t been sorted out as yet.

However, your healthcare insurance provider will demand that the liability insurance carried by the at-fault party should be responsible for payment of your hospital and medical expenses. Furthermore, your healthcare insurer will assert their rights to being compensated or reimbursed the hospital and medical expenses that they paid for when you were being treated after your accident.