One question frequently asked by our Tennessee automobile accident clients is why they have to repay their health insurance company out of any settlement they receive in their automobile accident claim. The clients feel that they have paid for the health insurance for many years and, when they have to use it to pay medical bills arising from a car accident, the health insurance company wants its money back. It seems unfair.
The reason that repayment of some amount is often necessary is because the health insurance contract has a "subrogation" or "reimbursement" provision that requires repayment if you get a settlement of a personal injury case and the bills were incurred because of the injury covered by the settlement. The power your insurance company has to enforce this provision depends on how it is written, whether it is governed by state or federal law, and other factors.
These provisions in health insurance contracts are now commonplace. Indeed, it is the rare health insurance contract that does not have such a provision. The laws that govern Medicare and Tenncare have similar provisions.
As experienced Tennessee personal injury lawyers, the attorneys and staff at the Law Offices of John Day help people understand their rights under subrogation and reimbursement clauses on almost a daily basis. Part of the service we offer our clients is to negotiate with these insurance companies to help our clients maximize the net value of their personal injury settlement.
Some people believe that they can settle personal injury claims without the assistance of a lawyer and, in fact, we tell some people who call our office that the nature of their case is such that they probably can get a better net settlement without our help. However, if you attempt to settle a case on your own remember that you must understand and take into account the rights of the health insurer (private or governmental). Failure to re-pay these insurers can result in a lawsuit against you for failure to pay back what you owe and even result in the loss of future health insurance coverage.
If you have a serious automobile accident or other personal injury case please contact John Day at 615.742.4880 (toll free at 866-812-8787) for a free consultation. Alternatively, you can fill out this Contact Form and we will call you.