Growth Business: Helping Insurers Recoup Personal Injury Medical Costs

By David Armstrong | June 11, 2015

  • June 11, 2015 at 4:12 pm
    OmniSure says:
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    My health insurance carrier, for premium paid, pays my health care related expenses for illness and INJURY of the ECONOMIC type. If I’m reading this article correctly, any “award/settlement” for NON ECONOMICAL DAMAGES ie: PAIN & SUFFERING, loss of consortium, etc, etc… that I may receive from the negligent party’s carrier OR PERHAPS MY UNINSURED MOTORIST covg…can be TAKEN from me, by my HEALTH insurance carrier via SUBROGATION! My health insurance policy/contract requires the carrier to PAY VALID “ECONOMIC” health care expenses for illness & injury I suffer. Where, within the health insurance contract does it say the carrier can TAKE my NON ECONIMIC settlement… The TWO types of financial “benefit” are designed to be MUTUALLY EXCLUSIVE and rightfully so. If the health carriers can access my NON ECONOMICAL benefits/damages/award, then… HEALTH INSURANCE should INCLUDE BENEFIT FOR BOTH HEALTH CARE COSTS and NON ECONOMICAL LOSS associated with INJURY CLAIMS… That being the case, there would be an EQUAL OFFSET of claim payment vs subrogation, to NULLIFY the entire process, which just shows ME how INNANE this “burgeoning HEALTH INS CARRIER WINDFALL” is… Subrogation against the NEGLIGENT PARTY for ECONOMICAL DAMAGES is one thing. If the NEG PARTY’s limits are exhausted, then SUE THEM PERSONALLY for the ECONOMIC CLAIMS you paid to your HEALTH INSURED… But to subrogate against your own, premium paying INSURED and THAKE their NON ECONOMICAL DAMAGES/AWARD/SETTLEMENT is a bastardization of our entire health insurance delivery system, legal system, economy and MORAL CODE!

  • June 11, 2015 at 4:23 pm
    It Just Aint Right says:
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    Well said OmniSure. Health insurers collect premiums and then only want to loan an insured $$ to pay their bills, hoping to recoup that $$ from their insured’s funds later. In reality, in these situations, the health insurer is just offering a short-term loan, not indemnification of the insured’s losses.

  • June 12, 2015 at 2:24 pm
    Patrick R. Sullivan says:
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    I read the article differently (though it is sparse on the details of how this subrogation works). It seems that the insurance company is recovering from the person who was responsible for the accident or other event that caused the victim to require medical care. Not from the victim.

    If the victim gets his medical treatment paid by a health insurer AND also received a financial settlement, for that medical treatment, from the person who was liable for damaging him, then he’s been compensated twice. The insurance company is merely recovering its costs from the person who was responsible.



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