Overview
When you file a personal injury claim, your health insurance and medical bills become tied to the process in ways that can affect your final settlement. Your health insurer may have rights to recover some of what they paid for your accident-related treatment, a process called subrogation, and understanding how this works helps you know what to actually expect to keep from any settlement. Getting ahead of these issues protects your payout.
Frequently Asked Questions
Will my health insurance cover treatment for my accident injuries?
In most cases, yes. Your regular health insurance typically covers accident-related medical treatment the same way it covers other injuries, though you may have a deductible and co-pays to pay. However, your health insurance company may later try to recover some of what they paid for your personal injury settlement, a process called subrogation.
What is subrogation?
Subrogation is the right of your health insurance company to recover what they paid for your medical treatment out of any settlement or verdict you receive from the at-fault party. For example, if your insurer paid $10,000 for your treatment and you settle for $50,000, they may seek to recover that $10,000 from your settlement. A lawyer can sometimes negotiate to reduce this amount or structure the settlement to minimize how much the insurer can claim.
How much can my health insurance company recover from my settlement?
That depends on your insurance policy and state law, but they typically can recover what they actually paid for accident-related treatment. Some policies cap this at your total recovery, while others may be able to recover even more. A lawyer can review your policy and negotiate on your behalf to try to reduce the amount they take.
Should I use my health insurance or the at-fault driver's insurance to pay for treatment?
If you have health insurance, you can typically use it and let it pay first, which means you don't have to deal with the other driver's insurance company for every test or appointment. Your lawyer can later negotiate with the responsible party's insurance for the full cost of care. Using your own health insurance is often simpler and faster for getting treatment.
What if I can't afford my insurance deductible or co-pays during treatment?
Some personal injury attorneys can help arrange for providers to defer payment until your claim settles, or they can negotiate directly with your health insurer to waive certain costs while your case is pending. This is one reason getting legal help early can ease the financial stress of treatment.
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Get A Free Case Review →This page is for general informational purposes only and does not constitute legal advice. Laws vary by state and every case is different. Contact us to discuss the specific facts of your situation.
