In the above video, Savannah attorney Ty Wilson discusses what may happen if you do not pay your health insurance company’s subrogation interest back. In this article we will break this down a bit more for informational purposes.

The topic is: What happens if I don’t pay the subrogation interest of my health insurance company?

First, let’s discuss how your health insurance can become involved in your case to the extent that you may need to pay them back.  If you have an injury from a car accident and you go to your doctor’s office for treatment, you may use your health insurance for payment.  At some point your insurance company learns that there was an accident and that another insurance carrier should have been making payment for your care.  This invokes what we refer to as subrogation.  This can also happen in the case of a workers’ comp injury where you are injured at work.

In the case that your medical (health) insurance carrier has paid for your treatment, they will want to be reimbursed and they will look to you for their money.  Depending on the type of benefits you have, you may be forced to pay.  However, it is very fact specific based on the terms of the medical coverage you have.  It can also affect future benefits depending upon the wording of your contract. So, this is very fact-specific.

Next, let’s discuss how you can prevent this type of issue.  If you are ever in an accident, whether it’s a personal injury or work related injury, you want to be sure to let your health insurance company know that.  Let’s say you are injured at work and you go to your regular doctor.  You use your regular insurance card and pay a co-pay.  At some point you receive a letter in the mail asking you for details about your injury.  Specifically, the insurance company wants to know if it was the result of something that happened at work.  This type of letter is sent from your insurance company because they are looking to someone else to pay for your care.  This means that your injury is the type of injury that often happens from either a work or personal injury type of accident.  Failure to respond to that type of letter can be a denial of your claim.  Failure to pay your insurance company can create a financial hardship if they decide to take action.

If you have already used your health insurance for your treatment of a personal injury or work related accident, we recommend that you speak with a Georgia personal injury attorney who has experience in the subrogation and reimbursement arena. You want to do this as soon as possible so you can determine the law, the contract that applies to you and your benefits and whether or not you are required to pay.

Subrogation is a tricky issue.  Insurance companies will always look for ways to re-coop their losses; or what they determine to be their losses.  If you have a situation like this or need a case review, contact Ty.  With years or experience on cases just like this, he can advise you on what to do next before you are in a financially dire situation.

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