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Can Your Health Insurance Company Sue You?

Posted by Annie Dike | Jan 29, 2018 | 0 Comments

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If you are injured in a car accident by an at-fault driver, do you know who pays for your medical expenses?  Your health insurer or the at-fault driver's auto insurer?  What happens if you settle with the at-fault driver's insurance company and don't fully reimburse your health insurer?  If you do not know the answers to these questions, this is the reason you need to seek the advice of an experienced car accident lawyer before settling a car accident insurance claim because the laws governing subrogation and the recovery of medical expenses in Florida just got more complicated.

In a recent opinion from the Eleventh Circuit Court of Appeals, a majority of the court denied a request to reconsider a ruling by the lower court which granted a health insurance provider rights to sue the at-fault driver's insurance company and recover DOUBLE the amount paid in medical expenses as a result of the auto accident.

Typically, in a car accident case, the health insurance provider only has subrogation rights.  Meaning, it cannot sue the at-fault driver's insurance company directly; it can only recover from its own insured, i.e. you.  With an experienced car accident lawyer involved, the medical expenses and your health insurance provider's right to recover a portion of those are handled as part of the settlement or judgment entered against the at-fault driver's insurance company, so you are not exposed to a lawsuit from your health insurance provider.  This is a complicated aspect of settling a car accident claim that Keith Weidner discussed in a recent video here.

This recent opinion from the Eleventh Circuit, if not appealed further, may mean that your health insurance provider—if you are on a Medicare Advantage plan and the medical expenses your insurer paid as a result of the accident are not fully covered in the settlement or judgment against the at-fault driver's insurance company—may be able to sue the at-fault driver's insurance company directly for double the amount paid for your treatment.  This is a sweeping change in how health insurance subrogation rights were handled previously and could have a dramatic impact on the resolution of car accident claims going forward, making them far more costly and complicated. 

At TWW, we handle car accident insurance claims every day and are always on the lookout for changes like this that can impact your rights if you are injured by an at-fault driver in a car accident.  Before you settle a car accident insurance claim, contact us or seek the advice of an experienced car accident lawyer to make sure you are protected from further litigation in the settlement.  We never charge an initial fee or cost to sit down with you, answer questions about your insurance claim, and explain your legal rights.  (850) 438-4899  

Humana Medical Plan, Inc. vs. Western Heritage Insurance Company, Case No. 15-11436 (11th Cir. Jan. 25, 2018), view here: http://media.ca11.uscourts.gov/opinions/pub/files/201511436.ord.pdf

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