As you pursue a personal injury claim in Missouri, you will likely encounter many new phrases and words. Subrogation is one of those terms. It is typically used by your insurance company.
Subrogation is the right of a party to assume a person’s right to sue. It is the process insurance companies use to seek reimbursement for the money they paid for a personal injury claim that another party is responsible for paying. Whether your insurance company has a subrogation right depends on the type of insurance plan involved and federal and/or state law.
For example, suppose your car insurance company pays your medical bills and property damage claims after a collision. However, the other driver is at fault. Your car insurance company could have a subrogation right to any proceeds you receive for a personal injury claim.
In some states, health insurance companies can assert subrogation rights against personal injury settlements and jury verdicts. However, Missouri laws prohibit health insurers from seeking subrogation unless a federal law provides this right.
If your insurance company sends you a letter asking what caused your injuries, it could be a warning that the company is preparing to assert its subrogation rights. Subrogation claims can be complicated when there are conflicting federal and state laws. Therefore, it is wise to seek legal advice immediately if you receive one of these letters or a notice of subrogation.
Table of Contents
Subrogation and ERISA Health Insurance Plans in Missouri
While your car insurance company might have the right of subrogation in Missouri, state law prohibits many health insurance providers from asserting subrogation rights. However, federal ERISA laws can preempt state law.
ERISA (The Employee Retirement Income Security Act of 1974) governs some employer health insurance plans that are self-funded by the employer. If ERISA applies, the insurance company might have the right of subrogation. These issues are complicated, so allowing an attorney who understands ERISA law to handle your personal injury case is in your best interest.
Subrogation and Government Health Assistance Benefits
If your health insurance is provided through Medicare, Tricare, or Medicaid, subrogation liens could impact your personal injury settlement. The companies and agencies that provide health benefits through these programs can place a lien on personal injury proceeds. The lien must be paid before you can receive any money from your personal injury settlement.
Can You Negotiate a Subrogation Claim for a Personal Injury in Kansas City, MO?
If an insurance company has a valid legal claim on personal injury proceeds, it is not required to negotiate a lower payoff. Your attorney has a legal duty to pay valid subrogation claims.
However, a skilled Kansas City personal injury attorney will investigate the subrogation claim to determine if the company is allowed to assert it under state or federal law. If the subrogation claim is valid, the attorney will attempt to negotiate a lower amount to resolve the subrogation claim.
Some insurance providers will agree to take a lower amount to pay off a subrogation claim, especially if the personal injury proceeds do not fully compensate the injured party for all damages. The company will likely want a comprehensive explanation of your efforts to recover compensation for damages. It will also want to know why you did not receive compensation for all damages.
For example, suppose you are severely injured in a car accident. The other driver has minimum car insurance coverage. The car insurance company agrees to pay the full policy limits for your insurance claim.
We’ll also assume that the chance of recovering funds from the driver if you win the lawsuit is poor based on your attorney’s investigation into the person’s assets and finances. The cost of suing the driver outweighs the potential for recovery. In that case, your attorney could make a compelling argument to an insurance provider to reduce its subrogation claim.
How Can You Project Your Rights Regarding a Missouri Subrogation Claim?
After an accident or personal injury, keep detailed records of all economic damages and expenses related to the accident. Many people overlook out-of-pocket expenses, which could total thousands of dollars.
Keep a pain and suffering journal to record details of your recovery that support a claim for non-economic damages. Detailed documentation of damages increases your chance of recovering a higher settlement amount for a personal injury claim.
Additionally, keep records of all amounts your insurance company pays for medical bills or other expenses related to the personal injury case. Make a copy of all insurance policies and provide the copies to your attorney’s office. Your attorney reviews the insurance policies to determine whether the companies have a legal right to make subrogation claims.
Contact Our Kansas City Personal Injury Lawyer for a Free Consultation
For more information about personal injury claims in Missouri, contact our Kansas City personal injury attorneys at Bradley Law Personal Injury Lawyers. We are here to provide legal advice, support, and guidance as you continue to recover from a devastating injury. Call now at (816) 408-3448 to schedule your free case evaluation with an experienced attorney.