03 Aug 2017

What is “subrogation” in health insurance?

What is “subrogation” in health insurance?

If you have ever been accidentally injured, you may have noticed that your health insurer asked you questions regarding the circumstances of the incident. The odds are good that they were trying to determine whether someone else was responsible for causing the injury or the damages to you.

They must determine if the accident was your fault and how much they should raise your premiums, if necessary. However, the insurer also needs to know whether they can sue the other party on your behalf.

That’s right, if someone else is at fault for the injury or the damages your insurer has to cover, said insurer can in most cases sue the party at fault to recoup the losses. This is known as the insurer’s “right of subrogation.” Subrogation allows one entity to enforce the rights of another for its own benefit. By pursuing subrogation, insurers effectively assume your place in court: they possess the same legal rights as you would have and any legal defenses that could be used against you can also be used against them. Insurers may not ask for an amount greater than the one they paid to cover your expenses. Even though subrogation most often comes into play within the auto insurance sector and the health care insurance sector, it also comes up within real estate insurance, liability insurance, and other types of insurance.

The existence of subrogation is of great benefit not only to insurers, but also to the insured. Indeed, it allows insurers to keep policy costs at a reasonable level by providing them with some protection against accidents caused by a third party. Additionally, if the insurer is successful in suing the other party, they are required to reimburse any deductible you paid. The insurance company will notify you that they are pursuing subrogation, but the process occurs almost entirely between the insurer and the party responsible for the damages. As the injured party, you have little involvement in it.

Some contractual agreements with the party responsible for the damages may require you to sign a waiver of subrogation, which surrenders your insurance company’s right to sue said party for damages. Keep in mind that many insurance policies will not allow you to sign such a waiver, and if you do so anyway, the insurance company may refuse to pay your claim. And since waivers of subrogation also surrender your right to sue the other party for damages, it may be a good idea to consult an attorney before signing such a document.

Subrogation is just one of the many ways health insurance can make your life easier. To find health insurance that really fits your household’s needs at an affordable price point, visit HealthQuoteInfo.

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