It has been a long battle: a set of crutches, too many doctor visits, but you did it! After a valiant fight, you have won your car accident claim. There is a hiccup, however, that you weren’t expecting. Your insurance company is expecting payment for all the medical bills they covered due to your policy. This seems like a complete injustice, after all you pay to be insured and extra money will help with wages lost due to your injuries. Can they do this?
Why Your Insurance Company Wants a Slice of your Pie
Sadly, despite the fact it should be the one at fault for your personal injuries that covers the bill, issues with that path often arise. So, your insurance foots the bill and covers the rest, or all, of your needed medical assistance. They are able to ask for some of your winnings for the simple reason it is in your contract with markings such as “right to reimbursement” or the popular “subrogation.” The same is true for Medicare and Medicaid according to federal and state statutes.
What can I do?
There are few options available to you in order to keep most or some of your winnings depending on certain circumstances and the interpretations of law. It is very rare, however, that you won’t give them some of the claim winnings.
- “Make Whole Doctrine” This common law, though recognized by all 50 states is interpreted a little differently by each state and situation. According to US Legal, “Make-Whole Doctrine is an equitable insurance law principle which holds that in the absence of valid contractual obligation to the contrary an insurer will not receive any of the proceeds from the settlement of a claim, except to the extent that the settlement funds exceed the amount necessary to fully compensate the insured for the loss suffered. Only after the insured has been fully compensated for all the loss the insurer acquires a right to subrogation or is entitled to enforce its subrogation rights. The rule applies to instances in which the insured has recovered from the third party and the insurer attempts to exercise its subrogation right by way of reimbursement against the insured’s recovery.”
- Negotiation- Your personal injury lawyer is often able to negotiate with your insurance company for a reasonable amount, in the event that “Make Whole Doctrine” doesn’t apply.
Bryan Caulfield takes great pride in helping injury victims hurt as a result of a car accident, motorcycle accident, truck accident or through medical negligence, and families who have suffered a wrongful death as a result of negligence. There is no fee or costs unless you win. Call for a fast free consultation at 1-800-535-2529, or contact Bryan Caulfield online
US Legal. “Make-Whole Doctrine Law & Legal Definition.” Make-Whole Doctrine Law & Legal Definition. N.p., n.d. Web. 30 May 2015. http://definitions.uslegal.com/m/make-whole-doctrine/