Subrogation letter: How to deal with it?

by crociada » Thu Jan 15, 2009 07:56 pm

Hi, I was in a car accident six months ago in which the other party was at fault in New Mexico.My car insurance covered all costs until my medpay ran out last week. I then received a subrogation letter indicating they would seek reimbursement from the other car insurance for their expenditure of 5K. I'm still receiving treatment (and paying out of pocket) so I'm not yet ready to settle. Can my car insurance company recover their 5K from the other insurance company, if I don't settle yet? Will they start harassing me since I'm waiting to settle?

Total Comments: 16

Posted: Thu Jan 15, 2009 10:01 pm Post Subject:

I guess the letter of subrogation was sent to you in time. They can, but chances are good that the at fault carrier won't pay the subrogation claim until they have settled with you. That is how it should be done. They should not pay the subrogated claim as it's part of the bodily injury settlement with you. They can't be sure that the claim will settle within their insured's policy limits until they settle with you, so they should not commit any money before then as it would lower what they have to offer you.

That is not to say that policy limits are an issue. I deal with million dollar policy limits and don't settle $3000 medical payment subrogation even when it looks like a $5000 claim.

Posted: Thu Jan 15, 2009 11:18 pm Post Subject:

Can my car insurance company recover their 5K from the other insurance company, if I don't settle yet?

doubtful as tcope posted, no way would i issue payment on their subro claim until i settled your b.i. claims..this is customary and your adjuster will know this...


Will they start harassing me since I'm waiting to settle?

Absolutely not, they CAN'T and they wouldn't anyway...they understand how b.i. claims are handled. That's why the subrogation letter was sent to you. They may check with you in a month or so just to make sure you haven't settled and the other company forgot to pay them...but that would be the end of it I would guess

Posted: Fri Jan 16, 2009 06:57 am Post Subject:

Lori, tocpe has mentioned that the insurer might harass the OP since he is delaying in settling the claim, when you have mentioned that they can't, which seems ethically right to me as well. But are there chances that the insurer start demanding money from the OP towards the medpay? I mean that we do not always go by ethics, do we?

What are the options the OP has if the insurer indeed decides to harass him to settle fast?

Can there be more than one letter of subrogation sent out to him on regular intervals ?

Posted: Fri Jan 16, 2009 12:38 pm Post Subject: subrogation letter

Lori, tocpe has mentioned that the insurer might harass the OP since he is delaying in settling the claim.,

Honey, where did he say that?

But are there chances that the insurer start demanding money from the OP towards the medpay? I mean that we do not always go by ethics, do we?


Absolutely not! honestly medpay subrogation, isn't like the adjusters top priority, and all claims folks know that this part of their subro on that claim will not be paid until their insured settled the bi...and there is NO pressure from the insured's carrier to settle with the claimant carrier...ever....

What are the options the OP has if the insurer indeed decides to harass him to settle fast?

I doubt it would EVER happen, but if it did they should tell the adjuster first off, 'shut up and stop bugging me' and if it continued contact their states dept of insurance and file a complaint.

Posted: Wed May 05, 2010 08:13 pm Post Subject:

As an insurance adjuster, yes, the company can be paid before you are willing to settle IN SOME STATES. For instance, in the state of Kansas, if you were in an accident and it was the other parties fault and you were injured, the other parties insurance does not have to pay your medical expenses; you must turn in a PIP claim to your own insurance carrier and anything above that coverage limit to your health insurer. Point being, every state has different guidelines and regulations.

Posted: Thu May 06, 2010 12:22 pm Post Subject:

To the OP, crociada . . .

You don't state the extent of your injuries, or even that the other party's insurance company has accepted liability for their insured's tort.

It seems to me that if it's taken you six months to burn through $5,000 of med pay, either the bulk of your bills have been paid by your medical insurance, or your injuries were not terribly serious, just time consuming to treat. Because $5,000 is "small potatoes" when it comes to medical bills.

Just a trip on your own to the ER, without much in the way of medical care, is a $500+ event. Add the charge for the ER doctor, x-rays, lab work, an ambulance ride, you're looking at $1,000+. Doctor's office visits are $125-$175 apiece, physical therapy sessions another $125+. Six months seems like a long time to accumulate just $5,000 in total expenses for something serious.

Understand that subrogation is simply an insurer's right to recover its expenditures on your behalf from an at-fault party and/or their insurer. Signing the subrogation letter does not mean you cannot collect damages from the at-fault party. You can sign the subrogation letter (although as others have pointed out, you may not want to yet), because it is just your acknowledgment that you are not entitled to recover the same damages from an at-fault party or their insurer, and if you did, the first $5,000 must be paid to your insurer, to indemnify them for their loss on your behalf.

My question is: If the collision was the fault of the other party as you state, why has your insurer even been involved in paying your bills? All of your expenses should be paid for as they arise by the at-fault party's insurer (or you would be keeping track of them for your claim against the at-fault party).

Unless fault has not been established or is in dispute. If the other party's insurer has not accepted liability after six months, then I would imagine it is in dispute or something's dreadfully wrong, and you are probably in way over your head and may not realize it.

Med pay is normally "excess coverage." If you have medical insurance, and have been using it to pay for your injuries, guess what? If your injuries are determined to be the fault of a third-party, the $5,000 in med pay from your auto insurer is rightfully that of your medical insurance company under the same subrogation concept, as is anything you obtain from the at-fault party beyond that, up to the full extent of what your medical insurance company paid to doctors and hospitals and therapists on your behalf.

Believe me, your medical insurer is quietly waiting on the sidelines with its own subrogation demand in hand, and will be happy to serve it on you after you settle. Why? Because you won't have any additional recourse against the at-fault party if you failed to include ALL of your medical expenses in your claim, not merely your out-of-pocket ones. Fail to turn the money over to your medical insurance company, and you'll find yourself being served as the defendant in a subrogation lawsuit with your medical insurance company. Do this wrong, and you could win a civil suit and have absolutely nothing left to show for it after lawyer's fees and subrogation claims are satisfied.

Even if the $5,000 is just reimbursement for your out-of-pocket expenses. The theory is that you wouldn't have that out-of-pocket expense if not for someone else's liability for your injuries. (It's the same reason you don't use your medical insurance to pay for injuries or illnesses that are rightfully a workers' comp claim, those damages are someone else's liability.)

If your injuries were serious and you're facing a very lengthy recovery/rehabilitation, you probably need the services of an attorney NOW, because this may be more complex than you appreciate. In addition to your medical claim, you probably have lost wages and other expenses to recover.

Failure on your part to obtain relief from the at-fault party's insurance company, and failure to file a civil action against the at-fault party within one or two years from the date of the accident (depending on state law), even if by just one day, could prevent you from collecting anything at all. That's not something you would want to let happen.

Posted: Mon Oct 11, 2010 04:57 am Post Subject: ssd/penion

I had a surgery 10 months ago and I had been off work for 18 months prior to 10 months ago but and recieved a settlement and agreeded I would no longer have senority and give up my benifits and not be able to sue them for other things but I said ok providing I keep under my wifes bcbs insuance and thats were I have been for years and she works were I did and they sent my wife subrogation form to fill out saying your deprndrnt may have a 3rd party responsible for the bills ?the 1st quesrion is was this claim a accident or a injury if no you are done just send form back, I was medically retired due to degenative disease and can't work no more and the want to no about my last surgery and I have had 3 of them, and they want to no if this was someoneelses fault and says if not you are completeded I am confused the only thing I can think of is a month ago I found that the doctors and hospital charged bcbs primary when it should of been medicare, and H/R I told and the hospital would I be liable for any of this mess ? Roadking

Posted: Mon Oct 11, 2010 04:57 am Post Subject: ssd/penion

I had a surgery 10 months ago and I had been off work for 18 months prior to 10 months ago but and recieved a settlement and agreeded I would no longer have senority and give up my benifits and not be able to sue them for other things but I said ok providing I keep under my wifes bcbs insuance and thats were I have been for years and she works were I did and they sent my wife subrogation form to fill out saying your deprndrnt may have a 3rd party responsible for the bills ?the 1st quesrion is was this claim a accident or a injury if no you are done just send form back, I was medically retired due to degenative disease and can't work no more and the want to no about my last surgery and I have had 3 of them, and they want to no if this was someoneelses fault and says if not you are completeded I am confused the only thing I can think of is a month ago I found that the doctors and hospital charged bcbs primary when it should of been medicare, and H/R I told and the hospital would I be liable for any of this mess ? Roadking

Posted: Mon Oct 11, 2010 05:15 am Post Subject: ssd/penion

I had a surgery 10 months ago and I had been off work for 18 months prior to 10 months ago but and recieved a settlement and agreeded I would no longer have senority and give up my benifits and not be able to sue them for other things but I said ok providing I keep under my wifes bcbs insuance and thats were I have been for years and she works were I did and they sent my wife subrogation form to fill out saying your deprndrnt may have a 3rd party responsible for the bills ?the 1st quesrion is was this claim a accident or a injury if no you are done just send form back, I was medically retired due to degenative disease and can't work no more and the want to no about my last surgery and I have had 3 of them, and they want to no if this was someoneelses fault and says if not you are completeded I am confused the only thing I can think of is a month ago I found that the doctors and hospital charged bcbs primary when it should of been medicare, and H/R I told and the hospital would I be liable for any of this mess ? Roadking

Posted: Mon Oct 11, 2010 08:08 am Post Subject:

Can you please post the question in proper English? This (all three) post hurt my brain.

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