When does 'subrogation' work? How can someone defend against it?
Total Comments: 8
Posted: Fri Aug 10, 2012 07:23 pm Post Subject:
Subrogation works when you suffer a covered loss, but that loss is due to the negligence of a third party. Your insurance is not designed to pay those claims, but may as a convenience to you. It will attempt to recover its loss through subrogation -- collecting what you are due on your behalf. If you paid a deductible, they will attempt to recover that and will reimburse you for it if they collect it. (Theoretically, they should pay that to you first, but they don't. If they don't recover your deductible, you may still be able to sue the other party in small claims court for that amount.)
But what is there to defend against? Your insurance company pays a claim on your behalf that should really have been paid by another person or insurance company. Your insurance company is entitled to recover what it actually paid that it was not contractually obligated to pay. There is nothing for you to defend.
The problem folks run into is the first thing they do following a traffic collision, for example, is rush out at hire an attorney, who sues the alleged at-fault party. When that happens, your insurance company will sit back and relax, and allow you to do all their work for them at your expense. When your attorney negotiates a settlement, he/she will conveniently forget about the issue of subrogation (why should he care, his fee comes off the top before any subrogation claims will be honored), and probably not account for that in your award.
Your insurance company is entitled to 100% of its expense on your behalf, and they don't have to negotiate a reduced amount. You just saved them thousands of dollars in legal fees, and they probably won't give you 50 cents on the dollar for that (if they give you anything at all).
So now, what is there to defend against? Trial lawyers. Don't get involved with one until you and the insurance company can no longer work things out between yourselves. Then, and only then, might you need some legal assistance.
Finally, if you were the at fault party, and you suffer a covered loss, your insurance company promises you a defense against any legal action. Doesn't mean you will win, but you won't have to pay for it, regardless of how much it costs the insurance company.
Having insurance is mostly a win-win situation, even when the loss is your fault. It certainly beats the alternative.
Posted: Thu Aug 16, 2012 08:41 am Post Subject: subrogation works
Subrogation can b a difficult legal concept, but is something you should understand if you receive money from your insurance company.Subrogation is typically done behind the scenes and without much effort from you, however, you should know your subrogation rights just in case there is a mistake that costs you money or the right to file a future claim
Posted: Thu Aug 16, 2012 03:45 pm Post Subject:
you should know your subrogation rights
Here's the misunderstanding. YOU have no subrogation rights. Those belong exclusively to the insurance companies.
Subrogation does not prevent YOU from filing future legal action against an at-fault negligent party. It prevents you from keeping, as your own, the money you receive in a legal judgment/settlement equivalent to that which an insurance company paid to others on your behalf. In essence, subrogation prevents YOU from collecting twice for the same loss, and allows the insurance companies to recover their loss due to another party.
Posted: Sat Aug 18, 2012 05:14 pm Post Subject:
Subrogation can be traced back as far as the Roman era. It essentially evolved from the payment by one person of the debt of another; the payor would then acquire certain rights against the debtor which were originally maintained by the creditor. Today, subrogation is still defined as the substitution of one person in the place of another with reference to a lawful claim or right. For example, if you are involved in a motor vehicle collision, your insurance carrier pays a certain amount of money for the damages to your vehicle. By making that payment, the right to recover that money from the other driver is transferred from you to your insurance carrier. This assignment of recovery rights is called subrogation. Subrogation is thought to have a number of societal benefits: 1. Subrogation lowers insurance premiums; a key function of subrogation is that it returns the excess, duplicate proceeds to the insurer who can then recycle them in the form of lower insurance proceeds; 2. Subrogation also helps recover from at fault parties deductibles and other forms of out of pocket damages that the innocent policyholder might not have recovered themselves; 3. finally, subrogation promotes a sense of justice and fairness by holding the responsible parties accountable for the harm they created.
If you are attempting to shield yourself from the effects of subrogation, then I am assuming you fall into one of two categories: 1. the subrogated insurance carrier for the other vehicle has targeted you as the at fault driver and is seeking to recover from you the money that carrier paid on behalf of its policyholder, or 2. your own insurance carrier has expressed an intention to place a lien on any recovery you might receive from the at fault party. In either situation your rights are dictated by the laws of your state and the terms of any insurance contract you might have. I would consult with an attorney to help better understand your situation, you can contact your local bar association for the names of attorneys who can provide you with free consultations. If you had insurance, your own carrier might be able to assist you in understating what is going on.
Posted: Sat Aug 18, 2012 09:06 pm Post Subject:
The single most common subrogation failure in litigation leading to a pre-trial settlement or judgment at trial, is ignoring the subrogation rights of one's health insurance. All too often, injured persons rely on their own insurance to pay the claims that rightfully belong to another, negligent party.
Because health insurance is intended only to pay first-party claims (those between the insured and insurer only, not those cause in one's work or by another party through their negligence), the health insurer will not argue for its subrogation right until the last possible moment -- at the time of the payment of settlement/judgment proceeds.
The health insurer simply sits back and lets the trial attorney do all the work, collect his or her fees, and then steps up to intervene in the payment of the settlement balance to the plaintiff. There is little the plaintiff can do at that point but negotiate a possible reduction of the health insurer's claim. In most cases, the health insurer will do that because 50% or 60% of something is better than 100% of nothing.
However, with the coming constraints on health insurers under the PPACA ("Obamacare"), health insurers will likely become more resistant to negotiating a reduction. They are entitled to 100% of their loss, and will soon be pressing harder for as much as they can get.
To litigants and their counsel alike: Don't ignore this aspect of subrogation. The auto insurer is not the only one to be concerned about.
Posted: Fri Feb 15, 2013 02:58 am Post Subject: Subrogation is a scam
If anyone is reading this and is being harassed regarding Subrogation don't worry about it. Both people that have posted above me are clueless. Unless there is a subrogation clause written in the PLAN DOCUMENT at the time of the incident, they have no claim. Some companies will try to push their Summary Plan Document (SPD) as being admissible in federal court but this is not true.
Some states do not allow Subrogation and have a "make whole" doctrine. Do not let any collection agency or attorney push you around on Subrogation. The funds they collect from suckers that give in go straight into executives pockets and not back into the plan.
If your company has a Subrogation clause your attorney is not bound by it's terms and can legally distribute your money to you should you prevail in a lawsuit. Once the money is in your hands simply keep it out of your bank accounts.
If you fight these thieves you will win. Their is an attorney in North Dakota that is the best at beating these insurance companies. Look up subrogation law professor on google.
Posted: Fri Feb 15, 2013 01:47 pm Post Subject:
If anyone is reading this and is being harassed regarding Subrogation don't worry about it. Both people that have posted above me are clueless. Unless there is a subrogation clause written in the PLAN DOCUMENT at the time of the incident, they have no claim
This is really sad.... as it _clearly_ shows that you have no idea what you are talking about... yet, you post that other people don't. You simply have no clue.
Let me try to break it down as simply as possible so that you might start to get a clue. You run a red light and hit my car. MY carrier pays for my damage under my collision coverage. My carrier is then "subrogated" to my right to recover my damage from you, the legally at fault party. There is no "clause" in a "plan document" needed to allow me or my carrier to collect from you. State tort laws allow for this.
Some states do not allow Subrogation and have a "make whole" doctrine
Again... you are clueless. "Make whole" laws really have nothing to do with subrigation. I don't think you could be any further off. Make whole simply means that your carrier needs to "make you whole" before they can keep any money that they collect from the other party. This means if you still have any outstanding losses and your carrier collects (hello... SUBROGATION already took place at this point) that they need to pay you back your entire loss before they can keep anything.
Before you fault someone else, know what you are talking about.
Posted: Fri Feb 15, 2013 02:14 pm Post Subject:
Summary Plan Document (SPD)
This nut-job is completely confused. SPDs are required in conjunction with ERISA employer-sponsored benefit plans -- meaning primarily health insurance claims.
Those plans have nothing to do with auto or homeowner's insurance claims.
make whole
This is a term used in reference to INDEMNIFICATION. tcope properly addressed that above.
Posted: Fri Aug 10, 2012 07:23 pm Post Subject:
Subrogation works when you suffer a covered loss, but that loss is due to the negligence of a third party. Your insurance is not designed to pay those claims, but may as a convenience to you. It will attempt to recover its loss through subrogation -- collecting what you are due on your behalf. If you paid a deductible, they will attempt to recover that and will reimburse you for it if they collect it. (Theoretically, they should pay that to you first, but they don't. If they don't recover your deductible, you may still be able to sue the other party in small claims court for that amount.)
But what is there to defend against? Your insurance company pays a claim on your behalf that should really have been paid by another person or insurance company. Your insurance company is entitled to recover what it actually paid that it was not contractually obligated to pay. There is nothing for you to defend.
The problem folks run into is the first thing they do following a traffic collision, for example, is rush out at hire an attorney, who sues the alleged at-fault party. When that happens, your insurance company will sit back and relax, and allow you to do all their work for them at your expense. When your attorney negotiates a settlement, he/she will conveniently forget about the issue of subrogation (why should he care, his fee comes off the top before any subrogation claims will be honored), and probably not account for that in your award.
Your insurance company is entitled to 100% of its expense on your behalf, and they don't have to negotiate a reduced amount. You just saved them thousands of dollars in legal fees, and they probably won't give you 50 cents on the dollar for that (if they give you anything at all).
So now, what is there to defend against? Trial lawyers. Don't get involved with one until you and the insurance company can no longer work things out between yourselves. Then, and only then, might you need some legal assistance.
Finally, if you were the at fault party, and you suffer a covered loss, your insurance company promises you a defense against any legal action. Doesn't mean you will win, but you won't have to pay for it, regardless of how much it costs the insurance company.
Having insurance is mostly a win-win situation, even when the loss is your fault. It certainly beats the alternative.
Posted: Thu Aug 16, 2012 08:41 am Post Subject: subrogation works
Subrogation can b a difficult legal concept, but is something you should understand if you receive money from your insurance company.Subrogation is typically done behind the scenes and without much effort from you, however, you should know your subrogation rights just in case there is a mistake that costs you money or the right to file a future claim
Posted: Thu Aug 16, 2012 03:45 pm Post Subject:
you should know your subrogation rights
Here's the misunderstanding. YOU have no subrogation rights. Those belong exclusively to the insurance companies.
Subrogation does not prevent YOU from filing future legal action against an at-fault negligent party. It prevents you from keeping, as your own, the money you receive in a legal judgment/settlement equivalent to that which an insurance company paid to others on your behalf. In essence, subrogation prevents YOU from collecting twice for the same loss, and allows the insurance companies to recover their loss due to another party.
Posted: Sat Aug 18, 2012 05:14 pm Post Subject:
Subrogation can be traced back as far as the Roman era. It essentially evolved from the payment by one person of the debt of another; the payor would then acquire certain rights against the debtor which were originally maintained by the creditor. Today, subrogation is still defined as the substitution of one person in the place of another with reference to a lawful claim or right. For example, if you are involved in a motor vehicle collision, your insurance carrier pays a certain amount of money for the damages to your vehicle. By making that payment, the right to recover that money from the other driver is transferred from you to your insurance carrier. This assignment of recovery rights is called subrogation. Subrogation is thought to have a number of societal benefits: 1. Subrogation lowers insurance premiums; a key function of subrogation is that it returns the excess, duplicate proceeds to the insurer who can then recycle them in the form of lower insurance proceeds; 2. Subrogation also helps recover from at fault parties deductibles and other forms of out of pocket damages that the innocent policyholder might not have recovered themselves; 3. finally, subrogation promotes a sense of justice and fairness by holding the responsible parties accountable for the harm they created.
If you are attempting to shield yourself from the effects of subrogation, then I am assuming you fall into one of two categories: 1. the subrogated insurance carrier for the other vehicle has targeted you as the at fault driver and is seeking to recover from you the money that carrier paid on behalf of its policyholder, or 2. your own insurance carrier has expressed an intention to place a lien on any recovery you might receive from the at fault party. In either situation your rights are dictated by the laws of your state and the terms of any insurance contract you might have. I would consult with an attorney to help better understand your situation, you can contact your local bar association for the names of attorneys who can provide you with free consultations. If you had insurance, your own carrier might be able to assist you in understating what is going on.
Posted: Sat Aug 18, 2012 09:06 pm Post Subject:
The single most common subrogation failure in litigation leading to a pre-trial settlement or judgment at trial, is ignoring the subrogation rights of one's health insurance. All too often, injured persons rely on their own insurance to pay the claims that rightfully belong to another, negligent party.
Because health insurance is intended only to pay first-party claims (those between the insured and insurer only, not those cause in one's work or by another party through their negligence), the health insurer will not argue for its subrogation right until the last possible moment -- at the time of the payment of settlement/judgment proceeds.
The health insurer simply sits back and lets the trial attorney do all the work, collect his or her fees, and then steps up to intervene in the payment of the settlement balance to the plaintiff. There is little the plaintiff can do at that point but negotiate a possible reduction of the health insurer's claim. In most cases, the health insurer will do that because 50% or 60% of something is better than 100% of nothing.
However, with the coming constraints on health insurers under the PPACA ("Obamacare"), health insurers will likely become more resistant to negotiating a reduction. They are entitled to 100% of their loss, and will soon be pressing harder for as much as they can get.
To litigants and their counsel alike: Don't ignore this aspect of subrogation. The auto insurer is not the only one to be concerned about.
Posted: Fri Feb 15, 2013 02:58 am Post Subject: Subrogation is a scam
If anyone is reading this and is being harassed regarding Subrogation don't worry about it. Both people that have posted above me are clueless. Unless there is a subrogation clause written in the PLAN DOCUMENT at the time of the incident, they have no claim. Some companies will try to push their Summary Plan Document (SPD) as being admissible in federal court but this is not true.
Some states do not allow Subrogation and have a "make whole" doctrine. Do not let any collection agency or attorney push you around on Subrogation. The funds they collect from suckers that give in go straight into executives pockets and not back into the plan.
If your company has a Subrogation clause your attorney is not bound by it's terms and can legally distribute your money to you should you prevail in a lawsuit. Once the money is in your hands simply keep it out of your bank accounts.
If you fight these thieves you will win. Their is an attorney in North Dakota that is the best at beating these insurance companies. Look up subrogation law professor on google.
Posted: Fri Feb 15, 2013 01:47 pm Post Subject:
If anyone is reading this and is being harassed regarding Subrogation don't worry about it. Both people that have posted above me are clueless. Unless there is a subrogation clause written in the PLAN DOCUMENT at the time of the incident, they have no claim
This is really sad.... as it _clearly_ shows that you have no idea what you are talking about... yet, you post that other people don't. You simply have no clue.
Let me try to break it down as simply as possible so that you might start to get a clue. You run a red light and hit my car. MY carrier pays for my damage under my collision coverage. My carrier is then "subrogated" to my right to recover my damage from you, the legally at fault party. There is no "clause" in a "plan document" needed to allow me or my carrier to collect from you. State tort laws allow for this.
Some states do not allow Subrogation and have a "make whole" doctrine
Again... you are clueless. "Make whole" laws really have nothing to do with subrigation. I don't think you could be any further off. Make whole simply means that your carrier needs to "make you whole" before they can keep any money that they collect from the other party. This means if you still have any outstanding losses and your carrier collects (hello... SUBROGATION already took place at this point) that they need to pay you back your entire loss before they can keep anything.
Before you fault someone else, know what you are talking about.
Posted: Fri Feb 15, 2013 02:14 pm Post Subject:
Summary Plan Document (SPD)
This nut-job is completely confused. SPDs are required in conjunction with ERISA employer-sponsored benefit plans -- meaning primarily health insurance claims.
Those plans have nothing to do with auto or homeowner's insurance claims.
make whole
This is a term used in reference to INDEMNIFICATION. tcope properly addressed that above.
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