In many of my personal injury cases, my clients (before retaining my law firm) often try to resolve their claims on their own. Many of them are surprised when they consult with our law firm and are advised about all of the issues involved. There are many things that must be carefully considered before resolving an auto collision injury claim in Ohio.
Here are some issues that many victims are never told about by the negligent driver’s insurance company.
Understand the Right of Subrogation
The first issue can be quite shocking to learn about. Most health and auto insurance companies have included provisions in their policies that requires policyholders to reimburse them in the event a settlement is accepted from the negligent driver’s insurance company. You read that correctly. Even though my clients pay insurance premiums on time, insurance companies have a special right called a subrogation claim to recoup any medical bills that they have paid on behalf of policyholders.
If you find yourself in this situation, these claims need to be carefully considered and negotiated with your health plan and auto insurance company. Often times, your health and auto insurance companies are willing to reduce the amount of money that they have a right to collect for payments made on your behalf.
If you are a Medicare, Medicaid, or Worker’s Compensation recipient, you also need to know that they also have a subrogation right and are entitled to be reimbursed for all medical bills that they pay on your behalf.
Ensure Proper Payment of Your Medical Bills
This subrogation right raises another important issue. Whenever you are involved in an auto accident, trucking accident, or slip and fall incident, you need to immediately ensure that all of your medical bills are paid through your health insurance first.
Many of the medical providers, including hospitals, your doctors, physical therapists, and chiropractors, prefer that they bill your auto insurance company. Here is the reason why: your auto insurance company does not have a contractual rate negotiated with your medical providers, so your medical providers can collect everything that they charge (and do not need to write off any outstanding bills). Unlike your auto insurance, your medical providers have a contractual rate that they have negotiated with your health insurance plan, which requires them to provide you with the health plan rate that is lower than the actual charged amount. In other words, your auto insurance company will pay them for their entire bill as charged.
Keep in mind, however, that your health plan will pay for medical bills submitted – even if you are involved in an auto accident/personal injury incident. It is critical that you submit all of your medical bills to your health plan and instruct your medical provider to bill your health plan. Your health plan should be your primary source of recovery. Only in the event that your health plan does not pay a medical bill (or if you need to be reimbursed for your deductibles and out-of-pocket expenses) should you submit your bills to your auto insurance company.
Be Diligent & Clear
It is extremely important to successfully communicate with these carriers to avoid issues later on. There is no place where the proper handling of a subrogation claim is more important than in a truck accident, auto accident, or slip and fall case.
Insurance companies are paying less on these claims, which means it is essential that you have an effective plan for your recovery.