What is subrogation? How does it impact your rights in the event you are injured?
This article is the first in an upcoming series on the topic of subrogation in Ohio. We’ll briefly discuss what subrogation means and when to take action.
Need assistance on a personal injury claim? If you would like to speak to a lawyer about this matter, click here to schedule a consultation with Ohio attorney, Tom Somos of The Law Office of Tom Somos, LLC. Our office phone number is: 614.488.2270.
Subrogation in Ohio
Many of our clients are not aware of this seeming infringement of their rights.
Basically, a subrogation claim means that an individual’s health insurance and automobile insurance companies have a right to recoup any medical bills that they pay relating to a personal injury claim – even though our clients have paid their premiums to have this coverage.
These subrogation claims are extremely unfair because our clients pay to have this coverage. The insurance company should not have a right to recoup these medical bills just because an automobile or a motorcycle accident occurred that they did not cause. Unfortunately, under Ohio law, these health insurance and automobile insurance companies have the right to make this claim.
In an automobile, truck, motorcycle, pedestrian, or bicycle accident, or in a slip and fall case, these health insurance and automobile insurance companies have to be paid back by our clients for medical bills that they paid on their behalf when our clients receive a settlement at the end of their cases.
With the recent upsurge of these subrogation claims by health insurance and automobile insurance carriers, it is becoming extremely important to successfully communicate with these carriers and aggressively negotiate these claims in a way that best represents the interests of our clients.
There is no place where the proper handling of subrogation is more important than in an automobile accident case. Insurance companies are paying less on these auto cases, and the risk of non-recovery or unsatisfactory recovery is growing.
What Action Should You Take?
Whenever you have a subrogation claim, you first need to identify the subrogated interest you are dealing with. It can be either:
(1) health insurance (determine if ERISA or not);
(2) a medical payment provision from an auto policy;
(3) Medicare – 42 U.S.C. 1395 Y(B)(2)(b)iii;
(4) Medicaid – O.R.C. 5101.57 – 5101.59; or
(5) Workers’ Compensation (BWC and self-insured) – O.R.C. 4123.93.
Secondly, send a request, via certified mail, for copies of the plan documents to verify that a right of subrogation exists and if the subrogation language is contractual. We always make the following arguments to do everything we can to reduce these subrogation claims.