Wisconsin Law Allows Health Insurance Reimbursement From Injury Victim’s Settlement

Posted by rozeklawoffice on May 10, 2010 under General | Be the First to Comment

The legal term “subrogation” refers to the health insurance carrier’s right to get reimbursed for payments they made for an injured person’s health care, when that injured person recovers money from a third party.

The rationale behind subrogation is that if an injured person is allowed to recover all of his/her health care expenses from the at-fault insurance company, but those bills have already been paid by the injured person’s health insurance carrier, they are getting paid twice for the medical bills incurred in the accident, once by the at-fault insurance company and once by their health insurance company via payment of the medical bills.

Many states do not allow reimbursement to the health insurance carrier from injury victim’s settlements; however, Wisconsin law allows it. I strongly disagree with the concept that the health insurance be reimbursed. After all, why do we pay health insurance premiums? Wouldn’t this process just make the original payment by the health insurer a loan to the customer?

Luckily, there is an exception to subrogation in Wisconsin. If the injured person has not been made 100% whole from the settlement with the at-fault insurance company or from a jury verdict, then the health insurance company gets nothing. A good Wisconsin Personal Injury Attorney will be able to get the subrogated health insurance carriers to take substantial reductions with  the promise that they will receive nothing if the judge is convinced that the client did not recover 100% of their damages. These reductions always result in more recovery for the injury victim.

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For more information on Wisconsin Personal Injury Claims