Demystifying the Personal Injury Process- Part 7: Subrogation and Reimbursement

Today, we continue our blog series where we do our best to answer recurring questions we’ve heard over the years. To see previous posts in this series, click here.

During our representation of injured people, we spend a lot of time helping clients coordinate benefits that may include private health insurance, federal- or state-provided health insurance (like Medicare and Medicaid), workers’ compensation, and personal and commercial vehicle insurance coverages.

When insurers pay for medical treatment that our clients undergo due to the personal injury, our clients may have to deal with those insurers’ subrogation or reimbursement interests.  While technically different legal concepts, both mean that our clients may need to repay some portion of the monies obtained by settlement or judgment to their insurers for related medical payments paid on their behalf.

Private health insurance and personal or commercial vehicle policies are governed by contract.  In the case of Medicaid and workers’ compensation, state law addresses the rights of those entities.  Federal law outlines Medicare’s rights in that regard.

As it relates to personal injury matters, all of those potential coverages could require you to put those entities on notice of your claim. You should plan to provide your attorney with all of that information at the beginning of the representation so that you can have a conversation about how to approach these potential interests.

Medicaid has an online portal that your attorney can use to expedite the process of obtaining the alleged interest at the time of any settlement. Unfortunately, Medicaid-type coverage is provided through several managed care entities in addition to the State, which can complicate matters.

Medicare also provides an online portal that your attorney can use to expedite the process of obtaining an alleged interest, but the expedience of that system still tends to vary from case to case.

In the case of private insurances, your attorney will handle any and all negotiations with adjusters representing those insurers.

Simplifying Personal Injury Claims

Subrogation and reimbursement bring many complexities that one blog cannot possibly address.  Call your local Cincinnati personal injury attorney at The Richards Firm today to discuss your vehicle or truck accident, dog bite, defective product, defective premises, nursing negligence, or other personal injuries today.  We can help you navigate those complexities.

We can be reached at 513-868-2731 or rhys@richardsinjuryfirm.com.

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