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What is subrogation?

Subrogation or the “right of contribution” is the mechanism by which an injured parties’ insurance company is reimbursed by the at-fault parties’ insurance company for money and benefits previously paid on behalf of the injured party.

legal definition

The legal definition of subrogation is:

1.  The substitution of one party for another whose debts the party pays, entitling the paying party to rights, remedies, or securities that would otherwise go to the debtor.

2.  The principle under which an insurer that has paid the loss under an indemnity policy is entitled to take on all the rights and remedies belonging to the insured against a third party with respect to any injuries or breaches covered by the policy.

Blacks Law Dictionary

In car accident cases, the second definition is the one that most commonly comes into play.

Subrogation Reimburses Insurance Company

The easiest way to understand subrogation is that it is the injured parties’ insurance companies’ right to be reimbursed by the responsible person’s insurance company for medical and other expenses that it pays out on behalf of the insured.

For example, when a person is injured in a car accident and requires medical care for the injuries sustained, the majority of the time, the injured person’s own insurance company (medical or auto) will initially pay for the medical expenses.

Notification of a claim

Once the injured person makes a claim against the responsible party, his/her insurance company will then notify the injured person or his/her attorney that they have a subrogation interest on any amount recovered and that the injured person is obligated under their insurance contract to reimburse his/her insurance company for what they have already paid towards medical bills and expenses.

Discount medical bills

Prior to being reimbursed their subrogation interest, all insurance companies will have previously negotiated down the actual amount of medical expenses being billed by the medical providers.  Many insurance companies actually have contractual agreements with the larger medical providers to pay a considerable amount less than what the provider actually bills.  This practice results in a discount to the injured party when having to honor their insurance companies subrogation amounts but it also lowers the amount recovered pursuant to the claim.

Disbursement of settlement or award

In the majority of all car accident cases, the insurance company simply notifies the injured party (insured) or the person’s attorney that they have a subrogation interest in a set amount.  The person’s injury attorney then acknowledges that interest and agrees, with the consent of the client, to ensure that the insurance company’s subrogation interest is protected.  Once the case is settled or tried to a jury verdict and the funds are actually disbursed, the attorney is also entitled to a reasonable fee from the insurance company for the collection of the subrogation interest.  This is often times the same percentage of the recovery as contracted with the Plaintiff.

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