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Subrogation is a concept that's understood among insurance and legal professionals but often not by the customers they represent. If this term has come up when dealing with your insurance agent or a legal proceeding, it would be to your advantage to understand an overview of how it works. The more knowledgeable you are about it, the better decisions you can make about your insurance policy.
Every insurance policy you hold is a commitment that, if something bad occurs, the business on the other end of the policy will make restitutions in one way or another in a timely manner. If you get injured on the job, your company's workers compensation agrees to pay for medical services. Employment lawyers handle the details; you just get fixed up.
But since determining who is financially accountable for services or repairs is typically a heavily involved affair – and delay often compounds the damage to the victim – insurance companies usually decide to pay up front and assign blame afterward. They then need a mechanism to recover the costs if, when there is time to look at all the facts, they weren't in charge of the expense.
Let's Look at an Example
You head to the emergency room with a gouged finger. You give the nurse your health insurance card and he records your policy details. You get taken care of and your insurer is billed for the tab. But on the following afternoon, when you arrive at your workplace – where the accident occurred – you are given workers compensation paperwork to fill out. Your employer's workers comp policy is in fact responsible for the bill, not your health insurance company. It has a vested interest in getting that money back in some way.
How Subrogation Works
This is where subrogation comes in. It is the way that an insurance company uses to claim reimbursement when it pays out a claim that turned out not to be its responsibility. Some insurance firms have in-house property damage lawyers and personal injury attorneys, or a department dedicated to subrogation; others contract with a law firm. Ordinarily, only you can sue for damages done to your person or property. But under subrogation law, your insurer is extended some of your rights for having taken care of the damages. It can go after the money that was originally due to you, because it has covered the amount already.
How Does This Affect Individuals?
For a start, if you have a deductible, your insurer wasn't the only one who had to pay. In a $10,000 accident with a $1,000 deductible, you lost some money too – namely, $1,000. If your insurance company is lax about bringing subrogation cases to court, it might opt to recoup its costs by increasing your premiums and call it a day. On the other hand, if it knows which cases it is owed and pursues those cases efficiently, it is acting both in its own interests and in yours. If all $10,000 is recovered, you will get your full $1,000 deductible back. If it recovers half (for instance, in a case where you are found 50 percent responsible), you'll typically get $500 back, based on the laws in most states.
Furthermore, if the total expense of an accident is more than your maximum coverage amount, you may have had to pay the difference, which can be extremely expensive. If your insurance company or its property damage lawyers, such as criminal lawyer Portland, OR, pursue subrogation and wins, it will recover your costs in addition to its own.
All insurance companies are not the same. When shopping around, it's worth comparing the records of competing firms to evaluate if they pursue legitimate subrogation claims; if they do so in a reasonable amount of time; if they keep their accountholders informed as the case proceeds; and if they then process successfully won reimbursements quickly so that you can get your deductible back and move on with your life. If, instead, an insurance company has a record of honoring claims that aren't its responsibility and then safeguarding its profitability by raising your premiums, even attractive rates won't outweigh the eventual headache.
Subrogation is an idea that's well-known among insurance and legal firms but sometimes not by the customers they represent. Even if it sounds complicated, it is to your advantage to comprehend the steps of the process. The more you know, the better decisions you can make about your insurance policy.
Any insurance policy you hold is an assurance that, if something bad occurs, the insurer of the policy will make restitutions in a timely fashion. If your vehicle is rear-ended, insurance adjusters (and the courts, when necessary) decide who was to blame and that party's insurance covers the damages.
But since ascertaining who is financially accountable for services or repairs is regularly a heavily involved affair – and delay in some cases compounds the damage to the victim – insurance companies usually decide to pay up front and assign blame afterward. They then need a way to get back the costs if, when all is said and done, they weren't actually responsible for the payout.
Can You Give an Example?
You go to the hospital with a sliced-open finger. You hand the receptionist your medical insurance card and he records your coverage details. You get taken care of and your insurance company gets a bill for the expenses. But on the following morning, when you clock in at your place of employment – where the accident occurred – you are given workers compensation paperwork to file. Your workers comp policy is in fact responsible for the invoice, not your medical insurance company. It has a vested interest in getting that money back somehow.
How Does Subrogation Work?
This is where subrogation comes in. It is the way that an insurance company uses to claim payment when it pays out a claim that turned out not to be its responsibility. Some insurance firms have in-house property damage lawyers and personal injury attorneys, or a department dedicated to subrogation; others contract with a law firm. Usually, only you can sue for damages to your person or property. But under subrogation law, your insurance company is considered to have some of your rights in exchange for having taken care of the damages. It can go after the money originally due to you, because it has covered the amount already.
Why Should I Care?
For a start, if you have a deductible, your insurance company wasn't the only one that had to pay. In a $10,000 accident with a $1,000 deductible, you have a stake in the outcome as well – to be precise, $1,000. If your insurer is timid on any subrogation case it might not win, it might opt to get back its expenses by boosting your premiums. On the other hand, if it has a knowledgeable legal team and pursues them efficiently, it is acting both in its own interests and in yours. If all $10,000 is recovered, you will get your full thousand-dollar deductible back. If it recovers half (for instance, in a case where you are found one-half responsible), you'll typically get half your deductible back, based on the laws in most states.
Moreover, if the total price of an accident is over your maximum coverage amount, you could be in for a stiff bill. If your insurance company or its property damage lawyers, such as criminal law defense attorney Portland OR, successfully press a subrogation case, it will recover your costs as well as its own.
All insurers are not created equal. When comparing, it's worth scrutinizing the reputations of competing firms to determine if they pursue winnable subrogation claims; if they do so without dragging their feet; if they keep their accountholders posted as the case continues; and if they then process successfully won reimbursements immediately so that you can get your money back and move on with your life. If, on the other hand, an insurer has a reputation of honoring claims that aren't its responsibility and then safeguarding its bottom line by raising your premiums, you should keep looking.
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