Legal Question in Insurance Law in Texas

Re: insurance subrogation

I read the answers of two attorneys..they are right..call a lawyer experienced in personal injury claiss...usually a member of TTLA .

Re: insurance subrogation

The health insurance has a right of subrogation (they can be reimbursed for a portion of what they paid) However, you have the right to be made "whole" and the insurance company can't offset 100% as you collected their money back for them. I suggest you speak with an attorney before you settle, as these liens are negotiable. Most attorneys will meet with you for free, and many will not charge you if they cant get you a better deal than what you have right now.

Re: insurance subrogation

What you are referring to is called "subrogation." Almost all insurance policies, and especially health insurance policies, now contain subrogation clauses. Subrogation means in effect that, while your health insurance may pay for your medical bills up front, it is entitled to reimbursement if you collect from a third party. However, subrogation liens in Texas are governed by the �made whole� doctrine set out in Esparza vs. Scott and White Health Plan, 909 S. W. 2d 548 (1995 Tex. App.), which, in sum, bars recovery of subrogation unless the insured was �made whole� by his settlement. The "made whole" doctrine, which is state law, does not apply to ERISA plans, which are governed by federal law. Also, some subrogation clauses include the right of the insurance company to recover from your underinsured motorist coverage and some do not. All subrogation liens are, to one degree or another, negotiable. This is a fairly complex issue and you should seek the advice of an experienced personal injury attorney.