THE CMG VOICE

Subrogation – A novel way to create more harm for an already injured person

Our clients are often catastrophically injured, and such injuries result in medical care that can cost tens and sometimes hundreds of thousands of dollars. Luckily for many of our clients, they had health insurance through their employer or on the individual marketplace to cover such expenses. They paid premiums for the insurance, and unfortunately something very bad happened to them and they need it.

Almost universally, when folks sign contracts for this insurance, there is no bargaining that goes on. Here is the premium price, here are the benefits. Sign here. Rarely do any of us read the fine print.

Yet once there is a third party involved that may have caused your injuries, the fine print becomes important. There is almost always a clause that was tucked in there that obligates you to repay your insurer for any bills that they paid due to the negligence of a third party.

Why it becomes important – and why subrogation is a multi-billion dollar industry – is the subject of a recent article you can read here:

[The Lawyer Who Invented a Way to Take Cash From Accident Victims](http://www.bloomberg.com/news/articles/2015-06-10/the-lawyer-who-invented-a-way-to-take-cash-from-accident-victims)

The article tells the story of George Rawlings, an attorney in Kentucky. Mr. Rawlings found a way to help health insurers recover billions of dollars from their insureds for money they paid for injuries that were caused by a third party.

Because there are legal arguments the insurers can make to recover costs paid, typically injured people will settle with Rawlings (working as the bounty hunters for the insurance plans) rather than risk being sued themselves for breaching their contractual duty to repay.

Now, when an injured person has the opportunity to resolve her case against a negligent actor, such as a surgeon, nurse or hospital, the fight is not over. Now it’s with the company who she has paid premiums to for years, who wants money too.