SUBROGATION – LAW 101

Hello, I’m attorney Kyle Bachus. The legal world is full of overly complicated jargon and terminology that can be intimidating if you don’t know what it means. In my law 101 video series, I’m breaking down some commonly used legal terms so you can be informed and confident should you ever need to take legal action.

In this episode of law 101, we’re going to break down the legal term subrogation.

That’s a big word; the meaning is very simple. Subrogation literally just means the right to be paid back. In another video, we talked about collateral sources. That is people or entities that might make payment to you aside from the person who actually caused the injury like a health insurance or a disability insurance. Subrogation asks the question of whether your health insurance, let’s say your health insurance pays for medical treatment, alright.

They pay you for medical treatment, but that injury and the need for medical treatment was actually caused by somebody else. And let’s say you bring a claim against the person who actually caused the injury, and you recover the same medical benefits that were paid by your health insurance. The question is, does your health insurance plan have a subrogation right? Do they have a right to be paid back for the benefits that they paid out to you that you’ve now recovered from the person who actually caused the injury? It’s a very complicated answer, and it depends on the type of benefits.

There are all types of benefits. Medicare, Medicaid, private health insurance, VA benefits, disability insurances. Each one of these has a different analysis; you have to look at the contract, that’s the first place we look. The health insurance benefits that you received come through a health insurance policy, which is nothing more than a contract. So we look at the contract. Does the contract require reimbursement or not? Then we look at the law.

Even if the contract requires reimbursement, does the law protect you against having to pay back? And in Colorado, there are very strong straight laws that can prevent subrogation clauses from being enforced. But when we talk about the legal principle, all we’re talking about is, you need to know from a legal perspective that anytime that you receive benefits through an insurance contract, that if you make a recovery from the person who actually caused those bills to be incurred. If you make that recovery, it might trigger a subrogation provision or a provision under the law that says that the initial payer of those benefits has a right to be paid back.

If you have a question about your case, and whether or not there is a subrogation right from any first payer of benefits to you, and whether that’s an enforceable subrogation right, we’re happy to answer those questions for you and talk with you about it at Bachus & Schanker. To learn more about other law topics that can help you feel informed and confident about the law, make sure to check out more videos in this series.

SUBROGATION CLAIMS – FAQs