I saw a political cartoon a few years back that wondered what other industries would look like if they operated the same way out health insurance system does. “You want to join our gym? OK. However, our data suggests you might actually use the equipment, so you cannot be a member here.”
So, as we await the Supreme Court’s decision on the Affordable Care Act in the Florida v. Department of Health and Human Services case (as if the outcome is in doubt), it seemed a post on health insurance was timely.
We all know that health insurance companies exist for one reason and one reason only: to make a profit. And they seem to be doing quite well at that. One of the ways they recoup funds is through a process called subrogation, which is just a fancy word for “pay back.” If health insurance pays money for you to go to the doctor, and if it is someone else’s fault you had to go to the doctor – because you were in a car crash or were injured by a defective product – the health insurance company generally has the right to be repaid out of any settlement or recovery you make.
What does this mean to you:
Though health insurance companies often have the right to be paid back in full before the injured person sees dime one (thanks to an Ohio Supreme Court ruling), lawyers handling a personal injury case frequently negotiate with the health carrier to reduce the amount that is owed back..