What is a subrogation claim?

If you have been injured and incurred medical bills because of the negligence of a healthcare provider, your medical bills may have been paid by Medicare, Medicaid, or a group health insurance company or HMO. If you obtain a recovery from the negligent healthcare provider that caused your injuries, you may find that you have to pay back Medicare, Medicaid, or the group health insurance company or HMO for the bills they paid as a result of the negligence of the defendant. The laws and procedures dealing with Medicaid and health insurance programs are different from state to state, and even between insurance companies, so you will need to check with your lawyer about the specifics for your case. Medicare is a federal program and no matter where you are if your bills were paid by Medicare you will have certain obligations to at least partially reimburse Medicare for what it paid. These claims of Medicare, Medicaid or your insurance company that they should be paid back are called “subrogation claims.” Similarly, if a medical bill for services relating to your injury is unpaid, the unpaid healthcare provider may also have a subrogation claim and need to be paid out of the recovery. Under most circumstances your lawyer should handle these matters for you.

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