Subrogation and How It Affects Policyholders

Subrogation is a term that's understood among insurance and legal companies but rarely by the people they represent. Rather than leave it to the professionals, it would be in your benefit to know an overview of the process. The more knowledgeable you are about it, the better decisions you can make about your insurance policy.

Any insurance policy you own is a commitment that, if something bad occurs, the business on the other end of the policy will make restitutions without unreasonable delay. If you get injured on the job, your employer's workers compensation insurance agrees to pay for medical services. Employment lawyers handle the details; you just get fixed up.

But since ascertaining who is financially responsible for services or repairs is regularly a confusing affair – and time spent waiting sometimes increases the damage to the policyholder – insurance companies often decide to pay up front and figure out the blame afterward. They then need a path to recoup the costs if, when all the facts are laid out, they weren't actually in charge of the expense.

Can You Give an Example?

You head to the emergency room with a gouged finger. You give the receptionist your medical insurance card and she records your policy information. You get stitched up and your insurer gets a bill for the expenses. But the next day, when you clock in at your place of employment – where the accident occurred – you are given workers compensation forms to turn in. Your employer's workers comp policy is actually responsible for the costs, not your medical insurance company. It has a vested interest in getting that money back in some way.

How Subrogation Works

This is where subrogation comes in. It is the process that an insurance company uses to claim reimbursement after it has paid for something that should have been paid by some other entity. Some insurance firms have in-house property damage lawyers and personal injury attorneys, or a department dedicated to subrogation; others contract with a law firm. Under ordinary circumstances, only you can sue for damages to your self or property. But under subrogation law, your insurer is extended some of your rights for having taken care of the damages. It can go after the money originally due to you, because it has covered the amount already.

Why Do I Need to Know This?

For one thing, if you have a deductible, it wasn't just your insurer that had to pay. In a $10,000 accident with a $1,000 deductible, you lost some money too – to be precise, $1,000. If your insurer is unconcerned with pursuing subrogation even when it is entitled, it might choose to get back its losses by ballooning your premiums. On the other hand, if it has a capable legal team and pursues those cases enthusiastically, it is acting both in its own interests and in yours. If all is recovered, you will get your full deductible back. If it recovers half (for instance, in a case where you are found 50 percent culpable), you'll typically get half your deductible back, based on the laws in most states.

Additionally, if the total loss of an accident is over your maximum coverage amount, you may have had to pay the difference, which can be extremely costly. If your insurance company or its property damage lawyers, such as attorneys that specialize in auto accidents Austell GA, pursue subrogation and wins, it will recover your expenses as well as its own.

All insurers are not created equal. When shopping around, it's worth weighing the records of competing agencies to evaluate if they pursue winnable subrogation claims; if they resolve those claims quickly; if they keep their policyholders advised as the case goes on; and if they then process successfully won reimbursements immediately so that you can get your losses back and move on with your life. If, on the other hand, an insurer has a reputation of paying out claims that aren't its responsibility and then protecting its bottom line by raising your premiums, you should keep looking.