Subrogation is a term that's understood in legal and insurance circles but sometimes not by the people who employ them. If this term has come up when dealing with your insurance agent or a legal proceeding, it is in your benefit to know the nuances of how it works. The more you know, the better decisions you can make about your insurance company.
An insurance policy you hold is a promise that, if something bad occurs, the company that insures the policy will make good without unreasonable delay. If your house is robbed, for example, your property insurance steps in to repay you or enable the repairs, subject to state property damage laws.
But since figuring out who is financially responsible for services or repairs is usually a confusing affair – and delay often compounds the damage to the victim – insurance firms usually opt to pay up front and figure out the blame later. They then need a means to recover the costs if, when all the facts are laid out, they weren't responsible for the expense.
Can You Give an Example?
You head to the emergency room with a deeply cut finger. You hand the nurse your medical insurance card and he records your coverage information. You get stitched up and your insurance company gets a bill for the medical care. But the next morning, when you clock in at your place of employment – where the injury occurred – your boss hands you workers compensation forms to turn in. Your company's workers comp policy is actually responsible for the invoice, not your medical insurance. It has a vested interest in getting that money back somehow.
How Does Subrogation Work?
This is where subrogation comes in. It is the process that an insurance company uses to claim payment when it pays out a claim that turned out not to be its responsibility. 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. Usually, only you can sue for damages to your person or property. But under subrogation law, your insurance company is given some of your rights for making good on the damages. It can go after the money that was originally due to you, because it has covered the amount already.
How Does This Affect Me?
For a start, if your insurance policy stipulated a deductible, your insurance company wasn't the only one 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 opt to recoup its expenses by boosting your premiums. On the other hand, if it has a proficient legal team and pursues them efficiently, it is doing you a favor as well as itself. If all $10,000 is recovered, you will get your full deductible back. If it recovers half (for instance, in a case where you are found 50 percent to blame), you'll typically get $500 back, based on the laws in most states.
Moreover, if the total cost of an accident is more than your maximum coverage amount, you may have had to pay the difference, which can be extremely expensive. If your insurance company or its property damage lawyers, such as workers compensation Whitewater, WI, pursue subrogation and succeeds, it will recover your expenses in addition to its own.
All insurance companies are not the same. When comparing, it's worth weighing the reputations of competing companies to determine whether they pursue legitimate subrogation claims; if they do so without dragging their feet; if they keep their clients posted as the case continues; and if they then process successfully won reimbursements quickly 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 safeguarding its profit margin by raising your premiums, you should keep looking.