Health Plan Subrogation –   In the News

            By Joni L. Landy, Esq.  

In a nutshell, subrogation is the right of a health plan to recover money it paid out for medical care to treat injuries or conditions caused by another party. For example, subrogation may apply when a participant sustains injuries as a result of a slip and fall on a slippery sidewalk, or may apply if a participant is injured by another driver in a car accident. If the participant sues the party that caused his injuries and recovers, the health plan gets paid back from the recovery. Subrogation rights are typical provisions in health plans.  

Recently, the Wall Street Journal highlighted how employer plans are becoming more aggressive in pursuing subrogation rights to keep health benefit costs down for the employees. In addition to large claims, plans are also pursuing subrogation on smaller claims. See Vanessa Fuhrmans, Wall Street Journal, Tuesday, Nov. 20, 2007.

Tucker Arensberg handles subrogation for employer health plans.