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Thread: Subrogation

  1. #1
    Join Date
    Jun 2009
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    2

    Default Subrogation

    After settlement with workcomp insurance company, in pusuit of third party suit, workcomp insurance company puts lien on suit for full recovery of their expenses. Understanding, according to Statute 62-4-39, they are entitled to recovery minus attorney fees for suit and recovery. Is this statute clear cut for full recovery minus attorney expenses?

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Subrogation

    What do you mean by 'clear cut" ?
    The ER/IC is entitled to subrogation rights... a reimbursement of the money/benefits they have provided for your injury. Where there is another/third party holding liability, there is no reason the money should not be returned to the ER/IC.

    The issue of future medical treatment though is something that could be negotiated. The WC ER/IC is still holding liability for coverage of additional medical treatment you may need. The 3rd party will no doubt be providing money for this..and the comp carrier can require you exhaust that money before they provided any more benefits/medical..they take a credit for that amount...sometimes the credit isn't as big as might be necessary.

    If you take the lump sum though for medical..and then allow another party to pay for treament it would be double dipping...which could be viewed as fraud on your part.

    Third party and comp can be very difficult...and do require legal representation. These are not claims an IW should attempt on thier own.

  3. #3
    Join Date
    Jun 2009
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    2

    Default Re: Subrogation

    I do understand the WC insurance company is entitled for reimbursement of their costs from third party. My question is, are they liable for the attorney fees in recovering from third party?

    Thanks

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    17,943

    Default Re: Subrogation

    My question is, are they liable for the attorney fees in recovering from third party?
    Could be. Depends on the facts in the claim. It's not enough to say 'yes' to your question.
    Nearly everything that isn't spelled out by statute/law is negotiable between the parties.

    WC is pretty much set,...PI/3rd party not so much...civil/tort can be settled by jury... comp isn't.

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