Go to navigation Go to content
Toll-Free: 800-354-6275
Phone: 817-294-1900
Anderson Law Firm
A- A A+

Why do I have to pay back my health insurance company?


Located in the fine print of most health insurance contracts is something called a subrogation clause. The subrogation clause, which is buried in your health insurance contract, states that if an insured party makes a recovery in a personal injury case, he or she is required to reimburse the insurance company.

Here's an example:
Let's say you were injured in a car accident in Fort Worth by another driver. The accident wasn't your fault and you had to go to the hospital. You pay for your medical treatment with your health insurance. Later, you decide to file a personal injury claim against the insurance company of the negligent driver that caused your accident. Through that settlement, you are able to recoup damages for your medical treatment, lost wages and pain and suffering. But then, you get a letter from a company called, "Ingenix." What does that mean?

Most of the time, health insurance companies hire outside companies (Igenix, Rawlings and Phia) to collect money on subrogation claims. The letter you received from Ingenix is the subrogation letter and because of that clause in your health insurance contract, your insurance company wants you to reimburse them for the medical treatment they paid for after the accident.

While all contracts are different, generally when you receive a call or a letter from these companies, it means that you do have to pay the health insurance company back for the money they paid on your behalf due to the accident.

How much you have to pay them back depends on a lot of things, including the interpretation of the "fine print" contained in the insurance contract. These subrogation claims can become, and often are, huge hurdles in getting a personal injury claim resolved.

However, you shouldn't let subrogation claims keep you from filing a personal injury claim if you have been injured because of someone else's negligence. Hiring a good lawyer is the most important step in your personal injury case, especially if you think you might receive a subrogation letter from your insurance provider.

The personal injury and accident attorneys at the Anderson Law Firm can help you decipher the fine print in your health insurance contract. We are skilled and experienced in negotiating the right amount for your settlement, so that even if you do have to reimburse your insurance company, you are still fairly compensated for your injuries.


Other Articles You Might Be Interested In:
Medical Liens and Subrogation
What To Do When You Receive A Subrogation Letter
Can I still bring a claim if my medical bills were paid by health insurance?
How are settlement proceeds split up?
Why should I use my health insurance to pay for my medical expenses if the accident was not my fault?




The Anderson Law Firm offers free no obligation consultations to people injured in accidents or who have suffered physical harm as a result of someone else's actions. We do not charge you to initially discuss your situation and establish whether you have a claim to pursue. You can call us and discuss your case over the phone, we can set up an appointment for you to come into our office, or we can visit you in your home anywhere in the metroplex.

If after meeting with us you decide that we are the best personal injury lawyer for you, then we will enter into a contingent fee agreement. This means that we only get paid when we win a settlement or jury verdict in your favor. You don't pay us anything up front. We will cover all expenses spent working on your case. Only when we win for you will you need to pay us. If we don't win, then you owe us nothing.

Contact us online now or call us 24 hours a day toll free on 1-800-354-MARK (1-800-345-6-275). You can also call us locally in Fort Worth on 817-294-1900 or in Dallas on 214-327-8000.


best personal injury lawyer arlington pi attorney fort worth