Virginia Subrogation Statutes

[SMJ_08]

What is the name of your state? VA

I would like to better understand these statutes.

http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+38.2-3405

Any addtional information would be appreciated.

Thank you.

 

[moburkes]

What is the name of your state? VA

I would like to better understand these statutes.

http://leg1.state.va.us/cgi-bin/legp504.exe?000+cod+38.2-3405

Any addtional information would be appreciated.

Thank you.

We aren't going to interpret them for you, but if you have a legal question,we can try to answer it.

 

[ecmst12]

Be more specific about what part you are confused about, and it would help if you explained the situation you are in so maybe we can tell how these laws apply to YOU.

 

[SMJ_08]

I was a passenger in a work colleagues car that was rear-ended.

I went immediately to the emergency room due to injuries sustained in the accident. The ER bill was approximately $8500. My health insurance was used at the hospital.

Subsequently I have been using my health insurance and my own money for medical care as my primary physician and specialists will not work directly with auto insurance companies for payment (It has been a big pain both literally and figuratively)

My question regarding the linked statute is how this applies to my situation.

Do I have my health insurance company work with the auto insurance company of the party at fault? Or, do I build the health insurance bills in to my settlement with the auto insurance comapny and then reimburse them?

Quite frankly I do not want to notify the health insurance comapny yet so that they do not cut me off mid-treatment, and before I can reach a settlement with the at fault's auto insurance company.

TIA

 

[moburkes]

The health insurance company, in your state, has no obligation to "work with" your auto insurance company.


edit: I think what you're looking for, OP, is that your health insurance company does not have the right to be reimbursed from your settlement. However, does your health insurance policy specifically EXCLUDE coverage for auto accidents? You'll need to read your policy to be sure.

 

[SMJ_08]

Your answer confuses me. My auto insurance company? Why are they involved? I was not in my car and I was not driving?

So should I get reimbursement from the at-fault's auto insurance company for the health insurance benefits and then pay back the health insurance company?

 

[moburkes]

Your answer confuses me. My auto insurance company? Why are they involved? I was not in my car and I was not driving?

So should I get reimbursement from the at-fault's auto insurance company for the health insurance benefits and then pay back the health insurance company?

Didn't mean to be confusing. Your medical payments coverage under YOUR auto insurance policy can pay some of these medical bills. Then, the at fault driver's liability coverage can pick up the rest, up to the per person policy limits.

 

[ecmst12]

Where do you get your health insurance from? Through your employer? If your employer-sponsored health plan is self-funded, then this law may not apply to them at all, since that type of plan is governed by federal law and not state law. But if your plan IS subject to this law, it appears that they are not able to seek reimbursement from you or any auto insurance company for the amounts that they paid towards your medical bills.

 

[SMJ_08]

OP? Not sure what that means.

I do not expect to get paid for something that I should not. If I get reimbursed for what the health insurance company paid for, then I will pay them back.

I just do not want to get in to a situation where they ask me to pay them back, and I have not gotten paid for the expenses myself.

I just need to understand how the process works and what I can and cannot do. And, the best way to proceed from here.

 

[SMJ_08]

Where do you get your health insurance from? Through your employer? If your employer-sponsored health plan is self-funded, then this law may not apply to them at all, since that type of plan is governed by federal law and not state law. But if your plan IS subject to this law, it appears that they are not able to seek reimbursement from you or any auto insurance company for the amounts that they paid towards your medical bills.

I get my health insurance through my employer; I pay 100% of the premiums.

 

[moburkes]

OP: original poster, person who started the thread, you.

ecmst12: Not necessarily true. Especially if they specifically exclude auto accident coverage. Then, they aren't seeking reimbursement, but can simply undo all of their payments to the providers.

You need an attorney. You weren't the driver. You may or may not have medical payments coverage on your OWN policy. The co-worker may have underinsured motorist coverage on their policy. The at fault driver hopefully has insurance.

 

[ecmst12]

The law says that benefits cannot be reduced due to payments associated with liability coverage.

Most plans that exclude claims associated with auto accidents exclude only if there is other insurance available; they still pay if there is no auto coverage or if it is exhausted. This would not be legal under this law.

Self funded has nothing to do with premiums, it has to do with where the money to pay claims comes from. How large is your employer? The bigger the company, the more likely that the plan is self funded. You should be able to find out whether or not the plan is self funded by calling your health insurance customer service.

 

[moburkes]

Agreed. However, I am doubtful that all 3 people had no insurance.

 

[SMJ_08]

The law says that benefits cannot be reduced due to payments associated with liability coverage.

Most plans that exclude claims associated with auto accidents exclude only if there is other insurance available; they still pay if there is no auto coverage or if it is exhausted. This would not be legal under this law.

Self funded has nothing to do with premiums, it has to do with where the money to pay claims comes from. How large is your employer? The bigger the company, the more likely that the plan is self funded. You should be able to find out whether or not the plan is self funded by calling your health insurance customer service.

FWIW, it is a 10 person company. I do not believe it is self-funded, but I will check.

 

[ecmst12]

But that's not my point. The law says that benefits cannot be reduced because of liability coverage. Meaning that they CAN'T exclude auto accidents when other coverage exists, they have to pay regardless of auto insurance liability. They might be able to exclude auto accidents REGARDLESS of other coverage, but if they did that, they probably wouldn't have paid in the first place. And they are forbidden from seeking reimbursements from anyone's right to recover from a third party.