Your health insurer may want repayment from your settlement. Here's how that works.
Why Your Insurer Wants Repayment
When your health insurer pays for injury-related care, it may claim a right to be repaid from your settlement, a process called subrogation.
This can reduce your net recovery if not addressed.
How Subrogation Works
The insurer asserts a lien or reimbursement right against the portion of your settlement attributable to medical expenses.
Understanding the basis of the claim is the first step to managing it.
Made-Whole and Common-Fund Rules
California doctrines like the made-whole rule and the common-fund doctrine can limit or reduce what an insurer may recover from your settlement.
These rules can meaningfully increase what you keep.
ERISA and Government Plans
Repayment rights differ for ERISA employer plans, Medicare, and Medicaid, which follow their own federal rules.
The type of plan changes the analysis significantly.
Negotiating the Repayment Down
Subrogation and reimbursement claims are often negotiable, and reducing them directly increases your net recovery.
This negotiation is a key part of resolving a claim.
Protecting Your Net Settlement
Handling subrogation correctly is as important to your bottom line as the size of the settlement itself.
A free case review can explain how subrogation may affect your case.
This article is for general informational purposes only and is not legal advice. Laws change and every case is different. For advice about your specific situation, consult a licensed California attorney.