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I Was Hurt in an Accident in Stockton—Will the Health Insurance Company Take My Personal Injury Settlement 

According to data from the Kaiser Family Foundation (KFF), more than 90 percent of California adults have health insurance coverage. It may be from an employer, private plan, Medicaid, Medicare, or another source. If you are hurt in an accident caused by another party, your health insurance company is not off the hook. They should still provide the appropriate coverage. Indeed, in many cases, a health insurance company pays for medical care first while a claim is pending. 

This raises an important question: Will my health insurance company take my personal injury settlement? The short answer is that a health insurer may be entitled to reimbursement for costs it paid through a process known as subrogation. Here, our Stockton personal injury attorney discusses the most important things that you should know about your health insurance company and your personal injury settlement. 

Your Health Insurance Company May Cover Many (or All) Medical Costs

Following a serious accident in Stockton, an injured victim’s medical needs are immediate. It is crucial that you or your loved one gets emergency medical attention as well as the proper ongoing and follow-up care. Of course, a personal injury claim takes months (or even longer) to be fully resolved. Health insurance provides coverage now. If you have health insurance, your insurer may cover many or all of your initial medical costs, including things like hospitalization, diagnostic care, surgeries, medications, and physical therapy.

A Health Insurer Can Seek Reimbursement for Costs Paid (Subrogation)

If your health insurance company does cover some or all of your medical costs, it is important to understand that they may seek reimbursement for those costs from any settlement or verdict that you receive from the responsible party. An insurance company’s ability to seek reimbursement for costs that it paid occurs through a process known as subrogation. Here is what you should know: 

  • Subrogation: Subrogation is a legal concept that allows one party—most often an insurance company—to step into the shoes of another party and pursue any legal claims or rights that the original party had. In the context of personal injury cases, subrogation typically arises when a health insurance company pays for medical treatment related to an accident, and then seeks reimbursement for those costs from any settle
  • ment or compensation the accident victim receives from the responsible party. Essentially, subrogation allows the insurance company to recoup the costs they paid for the accident victim’s medical treatment, so that they are not left bearing the financial burden of the accident.

Of course, subrogation can be frustrating for accident victims. It could lead to a portion of their settlement going to their health insurance company. That being said, the rights of an insurer are by no means unlimited. An experienced Stockton, CA personal injury lawyer can help. 

Your Personal Injury Settlement Must Be Properly Structured

Personal injury settlements are complicated. It is imperative that any settlement that you reach is properly structured so as to ensure that you receive the absolute maximum financial compensation in your pocket and your health insurance carriers receive the minimum through a subrogation claim. A Stockton, CA personal injury lawyer can help: 

  • Structure Your Settlement: A lawyer can help structure your settlement in a way that takes into account any subrogation claims from your health insurance company, so that you receive the maximum amount of compensation possible.
  • Negotiate with Your Health Insurer: A personal injury lawyer can negotiate with your health insurance company to reduce their subrogation claim or to agree to a payment plan for any amounts owed.
  • Ensure Proper Documentation: A personal injury lawyer can help ensure that all medical bills and documentation related to your treatment are properly documented and submitted to your health insurance company.

The Bottom Line: If you were hurt in an accident in Stockton, you have the right to pursue financial compensation for the full extent of your economic and non-economic damages from the at-fault party. Your health insurance company may cover some (or most) of your medical costs while your claim is pending. Your health insurance provider can seek reimbursement for money it paid through any future personal injury settlement or verdict. An experienced Stockton, CA personal injury lawyer can help you minimize the amount that the health insurer claims through subrogation. 

Schedule a Free Case Review With a Personal Injury Lawyer in Stockton, California

At Redkey Gordon Law Corp, we are devoted to protecting the rights of victims and families. If you or your loved one was hurt in an accident and you have questions about health insurance, our attorneys are here as a legal resource. Call us now or connect with us online to arrange your free, no strings attached consultation. With a legal office in Stockton, our personal injury lawyers fight for the rights and interests of injured victims in San Joaquin County and throughout the area.