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Why Does My Insurance Company Get To Recover Its Payments To Me? Isn’t That What My Premiums Are For?

Your Insurance Company Gets To Write The Policy Any Way They Want.

In Ohio, the legislature has decided a number of times that it will not tell the insurance companies what to put into their policies. There are a few exceptions – but that’s the general rule.

So if you submit a claim for medical payments coverage to your auto insurer, or for medical bills to your health insurer, you can count on them asking for their money back when your lawsuit against the other driver’s insurance settles.

Your insurance company’s right to recover its payments to you is called subrogation.

Sometimes, they even make you sign a document promising you will pay them back before they make any payments. I have seen one health insurance company threaten to cut off my client’s coverage if she would not sign the document.

What’s their justification? They would say you are just paying for insurance to help you through a tough time; when you recover your money from the other driver’s insurance company, the tough time is over. So it’s your turn to pay them back.

And they’ll tell you that’s how they keep their premiums as low as they are. (I’m holding my tongue.)

What can you do about it? Your lawyer can tell your health insurance company that you won’t agree to settle the case unless they agree to reduce their cut.

Or he can play the sympathy angle – he can talk about how a full recovery by the insurance company will leave you without anything left over from the settlement. Sometimes, the insurance company will waive their right to recover in part or in whole if full recovery will leave the policyholder (you) in bad straits.

Or your lawyer can point out that the insurance company is trying to get paid back for bills that were not caused by the accident.

I have been a lawyer over 30 years. Everything you do with insurance companies is a negotiation. If you have a personal injury case in Cincinnati, Ohio or if you want to know what your lawsuit is worth, talk with an experienced Cincinnati Personal Injury Attorney about the case. Call me, William Strubbe, at 513-621-4775.

Because all situations are different, and because there may be other facts pertaining to your case that I don’t know about, you should not rely on this answer for legal advice. I am not your attorney, and no lawyer client relationship has been formed. And past performance cannot be used to predict future results.

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