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Why Does My Health Insurance Want Me To Fill Out A Form After I’ve Been Injured In An Accident?

You have been sent the form because your health insurance has paid for medical bills which it believes may be the result of someone else’s fault. If so, they want to find out that information because they may have a right to be repaid or reimbursed if you obtain a settlement or recovery against the at-fault person, company or insurer for that at-fault person or company. This is called “subrogation”. Your health insurance policy will probably have a “subrogation” section or clause stating this.

It is also in your best interest to complete and return the form to your insurer because if you do not and you get a settlement or recovery in your personal injury case, your company may come after you for the amounts they’ve paid.

Under Pennsylvania Law, when you are injured in an accident, you may have to submit your medical bills to your health insurance. You may be wondering why you have to do that if the injury was caused by someone else and they have liability insurance. For example, If you are injured due to falling or being injured as a result of a dangerous condition to property, or as a result of an unsafe product, unless the liability insurance company has “med pay”, you have to submit your medical bills to your insurance. Your insurance may have a right of subrogation, meaning if you obtain a settlement or recovery against a third-party, your health insurance has the right to be repaid.

So, in the end, the at-fault insurance company is paying the medical bills by being responsible to reimburse your health insurance company from a settlement. Your health insurance is simply fronting it and the form they want you to fill out facilitates that process.

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