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Health insurance subrogation is one of the most overlooked issues in bike accident cases, but it can significantly affect your settlement. So, what exactly is subrogation?
After a bike accident, your health insurance might initially cover your medical bills. If you later receive a settlement or court award from the at-fault driver or their car insurance provider, your insurer can ask you to repay the amount they paid on your behalf. This subrogation process often catches people unaware.
An experienced bicycle accident attorney from Busald Funk Zevely can advise you of legal issues applicable to health insurance in Florence bicycle accident cases and help you prepare for them.
Why You Need To Understand Subrogation
Kentucky allows subrogation in most cases unless your insurance policy specifically prohibits it. For example, if your health insurance pays $15,000 for hospital and rehabilitation costs and you later receive a $50,000 settlement from the driver who hit you, your insurer might put a lien on your settlement to recover that $15,000. These liens are legally binding, and courts can enforce them if necessary. Notify your lawyer if you have received health coverage for your treatment thus far.
Not all health plans have the same subrogation rights. Private health insurance plans funded by the government and plans such as Medicaid and Medicare are subject to federal restrictions. Additionally, Kentucky Revised Statute § 411.188 limits what health plans may recover from your settlement. Some court cases apply to the process as well, making legal oversight necessary.
Subrogation is not automatic. Usually, the insurer must send a formal notice of the lien. A letter of this kind is not something to ignore or toss aside. Failing to address subrogation properly can delay your settlement payout or even reduce the amount you finally receive. Busald Funk Zevely has successfully negotiated health insurance lien reductions and challenged subrogation claims that overstepped the legal limits for bike crash claims in Florence.
Should You Use Your Health Insurance or Wait for the At-Fault Driver’s Insurance?
Many clients ask us whether to use their health insurance or wait for the at-fault driver’s auto insurance to pay. While waiting might seem like the smarter move, delaying treatment weakens your case and puts your recovery at risk.
Using your health insurance gets you immediate care. Some people worry that this will affect their future settlement; however, you can still seek compensation from the driver.
Keep track of what your insurance covers, since your provider might want their money back from your settlement through subrogation. Having a Florence cycling accident lawyer involved early can help you stay organized and avoid surprises during the medical insurance claims process.
Can Your Health Insurance Say No After a Bicycle Accident?
Health insurance companies cannot deny coverage just because the injuries came from a bicycle accident. If your treatment is medically necessary and your policy is current, they have to process the claim. This includes emergency care, surgery, rehabilitation, and follow-ups.
Some insurers might delay approval if they think someone else is liable. They may ask questions about the accident, but this is usually to see if subrogation might apply. A short delay in processing a Florence bike collision claim is different from a denial of health care coverage.
Ask a Florence Bike Crash Lawyer for Help With Your Medical Insurance Claim Today
Our legal team at Busald Funk Zevely brings decades of combined trial experience to every case. One of our team members currently sits on the Board of Governors for the Kentucky Justice Association, an organization dedicated to protecting the rights of injured people. We commit to helping people injured in bike accidents.
To speak to one of our lawyers about health insurance in Florence bicycle accident cases, contact us now to schedule a free case review.
