Subrogation For Claim In Fulton
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FAQ
Subrogation Law and General Insurance Policies Georgia's Made Whole Doctrine states that a benefit provider (health insurance, generally) may only recover from a third-party claim (such as a client's personal injury settlement) if the amount of the recovery exceeds the sum of all economic and non-economic losses.
When you file a claim, your insurer can try to recover costs from the person responsible for your injury or property damage. This is known as subrogation. For example: Your insurance company pays your doctor for your treatment following an auto accident that someone else caused.
Under O.C.G.A. § 33-24-56.1, Georgia law codifies the Made Whole Doctrine in the context of health insurance subrogation. The statute provides that an insured individual must be “fully compensated for his or her damages” before any subrogation rights of the insurer can be enforced.
When factoring comparative negligence and improper referrals, the recovery rate should be somewhere in the range of 85-90%. This requires adjusters properly identifying subrogation, assessing comparative negligence and pursuing only what they are entitled to.
One challenge you might face when fighting a subrogation claim is proving your innocence. If you were not liable for the injury and your lawyer is able to prove that, then the insurance company will have a much harder time pursuing you for reimbursement.
Georgia's subrogation statute is written to protect the claimant. The claimant recovers first and the intervenor (the employer/insurer) recovers only after the claimant.
Insurance companies don't have forever to make a subrogation claim. While the statutory limitations period can vary depending on the type of subrogation claim made—and in which jurisdiction it is made—the standard statute of limitations ranges from one to six years.
New York. North Carolina. Virginia. Georgia – essentially anti-subrogation through a strong made whole doctrine that cannot be overridden by contract language.
