Effectively Recoup Losses from Health Insurance Payouts via Subrogation

The litigation of health insurance subrogation claims and the subrogation of disability insurance claims can be very complicated. Between the changing federal laws governing healthcare providers and constant alterations to anti-subrogation state laws mandating the Made Whole and Common Fund Doctrines, these claims can feel like a moving target. Without the right subrogation counsel to handle these claims, you may be leaving money on the table. 

Rathbone Group has extensive experience in the field of health and disability subrogation, and we understand the importance of HIPAA compliance for all our subrogating healthcare clients. When personal injury claims arise, self-insured employers as well as traditional insurance companies should avail themselves of the opportunities and defenses available through subrogation law to protect their reputation and bottom line.  

Why Retain a Subrogation Law Firm for Health & Disability Claims?

The complications that arise from these types of insurance claims can be many, and the losses sizable if the subrogation process is not handled correctly. Often, an insurer simply does not have the resources to fully pursue viable subrogation claims. A subrogation-focused legal team can take on the burden of existing claims, revisit the viability of past claims, and handle future cases. This offers the client several benefits:

  • Recover the cost of paying out employee claims.
  • Protect your interests.
  • Avoid legal liability.
  • Improve your bottom line.

Payouts for employee workplace injuries add up fast, and a cost-conscious approach to handling health and disability claims is paramount. When relevant, self-insured clients must cover medical benefits, rehabilitation benefits, wage loss benefits, and disability benefits. An integral characteristic in a subrogation law firm is cost-effective services – from initial investigation through claims resolution and payout.

Strategic management of a subrogation claim is a key component to recouping losses where other parties have exposure for the injury suffered by your employee. Our insurance attorneys work in conjunction with our clients’ plan benefit/HR managers and in-house subrogation departments to identify opportunities for pursuit, including taking a second look at subrogation cases the client may not have been able to take on themselves, and facilitate recovery.

Proactive Recovery Efforts for Health Insurance Subrogation Claims

The Rathbone Group team takes time to clearly explain your chances of recovery. We are adept at settling subrogated matters as directly as possible, exhausting all avenues to recovery, including:

  • Pre-suit negotiations
    • Whenever possible, resolving a subrogated claim directly with the other party is the most direct, time and cost-effective approach to attaining recovery. It also fosters cooperation between companies that are likely to encounter each other more than once in subrogated matters.
  • Mediation
    • Mediation provides a non-confrontational opportunity for two disputing parties to communicate through a neutral third party who listens to each side and makes recommendations based on the evidence. The parties may then choose to resolve the subrogated matter or proceed to another route.
  • Arbitration
    • A pre-suit approach to settling a subrogation claim, arbitration, especially in the use of Arbitration Forums, is a way to achieve a binding agreement between the opposing parties without having to proceed to a subrogation trial.
  • Litigation
    • Litigation cannot always be avoided, as contentious claims, complex cases, or those involving multiple liable parties are likely to escalate to an insurance lawsuit that is heard in a court. Rathbone Group retains renowned litigators who work tirelessly to argue the claim and close the matter as soon as possible to minimize cost of recovery pursuit.
  • Post-judgment action (if necessary)
    • A judgment in your favor does not always mean a subrogated health insurance claim is finished. If the opposing party refuses to comply with the court’s decision, our subrogation recovery team utilizes every legal avenue possible to pursue and collect the payment.

Clients may have concerns about the effectiveness of subrogation law in the non-ERISA plan context. Rathbone Group uses creative strategies to apply the Deemer clause to these types of claims, so that you don’t have to resort to forceful collection techniques. Rathbone Group can help you stop the hemorrhaging of health and disability payouts with robust, aggressive subrogation services that maximize chances of recovery on all claims.

Contact Rathbone Group