Subrogation
The right of your health plan to recover payments it made if a third party (auto accident, employer negligence, product liability) is responsible.
Subrogation is the legal right of your health plan to recover what it paid if a third party caused the injury. Example: you're hit by a car, plan pays your medical bills, plan then seeks reimbursement from the at-fault driver's auto insurance. ERISA plans have broad subrogation rights. State 'made whole' doctrines may limit recovery if the patient hasn't been fully compensated.
Frequently asked questions
What is subrogation?
Subrogation is the legal right of your health plan to recover what it paid if a third party caused the injury. Example: you're hit by a car, plan pays your medical bills, plan then seeks reimbursement from the at-fault driver's auto insurance. ERISA plans have broad subrogation rights. State 'made whole' doctrines may limit recovery if the patient hasn't been fully compensated.
Related terms
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