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What is subrogation?
Subrogation is someone else’s right to stand in your
shoes and sue to recover for anything they paid on your behalf.
In other words, if you were injured and your primary health
insurer paid medical and hospital bills that were caused by
the other person’s negligence, your health insurer has
a right to seek reimbursement for the money it paid out on
your behalf.
If you settle your case with the responsible party and receive
payment for your medical expenses and pain and suffering,
then in states that allow subrogation your health insurer
can look to you to get repaid (since you recovered monies
for medical expenses your insurance company paid). “Subrogation
simply means substitution of one person for another; that
is, one person is allowed to stand in the shoes of another
and assert that person's rights against the defendant. Factually,
the case arises because, for some justifiable reason, the
subrogation plaintiff (usually an insurance company) has paid
a debt owed by the defendant." Dan B. Dobbs, Law of Remedies
§ 4.3, at 404 (2d ed. 1993). However, a injured person
can argue that if the settlement or judgment did not make
him or her “whole” (the amount received does not
constitute full compensation for the injuries), then your
insurer does not have the right to obtain subrogation.
How does subrogation affect me?
Subrogation can affect you when you receive money in a settlement
or a favorable award from a jury for money damages. You need
to be aware that others (medical providers, hospitals and
insurance companies) must be taken into consideration. In
other words, their bills (or a portion thereof) may need to
be paid out of the proceeds of your recovery. Your attorney
can try to negotiate these payments with these parties on
your behalf prior to any pay-out of the recovery. If it appears
that your case may be resolving soon, you should ask your
attorney about subrogation and how he or she plans to handle
it.
In Georgia
Under Georgia law, hospitals and nursing homes can file a
‘lien’ against your cause of action to ensure
they get paid from any recovery you receive in your case.
Any person, firm, hospital authority, or corporation operating
a hospital or nursing home in this state shall have a lien
for the reasonable charges for hospital or nursing home care
and treatment of an injured person, which lien shall be upon
any and all causes of action accruing to the person to whom
the care was furnished or to the legal representative of such
person on account of injuries giving rise to the causes of
action and which necessitated the hospital or nursing home
care, subject, however, to any attorney's lien.” O.C.G.A.
§ 44-14-470(b)
In order to perfect the lien provided for in code section
44-14-470, the operator of the hospital, within 30 days after
the person has been discharged therefrom, shall file in the
office of the clerk of the superior court of the county in
which the hospital is located and in the county wherein the
patient resides, if a resident of this state, a verified statement
setting forth the name and address of the patient as it appears
on the records of such hospital; the name and location of
the hospital and the name and address of the operator thereof;
the dates of admission and discharge of the patient therefrom;
the amount claimed to be due for the hospital care; and, to
the best of the claimant's knowledge, the names and addresses
of all persons, firms, or corporations claimed by the injured
person or the legal representative of the person to be liable
for damages arising from the injuries. Such claimant shall
also, within one day after the filing of the claim or lien,
mail a copy thereof to any person, firm, or corporation claimed
to be liable for the damages, said copy to be mailed to the
address given in the statement. The filing of the claim or
lien shall be notice thereof to all persons, firms, or corporations
liable for the damages, whether or not they are named in the
claim or lien.” O.C.G.A. § 44-14-471 (West 2002).
Other potential liens are available under Georgia law. The
right to pursue an equitable lien may be different from state
to state.
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