Canyon Country, CA asked in Health Care Law for California

Q: In subrogation, is the healthcare provider seeking reimbursement for themselves or for the company they represent?

The incident occurred while I was getting my healthcare coverage through COBRA. I’m questioning whether the healthcare provider has a legal right to subrogation since I was no longer an employee

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2 Lawyer Answers
Theodore Allan Greene
Theodore Allan Greene
Answered
  • Sacramento, CA
  • Licensed in California

A: The healthcare company seeks subrogation for themselves. It doesn't matter where or how you get the coverage. Medicare, Medi-Cal and all private health insurance companies have such a policy. The theory is that you didn't pay for the treatment so if you get money from a 3rd party for your medical treatment then you shouldn't get to keep - but instead should give it to the medical provider.

William John Light agrees with this answer

1 user found this answer helpful

Dale S. Gribow
Dale S. Gribow
Answered
  • Palm Desert, CA
  • Licensed in California

A: more info would be helpful.

Subrogation is the substitution of one person or group by another in respect of a debt or insurance claim, accompanied by the transfer of any associated rights and duties.

It is usually the person or company that paid out on a claim and they see you as the person who should be responsible. They take the position that if you get money for a claim you should be responsible for the costs involved.

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