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Health Insurance Companies Must Work with Injured Victims in Texas

Recently, the Texas Legislature passed a bill which can greatly help people who are injured in accidents and who may be covered by health insurance insurance. The legislature is addressing an issue of Insurance Subrogation Law. This area of the law had reached the point that it benefited insurance companies to the detriment of the injured victim in many cases.

First, subrogation occurs as the result of an injury and an insurance claim. Oftentimes, a person is hurt due to the actions or negligence of someone else–the “negligent third party.” If the injured person has to go to the hospital or see a doctor, they may file a claim with their health insurance company; and, then that injured person’s health insurer might want to know what the actual cause of the injury was and might ask whether or not the accident was actually someone else’s fault. If the accident is the fault of some other “third party,” the health insurance company will assert a type of lien or claim against the third party insurance recovery – essentially telling the injured victim that if there is a recovery, the health insurance company wants to be reimbursed for the amounts it paid to hospitals, doctors and other health payments. But for clients who are seriously injured, a problem arises when the third party’s insurance is either too little to cover the damages sustained, or will not pay enough to cover the damages caused by the injuries. Many times, health insurers want all of their money, leaving little or nothing for the injured victim.

But, the Texas Legislature, by passing House Bill 1869 made it somewhat easier for injured parties to be compensated, and not have to give up most or all of their recovery to the health insurance carrier. This new law has re-designed how injured parties are compensated, with a greater concern for the injured parties, the real victims of someone else’s negligence. Now, the health insurance company is still entitled to be reimbursed, but the amount they are entitled to is limited to a percentage of the total recovery from the negligent person, ensuring that the victim of negligence will have a larger part of the recovery to compensate them for the other harms and losses suffered. If you find yourself in a situation where you or someone you know is injured and is experiencing the stress and confusion of dealing with multiple insurance companies, you may need an attorney to help you handle this complicated issue.