NEW LAW ON HEALTH INSURANCE SUBROGATION

        Starting in 2014, Texas has a new law that affects the subrogation rights of health insurance carriers. Currently, when a claimant’s health insurance carrier pays for medical services for which a third-party tortfeasor should be liable, the insurance company can seek reimbursement of all or some of its payments from the tortfeasor if the claimant attempts to recover any money from the tortfeasor. The new Chapter 140 of the Texas Civil Practice & Remedies Code limits the amount the health insurance company can collect to no more than half of the claimant’s total recovery. The statute also allows the health insurance companies to seek reimbursement from the claimant’s own uninsured/underinsured motorist coverage or medical payments coverage, but only if the claimant or his family did not pay the premiums for such coverage. According to this new law’s legislative history, this statute should facilitate liability settlements because the health insurance company’s subrogation rights are now limited – because the subrogation right is limited, the claimant can recover something from the third-party tortfeasor even when the settlement offer is less than the insurance company’s subrogation amount. This new statute only applies to health insurance benefits and does not affect workers’ compensation insurance subrogation or Medicare secondary payer recovery.

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