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Patrick, Esq.
Patrick, Esq., Attorney
Category: Personal Injury Law
Satisfied Customers: 12188
Experience:  Attorney with significant personal injury experience
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I live in California and was in a car accident July 29,

Customer Question

I live in California and was in a car accident July 29, 2014. I received a settlement which included reimbursement for some medical bills incurred due to the accident. I received a letter from my health insurance company today telling me they are pursuing subrogation. Is there a statute of limitations as to how long after the accident they can pursue reimbursement? What do I need to be aware of when I respond? I believe they are asking me to reimburse money that would have gone towards my deductible. Is it fair to fight that?
Submitted: 8 months ago.
Category: Personal Injury Law
Expert:  Patrick, Esq. replied 8 months ago.

Hello and welcome. My name is ***** ***** it will be my pleasure to assist you. Please just give me a moment to review your question....

Expert:  Patrick, Esq. replied 8 months ago.

Unfortunately, there is a clause written into virtually all health insurance contracts which requires the insured to reimburse their insurer if they receive compensation from a third party for accident-related medical treatment. The insurance company's entitlement to such funds is, thus, premised in contract law. The statute of limitations for breach of written contracts in CA is 5 years, so if your accident happened in 2014 they would be well within the timeframe they had to act. The health insurance company is only seeking reimbursement for that money it paid on your behalf. The payment you make to them should be applied to your deductible, but no part of the reimbursement would be excused because you met you deductible.

The good news is that these reimbursements are typically negotiable in terms of the amount you pay back. In the vast majority of cases the insurance company will accept a reduction, typically of around 1/3. You might be able to argue an even greater deduction if you can argue that the other driver's insurance only accepted partial liability (thus, presumably, they only were intending to reimburse for "part" of your medical expenses) or if the settlement was for the other driver's policy limits (in which case it could be presumed that you were not fully compensated for your injuries and thus that you should not have to completely reimburse your health insurance).

There is no way to completely get out of repaying this money, so the sooner you can call to negotiate the better.

If I can clarify anything at all for you, please do not hesitate to ask. It is my pleasure to assist you further if necessary....

Expert:  Patrick, Esq. replied 8 months ago.

Were you able to view my answer?