New Bill Helps Protect Consumers from Health Insurance Companies

Waxahachie, TX (Law Firm Newswire) August 1, 2013 – A Texas House Bill was signed this past May which restricts “subrogation,” the substitution of one person or group by another for insurance rights.

Texas House Bill 1869, passed unanimously in both the House and Senate, is designed to provide a legal framework which allows the settling of personal injury cases while helping an injured person meet their other expenses and providing certainty to health insurers. The law takes effect in January 2014.

Subrogation by an insurance company occurs when the company that collected premiums from an individual is determined to be reimbursed by their insured for that loss although they have agreed to that loss.

“The subrogated company assumes the legal rights of the insured in order to collect from their own insured after a settlement or from the person who caused the loss,” explained John Hale, a Waxahachie personal injury lawyer. “When a health insurance carrier takes on the legal rights of a claimant in order to take the recovery for itself, problems can arise. The responsible party who caused the harm often is not in possession of enough assets or insurance to pay the entirety of the injured party’s losses.”

What does Bill 1869 mean for consumers? Some health insurance carriers have made it a priority to collect subrogation from injured policy holders. The Supreme Court of Texas decided in Fortis v. Cantu, 234 S.W.3d 642 (Tex.2007) that insurance companies are allowed to require policy holders to pay out “first money” to the subrogated health insurance company, even if the actual injured party might be left with nothing.

In its ruling, the Supreme Court stated that a health insurer’s contractual subrogation rights overruled the made-whole doctrine. With Bill 1869, there is a formula put into place to allow for a balanced division of the recovery when there are not enough funds, so that both the injured party and the health insurer are compensated.

John Hale is a Waxahachie personal injury lawyer and Ellis County personal injury lawyer helping injury victims near Dallas, Texas. Learn more at The Hale Law Firm

The Hale Law Firm
100 Executive Court, Suite 3
Waxahachie, TX 75165
Call: 888.425.3911

View Larger Map

• Blood Thinner Side Effects of Pradaxa Triggers Multiple Lawsuits
  Following the formation of the pharmaceutical Pradaxa multidistrict litigation (MDL 2385) in late 2012, there have been more than 640 new federal claims filed. The majority of plaintiffs are alleging that the blood thinner has caused them internal bleeding and other potentially life-threatening side effects. Dabigatran, better known as Pradaxa, marketed by Boehringer Ingelheim, is an anti-coagulant prescribed to millions of patients since its release in 2010. Now patients are coming forward with claims of life-threatening and other serious side effects. An FDA MedWatch report states that Pradaxa caused at least 542 known deaths in 2011, the year after it […]
• Surgical Complications Can Mean Good Business for Many Hospitals
  According to an article published this April in the Journal of the American Medical Association (JAMA), rather than lose money when things go wrong, hospitals typically profit from the medical mistakes they make, whether or not negligence is involved. Interestingly, hospitals are compensated by insurers when patients stay hospitalized longer and additional care is required to address surgical complications and post-surgical errors. The study, “Relationship Between Occurrence of Surgical Complications and Hospital Finance,” looked at the results of nearly 35, 000 surgical discharges, the most common surgical procedures and complications, and how those were handled by insurers. The researchers also examined […]
• Better Workplace Regulations And Stricter Enforcement of Current Regulations Key to Workplace Safety
  The recent fertilizer plant explosion which caused multiple fatalities and serious injury in West, Texas, has raised the public visibility of workplace safety issues. “Every worker should be able to feel that their safety and the safety of their coworkers is a priority,” stated Waxahachie personal injury attorney John Hale. “But unfortunately, workplace safety continues to be a major concern in Texas.” April 28, 2013 was Worker’s Memorial Day, during which a vigil was held for 56 workers fatally injured in 2012 in Houston workplace accidents and other Texas workers who had been killed. The spokesperson for United Support & Memorial […]