Anyone know how Insurance works in MO?

billwert

New Member
Sep 25, 2007
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Naylor
On Sept. 11 I was involved in a head on collision. The driver of the other vehicle was at fault. He had no insurance and fled the scene of the accident. He also was high on drugs. He is a repeat offender in the state of Mo. for DUI. I was flown out by air evac to a local hospital to undergo emergency surgery for a compound fracture of the tibia. My fibula was also broken in two places. I made a claim with my auto insurance and they gave me my 25000 in coverage for uninsured motorist. (Keep in mind I have liability only) My health insurance now wants to use their subrogation rights to claim some if not all of my uninsured motorist money. My claim rep. from my auto insurance told me if they were part of an erisa program they might try to take it. I discussed with my health insurance and they said since my parents were government employed that we were exempt from the erisa program. When I talked to them today they told me that they had a claim recovery program to get my uninsured motorist money as well or that I could make an offer at which I thought was fair for them to get. I told them I had no offer in mind and that I would talk it over with my family. I also told them I am out wages from work I have dealth with pain and suffering and I have no car. The other guy has nothing I can get from him. He lives with his dad or mom and does not have a job. I do not know if he gets any wages from the state. My question is does my healthcare have a right to take money provided to me by my auto insurance? (Which I pay for and not my dad) I don't understand how they can when the check was written in my name only and I have put it into a savings account. Thanks for any responses.
 

flight doc89

Registered Murse
Apr 21, 2006
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Bessemer, Alabama, United States
Well, someone has to pay the hospital bill. Your uninsured motorist insurance is intended to cover medical bills and lost wages. Your health insurance's subrogation rights depend on your policy (go through and read fine print).

If your policy has the right type of subrogation written into it (which it probably does), then they have a right to some of the money from car insurance.

You have to argue with your health insurer that part of that money needs to cover lost wages and your pain and suffering, and then you make an offer.
Next options are:
A: They accept offer, and you fork over part of your car paycheck.
B: They deny offer, and give you counter offer, and you keep countering till you accept.
C: You refuse to accept any of their counter-offers and take them to court.

Does the other guy really have nothing? How old is he? You may be able to subrogate your right to sue that other guy over to the health insurance rather than let them take your car insurance, but I bet they will take part of your car check anyways.

Read the details of your policy. Make sure the subrogation clauses actually allow them to take money from you. IIRC, my own health insurance's subrogation clause is purely to allow them to sue somebody in my place, and doesn't let them take anything else from me.
 

billwert

New Member
Sep 25, 2007
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Naylor
The other guy seriously has nothing. He is like 30 years old and lives with his dad or mom. I'll find out whether he has anything or not when I go to court to testify in his preliminary hearing. Their recovery program is to get money out of the other guy but since he has nothing and I do they are going to try to get my money. I'll have my dad look over his policy and see what it says. It sounds like i'm going to have to get a lawyer if I can't settle on an amount with my dad's health insurance. Thank you for your reply