Subrogation Attorney in Florida
If you file a first-party claim, one with your own insurance company, your insurance company may want the other party’s insurance company to pay them back if the other party is at fault for your personal injury.
This is the process called insurance subrogation. If subrogation applies, your insurance company pays you, and the other party’s insurance company reimburses your insurance company. It is typically uninsured or underinsured motorist claims which are subject to subrogation, PIP benefits can be but generally are not.
Because subrogation occurs between the companies, you as the customer do not have much to do in the process except provide adequate notifications to those with an interest. This process is routinely handled by personal injury attorneys as part of their management of your claims.
If you decide to settle with the other company, you must follow the procedure set out in the Florida Statutes which requires that you (or your attorney) send written notice of the proposed settlement to the insurers that provided coverage. Your insurer may pursue its right of subrogation with the person at fault or their insurance company. Because the at-fault driver is responsible for your injuries, your insurance carrier has the right to sue the at-fault driver to recover money you or your insurer have already paid, including the amount of your deductible. Subrogation prevents the settlement benefits from duplicating any insurance benefit, services already covered, that you have already received from other sources.
Secondary sources involved in subrogation can include:
Because these sources made payments, they may have legal claim against any settlement you collect from the at-fault party, and should be reimbursed for payments they have made to your doctors and health care providers.
Common reasons for claim denials and how to move forward
It is very common for car insurance companies to deny your claim for damages. Personal injury attorneys routinely handle these denials after the client has tried to manage the claim themselves or after a large or complex claim has been submitted. Depending on the reason, the first step is often to appeal the decision and submit further evidence supporting your claim. Your insurer will have a specific process in place for this that you or your attorney will need to follow. Some common reasons for denial and how to rebut them are as follows:
This group of reasons for claim denial arise from the issue of fault in the accident. If there is evidence the accident was avoidable, that you admitted fault, or insufficient evidence you were not at fault – your insurer may have denied the claim. What you or your attorney can do is gather additional supporting evidence of your lack of fault or lesser fault, under Florida’s comparative fault rules, and organize it well in a demand letter. If there is little evidence, you may have to be prepared for a lower settlement value from the claim, but this gets many claims considered beyond an initial denial.
A denial from the insurance company which is based on your injuries not being apparent, treated, or already existing are best refuted with an expert opinion to the contrary. Sometimes the insurance company simply did not receive your medical records which indicate treatment or an injury, in which case, sending those should be sufficient. In other cases however, you will need to have your medical provider generate a letter explaining your diagnosis or visit a medical provider to obtain one and send the company. Although preexisting conditions can make it difficult to determine how a car accident injured you further, the at-fault party is still liable for that further injury. It is important to note that the 14-day rule in Florida for claiming coverage under PIP is often strictly enforced and if you failed to seek any treatment during that time, your insurer is permitted to deny the claim.
When your insurance company denies your claim based on the policy itself, it is best to seek the counsel of an experienced personal injury attorney. Insurance policies are contracts and it takes a skilled eye to identify the relevant terms as there are often exclusions and particular meanings to these terms. While a failure to pay the premium is rarely appealable, denials based on no coverage or a failure to follow requirements can often be refuted if handled by someone familiar with how insurance policies work.
If you have been in a car accident and experienced denial of your claim, the experienced personal injury attorneys of Oldham & Delcamp are available to review your case. We have experience dealing with insurance companies and appealing claims to seek the compensation you are entitled to for your injuries.
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