Legal Question in Insurance Law in California

Insurance company tries to get reimbursed

A policy holder gets injuried as a friends house. Their insurance pays medical bills. Then the insurance company wants to contant friend to see if they might be ale to get reimbursed for claims paid, putting blame on friend and/or homeinsurances insurance. Can they legally do this?


Asked on 4/21/08, 9:42 am

2 Answers from Attorneys

Avi Wagner The Wagner Firm

Re: Insurance company tries to get reimbursed

Probably. Arguably this is would be a fair exercise of subrogation rights (assuming the policy provides them).

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Answered on 4/21/08, 2:10 pm
Edward Hoffman Law Offices of Edward A. Hoffman

Re: Insurance company tries to get reimbursed

Yes. It's called subrogation, and it happens all the time. If you read the language of your insurance policy, you will likely see that it requires you to cooperate if the insurer brings a subrogation lawsuit.

Your insurance company has promised to pay your medical bills (subject to certain limitations), but it has not promised to absorb those costs itself. If you had no insurance you could have sued the people responsible for your injuries, but you might not have been able to collect anything and even if you could the process would have taken time. The insurance company spares you the uncertainty and the delay, but then it can sue in your place if it thinks doing so would be cost-effective.

If insurers had to absorb losses instead of recovering them from the responsible parties, insurance premiums would be much higher than they are now and many people would not be able to afford coverage. Subrogation helps keep premiums down and places the financial burden on the people who caused the harm. After all, why should the fact that you have insurance benefit the people who injured you?

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Answered on 4/21/08, 2:43 pm


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