![\"Oregon](\"https:\/\/pdxinjurylaw.com\/wp-content\/uploads\/2011\/07\/Understanding-Personal-Injury-Protection-Insurance.jpg\")
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If your health insurance or your auto insurance (PIP) pays your medical bills due to an injury that was someone else\u2019s fault, and then you get a settlement from that person (or their insurance company), then your insurance company (that pays your medical bills) has the legal right to get back the money they paid for your medical treatment. They can do this by \u201clien\u201d or by \u201csubrogation.\u201d Their legal right to do this is in ORS 742.534, 742.536, and 742.538.<\/p>\n
Subrogation is defined as circumstances in which an insurance company tries to recoup expenses for a claim it paid out when another party should have been responsible for paying at least a portion of that claim.<\/p>\n
Our definition is when your health insurer (or auto insurer, or Medicare, or other insurer) steals your money.<\/p>\n
In our opinion, this is an outrage. You have been paying insurance premiums so they would pay your medical bills, not so they would give you a loan. But it\u2019s the law, and you need to be aware of this flawed system because it can significantly affect your financial situation.<\/p>\n
Often, the insurance companies will work out the payment among themselves without involving you. But sometimes they will force you to pay the lien.<\/p>\n
Tu mejor acci\u00f3n es tratar primero de que lo resuelvan por s\u00ed mismos. Anima a tu propia compa\u00f1\u00eda de seguros a obtener el reembolso de la compa\u00f1\u00eda de seguros de la persona que te lastim\u00f3.<\/p>\n
If that doesn\u2019t work, the next best option is to negotiate the amount of the lien. Insurers will often reduce the amount you owe them if you negotiate well. For example, if they paid out $130,000 in medical bills, you may be able to talk them into accepting $80,000 or even less in full satisfaction of that money. In this negotiation, ORS 742.536 can be helpful, because it states that the insurance company should automatically reduce its lien by the percentage of your attorney fees and costs, which means that they normally reduce their lien by about 35%.<\/p>\n
Even if you don\u2019t have a lawyer, they may still be willing to make this reduction, though they would not be legally obligated to. But be aware that many health insurers believe that because they operate nationwide, they do not have to abide by Oregon law. So those insurers may not be willing to automatically reduce the lien. But they may still be open to a good argument about why they should reduce the amount they are collecting.<\/p>\n
Cuando negocies, recuerda, el vinagre funciona, pero la miel a menudo funciona mejor. Un argumento s\u00f3lido sobre la equidad es sorprendentemente efectivo para que reduzcan su gravamen. Incluso podr\u00edas querer recordarles algunos de los nobles sentimientos que probablemente tienen en sus sitios web sobre c\u00f3mo su misi\u00f3n es ayudar a las personas necesitadas.<\/p>\n
In Washington State and California, if you\u2019re not \u201cmade whole\u201d by your settlement, then you don\u2019t have to pay off the insurer. There\u2019s no subrogation until after an accident victim has been fully compensated. Oregon doesn\u2019t have that rule. In Oregon, the health insurer can take your premiums every month for decades, then take all your money from a settlement. They have the right to leave you without a penny if that\u2019s what their subrogation \u201crights\u201d allow them to do.<\/p>\n
It\u2019s a bad situation when you receive a settlement that is barely adequate, only to find out that you have to give a bunch of it to another insurance company. But with good negotiation skills, you can at least minimize the damage.<\/p>","protected":false},"excerpt":{"rendered":"