Do you have to pay back your insurance company for the medical bills it paid?

Texas Attorney at Law

This has been a disputed area of the law for some time. Health insurance companies generally want to get paid back for the medical bills they paid before your get any money. Unfortunately the Texas Supreme Court in Fortis Benefits v. Cantu,234 S.W.3d 642, (Tex 2007) gave insurance carries the right to obtain money from a settlement or judgment if the insurance policy gives them a contractual right to these funds. This is known as contractual subrogation because the insurance companies right to get these benefits are contained in their insurance contract. The U.S. Supreme Court in Sereboff v. Mid Atlantic Medical Services, Inc. made a similar ruling. Therefore it is important to try and negotiate with the insurance company before the case is settled. Once the case is settled an injured worker will have less power to negotiate with the health insurance provider.


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