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What Is a Subrogation Claim in Workers’ Comp?
Handling workers’ compensation claims can be difficult and expensive. In a workplace, accidents resulting from negligence are likely to happen often. The workers should receive immediate compensation coverage benefits from employers.
If a party other than the employer contributes to causing an accident, such an individual becomes the third party. The third party’s liability allows the employers’ insurance provider to get reimbursement. The workers’ compensation settlement works through a subrogation claim.
An employer can pursue compensation recovery they paid on a settlement from an at-fault party. A subrogation attorney can act on your behalf in attaining compensation. The attorney can persuade insurance companies to reduce a subrogation claim to achieve a fair settlement.
Contact Buchanan, Williams & O’Brien, P.C., for a consultation.
How Do Subrogation Claims Work in Workers’ Compensation?
Compensation for workplace injuries is run by the U.S. Department of the Interior (DOI). It also promotes the effectiveness of timely claim compensation from employers.
A subrogation claim is a legal right to pursue compensation against an at-fault party. It allows employers to recoup some of those costs through the subrogation claim. Some of those workers’ benefits include wages, medical care bills, and rehabilitation costs.
After the employer pays money to the victim, the employer’s insurance company can claim reimbursement costs from the other party’s insurance company. Subrogation Claims are relatively common in auto insurance policies, as well as property and healthcare policy claims.
Investigating and Pursuing Claims
The employer or insurance carrier should immediately investigate the accident. It will help in avoiding the critical challenges of bringing a subrogation claim. Before starting the legal action, the insurance company should identify the following:
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The cause of the accident
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The potential defendants in the claim
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The possibility of multiple third parties
The insurer pursuing the workers’ compensation subrogation claim should have the following:
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Employee reports injuries
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Medical records
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Witness statements
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Professional witness statements reports
Which Types of Workplace Injuries Might Involve Subrogation?
A subrogation claim allows an employee to receive compensation benefits. Some examples of workers’ compensation claims that may involve subrogation include the following:
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When a company driver is totaled through as the result of an at-fault driver. For example, a motor vehicle accident where the injured employee was on work duty
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In a product liability claim. If a personal injury results from equipment malfunctions due to negligence
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A premises liability claim. When a worker suffers injuries on someone else’s property
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With provable evidence that negligence caused the injury. When someone spills soap or oil in a slip-and-fall claim and left without cleaning it
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In settlement for the wrongful death of an employee. When employers have a subrogation lien to recover compensation
What Happens if a Subrogation Claim Fails?
Sometimes subrogation claims fail to recover compensation from the responsible third parties. Some of the most common reasons include the following:
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The insurer overlooks the subrogation potential and misses the opportunity to seek recovery.
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The insurance company fails to file the lawsuit on time.
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The at-fault third party may not have insurance or assets to subrogate against.
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The cost of the legal action may outweigh the recovery, making the subrogation efforts inadvisable.
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There is not enough evidence to hold the third party liable.
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The employer did something wrong that contributed to an injury, making it harder to recover damages.
If an insurance company doesn’t take legal action to recover money from someone who caused an accident, they can’t do it later.
What Is the Time Limit for Insurance Companies to File a Subrogation Claim?
The time limit to file a subrogation lawsuit depends on the state laws, accident occurrence, and nature of the accident. The time limitation is also known as the statute of limitations. Missouri has a five-year statute of limitations to make subrogation claims.
What Is Third-Party Recovery Subrogation?
During a personal injury claim, the insurer can pursue damages from the negligent third party on behalf of their client. In that case, the company/ insurer can file a third-party claim for compensation.
In Missouri, the employer first takes care of the medical bills. But, the workers’ compensation law allows employers to file subrogation claims. This helps them seek recovery from the third party. The employer can recover all the workers’ compensation benefits paid in a settlement.
The insurer can only pursue subrogation on the percentage of total losses or damages. The insurer/employer uses the Ruediger Formula to determine proper compensation. It helps calculate the total amount to claim from the third-party recovery.
What Is a Waiver of Subrogation?
A waiver of subrogation is an agreement that relinquishes your right of subrogation. The waiver of the subrogation prohibits your insurance company from recovering compensation. The compensation results from a claim payment by the negligent third party.
Suppose an employer chooses to settle a claim without involving their insurer. They should waive their rights to subrogation to avoid liability for damages.
Once you sign a subrogation waiver, your insurance company cannot act on your behalf. Notifying your insurance company before you sign a waiver of subrogation is essential.
What Is the Subrogation Condition?
Subrogation conditions are circumstances under which each claim should meet for court approval. Some conditions for subrogation include the following:
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The claimant should render payment to protect their interests.
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The claimant should not act as a volunteer.
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The person who wants their money back needs to pay off everything they owe before they can ask for it back.
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The person who pays the debt first should not be the one responsible for it.
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Everyone who should get their money back should be included in the request for money
Do You Need an Attorney’s Help With Subrogation Claims?
If you received injuries on the job, you may have trouble with your workers’ compensation claim. In cases with third-party involvement, you may want to take personal injury action against the at-fault party. To pursue such a case in a Missouri appeals court, you might need the help of a personal injury lawyer.
At Buchanan, Williams & O’Brien, P.C., we have personal injury attorneys who can assist you. They will determine your rights to subrogation recovery and evaluate your case. Contact us today to schedule a consultation.
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