I've got a motor vehicle accident case where we obtained the tortfeasor's policy limits and the underinsured motorist ins. co.'s policy limits. Both policies were minimal. Client had health insurance, and a subrogated company is wanting reimbursement. I know they can seek reimbursement as to the tortfeasor's policy, but, can the health insurance subrogate against the UM?
Answer: Yes. SeeProvident Life & Accid. Ins. Co. v. Ridenour, 1992 OK CIV APP 93, 838 P.2d 530 andReeds v. the Honorable Thomas S. Walker,2006 OK 43, 157 P.3d 100. I believeProvidentis actually subsumed by and modified byWalker.
The bottom line is that, assuming the subrogation language of the health policy is worded to permit it, the health insurance can be subrogated against a UM recovery. Even if the subrogation provision is worded broadly enough, though you may have a chance to avoid it by applying the "make whole" rule (as to which see:Equity Fire and Cas. Co. v. Youngblood, 1996 OK 123, 927 P.2d 572), if it is not an ERISA plan which negatives the make whole rule. If it is an ERISA plan, then ERISA preemption controls over the state law.
Posted on Thu, March 7, 2013
by Travis Law Office filed under