How Health Insurance Companies Will Subrogate Dog Bite Bills

Key Points:

• Investigation and Subrogation: Health insurance companies typically thoroughly investigate dog bite claims and may delay or deny payment if they think someone else is responsible.
• Legal Action by Insurers: Your insurance company is able to sue the person responsible for your dog bite in order to get back the money they spent on your medical bills.
• Challenges in Coverage: If the insurer believes that another party is liable, they could refuse to pay, even if that party doesn’t have insurance, which leaves you with the medical expenses.
• Impact on Victims: Discovering that insurance won’t cover your costs often pushes victims to file lawsuits to seek compensation for their injuries.

Table of Contents

Receiving the Daunting Letter from Your Healthcare Provider

Receiving a letter from your healthcare provider informing you that they are investigating the medical costs from a dog bite and are considering not paying them is a situation no one wants to face. Unfortunately, this happens frequently. Health insurance companies often scrutinize the cause of medical expenses. If they suspect any negligence by a third party, they will delay payments to the hospital or medical practitioner who billed them.

With medical bills being expensive this tactic has saved health insurance companies billions of dollars nationwide. It is an effective strategy, and it is unlikely to change anytime soon.

Is it Insurance Subrogation if My Healthcare Provider Will Not Pay for a Dog Bite?

Yes, it is considered subrogation if your healthcare provider either requests reimbursement for medical expenses they paid for a dog bite or delays payment to investigate the incident and determine if they are responsible for covering the costs. This is not anything new, it is common, and it does frustrate their clients because they want the bills to be gone, but health insurance companies are going to look out for their best interests.

Will a Health Insurance Company Question and Challenge a Dog Bite Claim?

Health insurance companies thoroughly investigate all dog bite claims before paying for them. They recognize that dog bites are a common and popular personal injury claim. They also know that most dog bites are inflicted by dogs owned by a third party, rather than the victim’s own pet. Consequently, it is very rare for a health insurance company to pay for dog bite medical expenses without first questioning the claim. This thorough vetting process helps them determine liability and potentially seek reimbursement from the responsible party.

Can Your Health Insurance Company File a Personal Injury Lawsuit to Recover Dog Bite Medical Bills?

If the responsible party or their insurance refuses to pay, your health insurance company can file a personal injury lawsuit on your behalf. This legal action aims to recover the amount they spent on your medical bills. While this lawsuit is technically filed by your insurance company, it is based on your injury and the costs incurred due to the dog bite. It is essentially a personal injury lawsuit.

Impact on You

• No Direct Involvement: Generally, the insurance company handles the legal proceedings, and you are not directly involved in the lawsuit
• Cooperation Required: You may need to provide information or testimony to support the case.
• No Additional Costs: Since the insurance company is seeking to recover their own costs, you typically do not incur additional expenses.

Can a Health Insurance Company Completely Reject Paying for a Dog Bite Personal Injury?

Yes, they can, and they will. If their investigation proves that another party was negligent and responsible for the dog bite, they will refuse to pay for the medical expenses. The insurance company will then expect you to seek compensation directly from the negligent party. This approach helps them avoid covering costs that they believe should be paid by the responsible party.

Can a Health Insurance Company Reject Paying for a Dog Bite if the Negligent Party Doesn’t Have Property Insurance?

Health insurance companies will avoid paying the hospital if they discover a third party is responsible for a dog bite, even if that party has no available insurance. They will leave it up to the dog bite victim to come up with the money to pay for the medical bills. This situation is particularly unfortunate because many dog owners are renters who do not have property insurance to cover a dog bite. As a result, the victim is left not only with a severe injury and potential scarring but also with the burden of medical bills.

Can a Health Insurance Company Reject Paying for a Dog Bite if they Do Not Win a Personal Injury Settlement?

Similar to not paying for a dog bite if the negligent party has no property insurance, a health insurance company will avoid payment if there is no successful personal injury settlement or verdict for the dog bite. If they firmly believe that another party is responsible for the dog bite, they will refuse to cover the expenses, regardless of the outcome of negotiations or litigation involving dog bite attorneys. This can leave the victim responsible for significant medical bills, even in the absence of a clear path to compensation from the responsible party.

Can it Be Considered Bad Faith if Your Health Insurance Company Refuses to Pay for a Dog Bite?

Depending on the circumstances, it could be considered bad faith if your health insurance company is holding out on paying you for your dog bite injury. Insurance companies have a right to fully investigate claims and deny payments if they think another party may be responsible, but if they deny a valid claim without a proper investigation or justification, it could be considered as acting in bad faith. If this occurs, you may have grounds to file a new lawsuit against the health insurance company for denying your coverage for the dog bite. If you do suffer a dog bite, it is highly recommended that you consult a personal injury attorney, as they can help you navigate these complex situations and ensure you take the best course of action.

Will a Health Insurance Subrogate for a Small or Minor Dog Bite Injury?

Even minor dog bites can precipitate trips to urgent care for treatment or stitches. This usually costs between $500-1000. Despite the relatively low cost compared to other types of injuries, many insurance companies pursue subrogation. This is due to the sheer volume of bills they receive for dog bites , the aggregate cost of which can be substantial.

Although insurance companies aren’t as aggressive with smaller claims, they still investigate them, often sending letters requesting more information about the injury in question. They recognize that more substantial injuries may be eligible for legal compensation, especially injuries that cause scarring or disfigurement. Companies tend to resist paying claims for cases where compensation is pursued, hoping instead that potential legal payouts will be applied first to lessen the amount they are expected to cover.

How do Hospitals Process Billing for Dog Bites?

Hospitals do not bill the dog owner, rather, they bill the victim’s health insurance directly. They are not involved in the legal complexities of any pending lawsuits, focusing instead on treating the victim and making sure they get paid. This is standard procedure.

What if You Get a Subrogation Letter from Your Health Insurance Company?

The best thing to do is cooperate fully and be honest with your health insurance company . If their investigation finds potential negligence by a third party, they may not cover medical expenses. If this happens, be prepared to file a legal claim. It might be a good idea to find a personal injury lawyer specializing in dog bites who can navigate this process for you, ensuring you receive fair compensation for your injury.

Does Health Insurance Subrogation Force Victims to File a Lawsuit?

Some dog bite victims are reluctant to file a lawsuit, believing their health insurance will automatically cover most of the costs, hereby avoiding conflict with a neighboring dog owner. However, when they discover their health insurance won’t pay the bills, many panic and subsequently pursue a legal claim.

Negotiating Bills if Insurance Denies Payment

You can negotiate medical bills if insurance refuses to pay. First, contact the healthcare provider’s billing office to explain your situation. You may be offered a payment plan or discounts for financial hardship. Review your bill for any errors or charges for services not rendered; make sure to dispute any discrepancies. You may also consider enlisting a medical billing advocate to negotiate on your behalf. Some nonprofits or government programs offer financial assistance for medical expenses. If these measures fail, consider consulting a personal injury lawyer to advise you on your options.

How Long Does Subrogation Last?

The subrogation process for a dog bite may last from a few months to over a year depending on a variety of factors. Insurance companies almost always conduct an investigation to determine liability. This may take several weeks to a few months. This is followed by a period of communication and negotiation with the dog owner or their insurance company, which may extend the timeline several more months. If negotiations fail, the insurance company may file a lawsuit, adding even more time due to court hearings and legal filings. Ultimately, how long the process takes depends on case specifics and the efficiency of subsequent legal proceedings.

How to Avoid Mistakes During Subrogation

There are several mistakes to avoid when dealing with subrogation. The first of these is communication. Always respond promptly to letters or calls from insurance companies and provide information in a timely fashion. Another mistake is not keeping records: make sure to check  medical bills for errors and dispute any inaccuracies. Record the evidence which can include photos and witness statements, and make sure to track expenses such as medical bills, lost wages and attorney fees, as this can result in an accurate future payout. By communicating and documenting the important items, you can eliminate mistakes that can reduce your payout. One other tip is to talk with a personal injury attorney. We can help you with subrogation questions and will give you advice for free.