How Health Insurance Companies Will Subrogate Dog Bite Bills

Key Points:

  • Investigation and Subrogation: Health insurance companies 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 can sue the person responsible for your dog bite to get back the money they spent on your medical bills.
  • Challenges in Coverage: If the insurer believes another party is liable, they might refuse to pay, even if that party doesn’t have insurance, leaving 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.

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?

Whether it can be considered bad faith if your health insurance company refuses to pay for a dog bite depends on the circumstances. If the insurance company continues to deny payment after losing a personal injury trial, the likelihood of bad faith increases. Insurance companies have the right to investigate claims and deny payment if they determine another party is responsible for the injury. However, if the insurance company unreasonably denies your claim without proper investigation or justification, it could be considered acting in bad faith. In such cases, you may have grounds to file a new lawsuit against the health insurance company for denying coverage for the dog bite. Consulting with a personal injury attorney can help you understand your options and determine the best course of action.

Will a Health Insurance Subrogate Even if its for a Small Minor Dog Bite Injury?

Minor dog bite injuries typically include scrapes and wounds that require stitches, often necessitating urgent care visits. Treatment for such injuries usually costs between $500 and $1,000. Despite the relatively low cost compared to their overall revenue, health insurance companies will still pursue subrogation. This is because they receive a large number of bills from urgent care centers and hospitals for minor dog bite injuries, which can add up significantly.

While insurance companies might not be as aggressive with smaller claims, they still investigate them and often send letters requesting more details about the incident. They also recognize that victims can receive substantial compensation from dog bite lawsuits, particularly for visible scars. To avoid paying out claims, insurance companies aim to ensure that any compensation received by the victim is accounted for before covering medical expenses.

What is the Process for Hospitals When Billing for a Dog Bite?

Hospitals do not focus on billing the dog owner; instead, they prioritize obtaining the dog bite victim’s health insurance information and bill the insurance company directly. They avoid involvement in the legal complexities, concentrating solely on treating the victim and ensuring they receive payment. The process is straightforward.

How Should a Dog Bite Victim Handle a Subrogation Letter from Their Health Insurance Company?

The best advice we can offer is to cooperate fully with your insurance company and be honest in all your communications. Additionally, consulting with a dog bite attorney is highly recommended. The insurance company’s investigation into the dog bite indicates they suspect potential negligence by a third party. If this is the case, you should be prepared to file a legal claim, as the health insurance company may not cover the medical expenses for the dog attack. An attorney can help you navigate the legal process, ensuring you receive the compensation you deserve.

Can Health Insurance Subrogation Compel a Dog Bite Victim to File a Legal Claim?

We have noticed that some dog bite victims are initially unmotivated to file a lawsuit, believing their health insurance company will cover most of the costs, thereby avoiding a legal battle with a neighboring dog owner. However, when they discover that their health insurance company will not be paying the bills, it can create panic, leading to a lawsuit. While subrogation does not force someone to file a personal injury lawsuit, it certainly motivates many to pursue a legal claim.

Can You Negotiate Medical Bills If Insurance Denies Payment?

Yes, you can negotiate medical bills if your insurance company denies payment. First, contact the healthcare provider’s billing department to explain your situation and inquire about payment plans or potential discounts for financial hardship. Review the bill for any errors or charges for services not received, and dispute any discrepancies. Additionally, consider enlisting a medical billing advocate to negotiate on your behalf. Exploring local charities, non-profits, or government programs that offer financial assistance can also be beneficial. If negotiations fail, consulting with a personal injury attorney may provide further options to manage the expenses effectively.

How Long Does the Subrogation Process Typically Take for a Dog Bite?

The subrogation process for a dog bite typically ranges from a few months to over a year, depending on various factors. Initially, the insurance company conducts an investigation to determine liability, which can take several weeks to a few months. This is followed by a period of communication and negotiation with the responsible party or their insurer, potentially extending the timeline by several more months. If negotiations fail, the insurance company may file a lawsuit, adding several months to a year or more due to court schedules and legal complexities. Ultimately, the duration depends on the specifics of the case and the efficiency of the legal proceedings.

What Are Common Mistakes to Avoid When Dealing with Subrogation?

When dealing with dog bite subrogation, it’s important to avoid some common mistakes. Always respond to letters or calls from your insurance company and provide any requested information promptly. Make sure to check your medical bills for errors and dispute any inaccuracies. Consulting a personal injury attorney can help you understand your rights and navigate the process smoothly. Keep all relevant evidence, like photos and witness statements, and be prepared for the process to take some time. Also, track all your related expenses, such as medical bills and lost wages, to ensure you get accurate compensation. By steering clear of these mistakes, you can make the subrogation process smoother and increase your chances of a favorable outcome.

Very knowledgeable and friendly staff. I’d recommend Millar Law Firm to anyone.

five stars
Ryan P.
linkedin icon