Competing for a Limited Amount of Money
In many subrogation or reimbursement cases, there is simply not enough money to pay all parties who claim a stake in a settlement. In addition to the employer or insurance company seeking funds, the plaintiff's attorney and the plaintiff himself often pursue a portion of any settlement. Careful insurance plan language, however, can protect a business' interests.
Other Party Liability Inc. (OPL), in conjunction with Laffey & Associates, aggressively pursues subrogation administration for employers and insurance companies, mainly health care plans. From its Pennsylvania headquarters the organization serves clients in all 50 states.
Made-Whole Doctrine
The made-whole doctrine generally states that an insured must receive payment for all damages before an insurance company can seek subrogation or reimbursement. The specific definition of what it means to be made whole varies from state to state, but the concept remains the same.
If a health care plan does not specify that the plan has the right to seek subrogation, it is usually subject to the made-whole doctrine and runs the risk of not recouping money paid for legitimate claims if there are insufficient funds. Therefore, it is highly advisable for businesses to write their plan language in a manner which allows them to pursue subrogation and/or reimbursement. The attorneys at OPL have extensive experience:
- Drafting health plan language to prevent an inability to recover funds
- Reviewing existing plan language to identify any potential problems
Common Fund Doctrine
Under the common fund doctrine, a plaintiff's lawyer has the right to demand a fee from most subrogation settlements under equitable principles. However, with appropriate plan language, a Plan can alleviate the attorney fee argument. The lawyers at OPL have the ability, resources and experience to draft and review plan language designed to protect your business from the common fund doctrine. They will evaluate your situation and advise your business regarding the common fund doctrine and insurance liability.
Limitations to Insurance Liability
To learn more about how you can protect your business against the made-whole and common fund doctrines, contact OPL online or call its office locally at 412-489-0328 or toll free at 888-540-4816.
