Health Care Subrogation & Recovery Issues/Third Party insurance claims :
Other Party Liability Inc. has detailed knowledge, and over 20 years of experience,performing subrogation services while navigating ERISA and state specific subrogation law.Since OPL lawyers work on behalf of insurance companies and employers throughout the country, they are well versed in state-specific laws that affect recovery actions. Compiling administrative experience with specialized subrogation attorneys, provides OPL the ability to provide a superior recovery rate to its customers.
Made-Whole Doctrine
The made-whole doctrine generally states that the injured party must receive payment for all damages before an insurance company can seek subrogation or reimbursement. The legal definition of what it means to be made whole is defined by individual state legislation and case law.
A health care plan that does not specify rights to seek subrogation,ordinarily subjects itself to the made-whole doctrine and running 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 specified manner to for optimal rights when pursuing subrogation and/or reimbursement.
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.
Maximizing Health Care Recoveries
- A major law firm administering subrogation claims in all 50 states, OPL, P.C. has the capabilities to efficiently pursue subrogation cases by:
- Using knowledgeable personal injury attorneys and staff to review and pursue referred cases;
- administering the entire subrogation process from claim identification through litigation;
- coordinating and maximizing your subrogation recovery efforts, an
- supporting, enhancing or replacing many of the subrogation functions of your Other Party Liability Department.
Live Claim Data Feed Synchronization and Internal Reporting
OPL offers a depth of knowledge, a proven process and comprehensive tracking and reporting services.Our attorneys approach subrogation cases by using knowledgeable staff who review and pursue all subrogation cases referred. OPL has the capacity to sync claim data servers and work with clients on providing the most efficient and secure means of protecting claim data. OPL can also aggregate claims paid data, by subscriber, to eliminate the need for claim updates and the archaic, back and forth administrator communications.