Subrogation

Feb 02, 2015

You may have heard of the term ‘subrogation’ but are unsure of what it means and how it is applied within a group benefits insurance policy. Subrogation is a clause that often prevails in the disability benefits section. However, it can form part of the extended health care benefit, such as paramedical practitioner claims for chiropractic and physiotherapist visits.

Subrogation is the responsibility of the employee to pay back the private insurer for any benefits and expenses that were paid to the employee. This applies if the employee were compensated for injuries by another insurer, such as ICBC, through a personal injury claim resulting from a motor vehicle accident.

As such, the employee must return any benefits received under the short or long term disability plan through their employer up to the amount paid to them by the insurance provider. The same principle applies with respect to extended health care benefits. Essentially, the group plan may pay those benefits, but the insurance company will look to the employee to pay back any amount received from the third party insurance company for those expenses.

Although group insurance policies state that they have every right to subrogate, it doesn’t always happen in practice. To collect from some employees for various reasons can be a difficult ordeal and every insurance company may have a different recovery procedure.

Subrogation does play an important role in helping to reduce claims to the group benefits plan and subsequent premiums that both employees and employers pay. It is important be aware of this clause, especially if the employee making a claim is being compensated by a third party insurer.

blog rss subscribe button

GET TO KNOW ROBERT

Jump to:

Place content block here for staff contact info
Place content block here for social media links

PREVIOUS BLOG

The Pre-Existing Condition Clause

By Robert Bogress on November 3, 2014

NEXT BLOG

Coverage and Limitations of Paramedical Practitioners

By Robert Bogress on May 12, 2015

sectionHeaderImg-Blue 

ROBERT'S LATEST BLOG POSTS

Place content block here. Add accent and heading in editor.

Why You Should Contribute to Your Group Retirement Plan

By Robert Bogress on February 15, 2016

Dental Fee Guide

By Robert Bogress on August 19, 2015

Subrogation

By Robert Bogress on February 2, 2015

The Pre-Existing Condition Clause

By Robert Bogress on November 3, 2014

What is the Living Benefit in a Group Plan?

By Robert Bogress on August 11, 2014

Generic Drugs – Are they really the same?

By Robert Bogress on May 20, 2014

Leaves of Absence

By Robert Bogress on February 18, 2014

Is Your Group Basic Life Insurance Coverage Enough?

By Robert Bogress on October 8, 2013

EFAP (Employee and Family Assistance Plans)

By Robert Bogress on July 30, 2013

Why Should You Contribute To Your Group Retirement Plan?

By Robert Bogress on February 18, 2013

Dental Scaling

By Robert Bogress on August 20, 2012

What is a Health Care Spending Account

By Robert Bogress on January 24, 2012

GET IN TOUCH WITH ROBERT

Learn how Robert can help with your group benefits.

Phone 604.714.4439, email rbogress@trggroup.com or send a message.

Message for Robert