When you file a claim, your insurer can try to recover costs from the person responsible for your injury or property damage. This is known as subrogation. For example: Your insurance company pays your doctor for your treatment following an auto accident that someone else caused.
When factoring comparative negligence and improper referrals, the recovery rate should be somewhere in the range of 85-90%. This requires adjusters properly identifying subrogation, assessing comparative negligence and pursuing only what they are entitled to.
Ways to Fight a Subrogation Claim for Property Damage Showing you are not at fault for the damage. Challenging the amount of the claim. Subrogation waiver. Technical violations of subrogation claims. Negotiate the claim.
Our Customer Service can help you learn more about our SCFHP Medi-Cal Plan and how to make it work for you. Call Customer Service at 1-800-260-2055 (TTY: 711), a.m. to 5 p.m., Monday through Friday.
Timely filing deadline SCFHP requires claims to be submitted within one year of the date of service.
We provide access to healthcare for individuals and families in Santa Clara County, including affordable health insurance coverage through California's Medicaid program, known as Medi-Cal.
In General. Please submit all claims within 90 days, coinciding with the date of service, date of discharge, or date of primary carrier's Explanation of Benefits (EOB).
Insurance companies don't have forever to make a subrogation claim. While the statutory limitations period can vary depending on the type of subrogation claim made—and in which jurisdiction it is made—the standard statute of limitations ranges from one to six years.
You will want to immediately notify your own insurer to determine how they can assist you. A subrogation claim is not going to go away on its own. If you ignore the letter, the insurer will file a lawsuit against you, the party being held responsible, and the insurer will win, almost every time.