BakersDozen Posted August 21, 2013 Share Posted August 21, 2013 I received a letter from some company I've never heard of informing me that my insurance company is pursuing a subrogation/reimbursement claim. From what I can find on-line, this is not good. The claim is from a nasty fall I had this last spring which led to an ambulance ride and a suspected broken ankle. The fall was my own dumb mistake - wasn't watching, missed a last step, down I went. All in front of about 100 people who have never let me forget the incident. The fault was absolutely not that of the theater where I was or anyone in or working for the theater. Has anyone gone through something like this? I am so afraid that the crooks (er...insurance company) are going to go after this small town theater for something that was my fault! Quote Link to comment Share on other sites More sharing options...
TechWife Posted August 21, 2013 Share Posted August 21, 2013 They will most likely go after the theater and have their insurance company pay them back for the claim. They should be insured for things like this, however. Let the insurance companies fight it out. This happens frequently. Quote Link to comment Share on other sites More sharing options...
Dandelion Posted August 21, 2013 Share Posted August 21, 2013 Subrogation is standard insurance procedure. Even if you tell your insurance company that you feel the theater is absolutely not at fault, your insurance company will try to get reimbursement from the theater's insurance company. The theater's insurance company will likely attempt to show that they were not negligent in your fall, and may deny the claim. I wouldn't worry about it. It's just the nature of the insurance business. - Julie (who worked as an insurance claims adjuster many moons ago) Quote Link to comment Share on other sites More sharing options...
ChocolateReignRemix Posted August 21, 2013 Share Posted August 21, 2013 Not a big deal and fairly standard business between two insurance companies (assuming the theater is insured). Quote Link to comment Share on other sites More sharing options...
klmama Posted August 21, 2013 Share Posted August 21, 2013 Yes, standard insurance procedure. If they can get the other guy's insurance to pay, they prefer that. Obviously. Quote Link to comment Share on other sites More sharing options...
BakersDozen Posted August 21, 2013 Author Share Posted August 21, 2013 This is so incredibly wrong. But then I suppose that is how insurance companies work. This sickens me. This was MY fault!! Crooks...disgusting crooks. Quote Link to comment Share on other sites More sharing options...
mamaraby Posted August 21, 2013 Share Posted August 21, 2013 This is so incredibly wrong. But then I suppose that is how insurance companies work. This sickens me. This was MY fault!! Crooks...disgusting crooks. Not crooks. I would hazard a guess that every single insurance policy out there has a subrogation clause. Your insurance company believes based upon the facts of loss that the other party is responsible for what took place. The theater's insurance company may very well disagree. The claims adjusters will come to an agreement on liability or seek out an intermediary to help them come to an agreement. They may decide that the theater is completely at fault or they may decide that they are partially at fault or not at all. Your insurance company may get everything back, some of it back, or nothing at all. It's what insurance companies do and it's what keeps insurance rates down. I'm sorry that this upsets you, but this isn't vindictive on the part of your insurance company. It really is one of the most mundane sorts of things in this world. Quote Link to comment Share on other sites More sharing options...
zoobie Posted August 21, 2013 Share Posted August 21, 2013 This is so incredibly wrong. But then I suppose that is how insurance companies work. This sickens me. This was MY fault!! Crooks...disgusting crooks. No, they're not crooks. (Well, not for this reason anyway! ;) ) That's the nature of insurance. The insurance companies will investigate the claim and decide who is responsible for covering the loss. If you get hurt in a car accident, your health insurance would not pay the bills. Same thing here. Whatever group you are a part of for health insurance--your rate is based on the risk estimated by the health insurance company for the group as a whole. If the insurance company pays out on an injury for you that really should be covered by another type of insurance, that cost gets passed along to the group when it's time to renew. A friend in a small firm had her insurance rates triple when a partner's wife had a costly cancer battle. Obviously that's a simplistic explanation of how health insurance works, but you get the idea. You bought a ticket to the theater. You paid for the insurance as a percentage of the fee they charge customers. As responsible business owners, they should have insurance. It's one of the costs of doing business. If your health insurance pushed you down the stairs and then went after the theater's liability insurance, they would be crooks. Right now they are doing their due diligence and being fiscally responsible for other members in your group and their shareholders. Quote Link to comment Share on other sites More sharing options...
Laurie4b Posted August 21, 2013 Share Posted August 21, 2013 No, they are not crooks; they are just following the rules for who pays. Think about it this way: do you feel guilty for your health insurance paying the doctor who cared for you for a fall that was your fault? Does that make them or you a crook, or is that what insurance is for? Your fall was an accident. Unless you deliberately fell to collect insurance (which would make you a crook but a crazy one since you were injured and the money is going to medical professionals) no one is acting like a crook, just following the rules. It's like traffic rules: if you hit someone from behind,even because someone speeding who didn't stop in time hit you from behind propelling you into the car in front, you are at fault. The insurance company of the car in front of you wouldn't be considered crooks from collecting from your insurance company. They are just following accepted procedures. Same thing in the case of your fall. Quote Link to comment Share on other sites More sharing options...
plansrme Posted August 21, 2013 Share Posted August 21, 2013 If it is any comfort, they probably won't go after the theater unless they find out that you sued the theater and received an award that included coverage for (or that they decide included coverage for) medical expenses. THAT is their primary target: insureds whose insurance pays expenses that are also included in a settlement from the guilty party. Theoretically, yes, they can go after the theater, but they probably won't try very hard. And no, it isn't crooked; they are actually trying to avoid your getting a double recovery, which would be crooked. Of course that is not what you are doing, but they don't know that yet. Insured people get in car accidents all the time and then receive settlements from the other guy's insurance for, among other things, their medical expenses. The insurance company absolutely deserves a share of that. If you answer their questions truthfully, probably that will be the end of it. Also, if you just ignore the form, that also will probably be the end of it. But don't tell them I said so. Quote Link to comment Share on other sites More sharing options...
HRAAB Posted August 21, 2013 Share Posted August 21, 2013 They're not crooks - well maybe, but not in this case. Every insurance policy I'm aware of (18 yrs. in property/casualty) has a subrogation clause. The insurance companies will work it out. The theater's insurance company might well deny the subrogation claim, and that will be the end of it. Don't worry about it. Quote Link to comment Share on other sites More sharing options...
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