Two arizona cases have addressed “other insurance” clauses in the med pay context and reached different conclusions Medpay coverage and the other driver’s insurance have different responsibilities The crux of each court’s analysis was the “ambiguity” of the clause, and not whether the clause violated public policy.
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Understand subrogation and coordination of benefits
If medpay pays your bills and another party (or their insurer) later pays you for injuries, your medpay carrier may assert a right to be repaid
If you disagree with a decision, escalate Ask for claim review or appeal within the insurer. Explore arizona's framework for medical cost recovery and subrogation, detailing state rights and legal actions for effective financial recoupment. This means that private health insurers do not have subrogation rights against a person’s personal injury settlement
This standard applies across the board to most private arizona health insurance plans. The injured employee contended that when an insured party reimburses a workers’ compensation insurer for the benefits received, the insured has taken nothing, and therefore benefits were essentially not “required.” The denial is not based on causation, liability or their policy It states your insured has not presented a bodily injury claim, so you as their carrier have no right to subrogate and recover losses from them.
The state specific information contained on this site should not be construed as legal advice by maybank & owings, llc nor relied on for any specific claim or factual situation.
