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Accident Victim Must Give Lawsuit Proceeds to Health Insurer to Cover Medical Expenses
Description Appeals court upheld the right of an employer's medical insurer to recover the proceeds an injured employee got in settlement from an accident that caused her to incur over $200,000 in medical expenses covered by the insurer.
Topic Insurance
Key Words Subrogation; Reimbursement
C A S E   S U M M A R Y
Facts Kinsey, an employee of Winnebago County, was injured in a car accident. Her medical expenses of $213,000 were mostly covered by her employer's health insurance. Kinsey sued the driver that caused the accident and settled for $142,000. Her employer demanded she turn over the money that was awarded to help reimburse her medical expenses as required by terms of her insurance policy. She contended that since the award was insufficient to make whole her losses, she did not have to give the insurer the award. The trial court held for the employer; Kinsey appealed.
Decision Affirmed. It is undisputed that Kinsey was not made whole by the settlement from the lawsuit. The insurance plan did not require that Kinsey be made whole from the litigation before she had a responsibility under the plan to reimburse her insurer. The plan's requirement is reasonable and does not violate federal law regarding such insurance plan requirements.
Citation Kinsey v. McCollough, 2000 WL 1426354 (Ct. App., Wisc., 2000)

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