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Expert: - 1/28/2012


Question
Hello there!

I was involved in a motor vehicle accident involving three cars, the person found at fault fled the scene, my HMO paid for the ambulance bill but now they sent me a questionnaire asking me about details of the accident because they say they can get reimbursement from my own car insurance or other party, since the person at fault is considered hit and run, can my HMO take money from my Underinsured Bodily Injury? I dont think it is fair that I will have to ended up paying my own HMO for my medical bills. I live in the state of California and I dont know if subrogation is applicable in this case...thank you

Answer
 Hello Bella,

Your HMO is correct.  Coverages can become primary over each other.  This means that both could ultimately pay, but the one with primary coverage pays first.  In the case of an auto accident, your auto insurance coverage is primary, meaning that your benefits would need to exhaust before the HMO takes over.

This is standard.  And, yes, subrogation is legal in all states to my knowledge.

I wish you well,

Jane Pytel

http://SolutionsForYourInsuranceClaim.com
http://FloridaAutoInsuranceCentral.com

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Jane Pytel

Expertise

I can answer questions related to auto accidents, auto damage, auto theft claims, or personal injury claims. I am specifically suited to answer questions concerning insurance investigations and the effects of those investigations such as claim delays, claim denials, examinations under oath, or the special investigations unit. I can answer most any question that relates to proper claims investigations, or claims handling procedures and processes. I have written a very detailed eBook, Power To Profit, which provides extensive insider information for who are in need of professional claims advice for their valid insurance claims. The book, along with numerous informative articles, are available on my website, http://SolutionsForYourInsuranceClaim.com

Experience

12 years of experience with 3 major insurance companies. I hold an all lines adjusters license in Florida. I am well versed in claims handling, claims investigations, and industry standards related to both. The bulk of my experience stems from my 10 years as a police officer / detective. Building on that investigative experience, I became an SIU (Special Investigations Unit) Investigator. Accordingly, my unique expertise lies in the investigation of claims. What is necessary and related, what is not necessary and related? What constitutes a fair claims investigation? What recourse is available for consumers who suspect they are experiencing unfair claims delays? During the course of my experience, I became a certified trainer, instructing adjusters and investigators proper techniques for claims investigation and claims handling.

Education/Credentials
B.A., Communications, University of Miami 350 credit hours of intense investigative training, Miami Dade Police 80 hours of investigative training, various Federal Agencies, Miami, Fl Intensive Accident Reconstruction and Pedestrian Injury Analysis, NHTSA, National Highway Traffic Safety Agency, Oklahoma City, OK 2 weeks Auto Damage Appraisal, Winston Salem, NC Legal Principles Claim Specialist, AEI

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