The Basics of ERISA

11/17/2008

Most people don't know what ERISA is.  Heck, most attorneys don't know what ERISA is.  And that's ok, as long as you don't hire an attorney that doesn't know what ERISA is. 

ERISA is the abbreviation for a federal law that does a lot of stuff--one of the most important things it does is allows health insurance companies to provide group insurance to people through their employers. 

What most people don't know, and what a lot of lawyers fail to understand is that if you are injured through the fault of another person, your health insurance company can make a claim to the proceeds of any judgment or settlement you receive from the at-fault party.  That's right, even though you may have paid the your own insurance premium for years and years, if you ever call on your insurance company to pay any of your bills related to someone else's negligence, whether is was a slip and fall, an automobile wreck, or even medical negligence, your insurance company will come back and try to take some to the money you receive to comensate you.

This is what is known as "subrogation."  And insurance companies are really trying to be heavy handed in enforcing these provisions against injured victims.  Sometimes, it makes it all but impossible to settle cases becase the health insurer's claim is so large, we can't put any money into our client's pockets.  What's even worse is that some attorney's don't understand the law very well and they dont' even try to negotiate with the insurance company to take less.   THAT'S A BIG MISTAKE.  If you have a personal injury or medical negligence case, before you hire an attorney, make sure they understand ERISA subrogation and reimbursement.  If they don't, run.

Here is a horrible story about a man who got bitten by the ERISA monster.

Hans Poppe