Describe the 'Subrogation' clause in health insurance.

Describe the 'Subrogation' clause in health insurance.

• A. It prevents duplicate claims being filed
• B. It allows recovery from third parties after payout
• C. It guarantees full payment for all claims
• D. It limits claims to certain medical conditions

Answer: (B)

The 'Subrogation' clause in health insurance pertains to the insurer's right to recover costs from third parties responsible for the insured's injuries or medical expenses after the insurer has made a payout. Essentially, if a health insurance company pays for medical expenses resulting from an accident or injury caused by someone else's negligence, the subrogation clause enables the insurer to pursue reimbursement from the third party's insurance or assets. This process helps ensure that the party responsible for the loss ultimately bears the financial burden, rather than the insurance company or the insured. This clause is significant because it helps maintain fair pricing in the insurance market. By allowing insurers to recover funds, subrogation can help keep premiums lower for all policyholders. It also serves to discourage fraudulent claims and ensures that individuals do not receive a double recovery for their losses.

The 'Subrogation' clause in health insurance pertains to the insurer's right to recover costs from third parties responsible for the insured's injuries or medical expenses after the insurer has made a payout. Essentially, if a health insurance company pays for medical expenses resulting from an accident or injury caused by someone else's negligence, the subrogation clause enables the insurer to pursue reimbursement from the third party's insurance or assets. This process helps ensure that the party responsible for the loss ultimately bears the financial burden, rather than the insurance company or the insured.

This clause is significant because it helps maintain fair pricing in the insurance market. By allowing insurers to recover funds, subrogation can help keep premiums lower for all policyholders. It also serves to discourage fraudulent claims and ensures that individuals do not receive a double recovery for their losses.