Here is a sample letter requesting that a client’s health insurer reduce their alleged subrogation claim.
Dear Subrogation Coordinator,
Please acknowledge, by signing at the bottom of this sheet, your waiver of any right for subrogation or reimbursement from your insured. As you may know, we have settled the above insured’s claim against the tortfeasor for their policy limits of $10,000. The settlement is extremely small given the nature of the injury.
Under Florida Statutes §768.76 (4) a “provider’s right of reimbursement shall be limited to the actual amount of collateral sources recovered by the claimant from a tortfeasor, minus its pro rata share of costs and attorney’s fees incurred by the claimant in recovering such collateral sources from the tortfeasor. In determining the provider’s pro rata share of those costs and attorney’s fees, the provider shall have deducted from its recovery a percentage amount equal to the percentage of the judgment or settlement which is for costs and attorney’s fees.”
Our attorney’s fees are 33%1/3 percent ($3,333.33) and costs are roughly $300.00. Applying Florida Statute §768.76 (4) to your lien would reduce your lien from $3,849.57 to $2,450.89. However, applying the law and facts of this claim we request that you waive your lien.
Under Florida Statutes §768.76 (5) any disputes between the claimant and the provider as to the actual amount of collateral sources recovered by the claimant from a tortfeasor shall be subject to determination by a court of competent jurisdiction.
In determining the actual amount of collateral sources recovered, the court shall give consideration to any offset in the amount of settlement or judgment for any comparative negligence of the claimant, limitations in the amount of liability insurance coverage available to the tortfeasor, or any other mitigating factors which the court deems equitable and appropriate under the circumstances.
Should you dispute that you are owed money, the court shall give consideration to the limitations in the amount of liability insurance coverage of $10,000.00 available to the tortfeasor.
The court shall also factor it that this claim is worth substantially more than $10,000.00, given the fact that the above client was riding a motorcycle and the no fault threshold does not apply, thus he does not need permanent injury to recover money for pain and suffering.
Pain and suffering in this claim is substantially greater than $10,000.00. You have failed to provide an itemized list of claims and this has prejudiced my client is delaying our ability to prepare an accurate closing statement, thus preventing your insured from receiving his proceeds.
Please call me first thing in the morning tomorrow; otherwise I may disburse our client’s money. Please send me an itemized list of claims processed by your office. I have attached a medical authorization signed by the injury party.
Sincerely,
Attorney
X_________________________ ________________
Signature above Date
I agree to waive our subrogation claim for the above client.
Enc. Medical Authorization
