Health Insurance: Could someone explain the walmart health insurance clause to pay them back in case a suit is won

Could someone explain the walmart health insurance clause to pay them back in case a suit is won?
Is it health insurance or is it not? If its health insurance, there is a contractual obligation to pay for the cost of health care. Why should someone have to pay them back money from a lawsuit to reimburse them?...that would make it not be insurance...if you have to pay back the benefits. If its not insurance, what is it? but the coverage should have nothing to do with how I can sick. they should simply cover because you are sick. If she was in some sort of accident where no one was liable or was just seriously ill from some degenerative disease, they would still have to pay. It seems like a clause insurance carriers put in there to make money. If the lady had insurance coverage, they owe her benefits because she paid premiums for those. Knowing all this, its like the lady and her family ..should not have even bothered suing the trucking company. why bother and do all of that so that walmart can swoop in and reap the benefits?
Law & Ethics - 3 Answers
Random Answers, Critics, Comments, Opinions :
1 :
This is called "subrogation", and it exists in ALL insurance policies, not just health insurance. The legal principal is that whoever is responsible for the injury or damage should pay for it. Health insurance (or car insurance, or home insurance) will pay your damages up front, but they will then recover from the party at fault. Richard
2 :
Consider this: when people are hurt and sue they just don't sue "because yes". They sue because they want their costs covered. Imagine this; you are in a 2 car accident that wasnt your fault. You are going to want the other party to cover it. In essence it shouldnt even go to your carrier because the "wrong" party should pay for everything. Same concept. To have an insurance pay and then to sue for medical expenses you didnt pay yourself is wrong and the carrier has every right to request it back..
3 :
You only get one bite at the apple. Insurance exists to make sure you do get one bite in case that bite is not otherwise forthcoming, but it doesn't mean you might also get lucky and get a second bite.

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Friday, December 28, 2012

Could someone explain the walmart health insurance clause to pay them back in case a suit is won