The “made whole” doctrine is a rule of law that even many California personal injury lawyers aren’t aware of. It ties into subrogation when public and private health insurance reimbursement after an injury victim’s insurance has paid some or all of the victim’s medical bills. The issue of reimbursing that plan what it paid out on the victim’s medical bills must be addressed. The California made whole doctrine that your lawyer can use to reduce any sums that a health insurer might be entitled to in reimbursement. That can operate to increase the client’s net proceeds from a settlement or award.
When the Loss is Greater than the Insurance Coverage
Given the fact that California’s mandatory insurance coverage is the lowest in the United States, it’s a perfect state to employ the “made whole doctrine” in. For example, an accident victim was hit by a negligent driver. The victim’s health insurer covered his medical bills in the amount of $50,000. The driver who was careless and negligent only carried minimum liability coverage of $15,000 though, and the personal injury case only settled for the full $15,000 policy limit. Now, the victim’s insurance company wants that $15,000 toward the $50,000 that it paid out. That’s unlikely to happen under the “made whole doctrine,” especially if the victim suffered $200,000 of personal injury damages.
The Rationale Behind the “Made Whole Doctrine”
In the above example, the loss was greater than the gross amount received in settlement. Liability coverage was exhausted. When the loss is greater than the insurance coverage available, the victim isn’t made whole again. Especially, if he or she didn’t have underinsured motorist coverage. When this rule is applied, the subrogating insurer might not receive any reimbursement at all, regardless of any rights it reserves in its policy, especially when the insurer does little or nothing to pursue reimbursement other than relying on the policy language that it wrote.
When you retain us at Maison Law to represent you for the injuries and damages that you suffered in an accident, our objective is to maximize any net proceeds that you might derive in a settlement or award. That’s what operates in your best interests. You can contact us for a free consultation and case evaluation after being injured in any California accident. We’re going to listen to you carefully and answer your questions. After that, we can talk about the legal options that are available to you. If the “made whole doctrine” appears to apply in your case, we’re going to advise you accordingly.
Contact a Personal Injury Lawyer
After an accident involving a serious injury in the Central Valley, contact attorney Martin Gasparian for a free consultation and case evaluation. Mr. Gasparian takes a hands-on approach to every case. He believes that every client should work directly with their lawyer. Get honest advice and personalized attention to detail your case deserves.
