On July 19, 2020, Adam Woodrum was out for a bike ride with his wife and kids, when his 9-year-old son Robert got into a bike riding accident. He needed medical attention and stitches immediately because of his dangerous cuts. Since the family had been on bikes, Robert referred to the health division in Carson City, Nevada. The boy was taken to Carson Tahoe Regional Medical Center and got stitches under anesthesia. Robert has since recovered well.
Soon after the accident, Adam Woodrum received the denial letter from his health insurance company. The insurance company denied their medical claim and the family was charged the entire bill of $18,933. Being a lawyer himself, Adam Woodrum recognized that their insurance company was trying to subrogate the medical bill. Subrogation is a term describing a process that allows insurance companies to recover the amount of the claim the company paid to the insured for the loss. In this case, Woodrum’s insurance company was trying to save money by passing the buck to other insurance companies. However, insurers could not agree who would pay the bill, and finally, it was sent to the patient.
Adam Woodrum decided not to panic and not to ignore the bill. He returned the documents, including the accident questionnaire, explaining that there was no liable third party for the bike crash. Due to Woodrum’s quick action, two months later the insurance company reconsidered the initial bill. As a result, the Woodrums ended up owing $1,852.45 (including the share of their copays and deductibles) instead of $18,933.
It is important to understand though that Woodrum’s case was an automatic process – their claim was denied based on the medical code indicating a possible accident. Therefore, if your insurance company denies all payment for the medical care, there might be some type of subrogation. It is important not to panic and act quickly as possible. The very first thing that you need to do is to fill out the accident questionnaire and be honest about what exactly happened. Do not ignore the bill and do not procrastinate because time and delay can become your enemies.