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SECTION 12.0 - SUBROGATION

Subrogation means that if you incur health care expenses for injuries due to an accident or illness caused by another person or organization, the person or organization causing the accident is responsible for paying these expenses.


For example, if you or one of your dependents receives Blue Cross and Blue Shield benefits for injuries caused by another person or organization, Blue Cross and Blue Shield have the right, through subrogation, to seek repayment from the other person or his/her insurance company for benefits already paid.


Blue Cross and Blue Shield plans will provide eligible benefits when needed, but you may be asked to show documents or take other necessary actions to support Blue Cross and Blue Shield plans in their subrogation efforts.


Subrogation does not apply to an individual insurance policy you may have purchased for yourself or your dependents or where subrogation is specifically prohibited by law.


For more information regarding subrogation, please refer to the information provided by the Preferred Blue PPO Program.