On a weekly, if not daily, basis, plaintiff’s personal injury lawyers have to deal with subrogation interests. Many of those subrogation claims involve the law of ERISA.
This opinion out of the Illinois Court of Appeals addresses the issue of disputes over the amount of money to be re-paid to the holder of the subrogation interest.
Defendant had a personal injury claim. Plaintiff sought subrogation and claimed that it was due almost $63,000. Defendant claimed that some of the expenses sought did not arise from medical treatment caused in the incident giving rise to the personal injury claim. Plaintiff countered with answers to interrogatories in the personal injury claim, in which Plaintiff contended that back surgery (the subject of the disputed medical claim) was related to the accident). Defendant argued that her physicians did not causally link the back problems to the accident, and therefore Plaintiff’s subrogation interest in any future personal injury settlement or judgment proceeds should be reduced accordingly. Plaintiff countered that one physician said the link was possible, that it determined the subrogation amount, and that under ERISA the court should defer to its decision and order that the amount of the subrogation interest include amounts for the surgery.