Unable to pay subrogated claim (AXA)

[matthewpercyp]

Good morning everyone, I would appreciate your help:

My wife and I had a car accident: I swerved to avoid an animal, we crashed and my wife broke her neck. This break was undiagnosed for two months. When a specialist at Gatwick Park diagnosed her correctly and suggested an immediate operation, AXA agreed to fund the cost via a Healthcare Plan we have with our business.

My wife sued me through my insurance and won. Subsequently, AXA are are demanding £18k via a 'subrogated claim'. This is causing my wife a great deal of distress, the amount she won isn't that great and she cannot afford to pay this claim. This morning she received a letter threatening legal action.

Briefly, what is the worst that can happen? If someone could advise, I would be most grateful. M

[teaboy2]

Re: Unable to pay subrogated claim (AXA)

So let me get this straight.

Your insurance paid for her operation, your wife sued you for compensation and now your insurance company has found out and is now claiming what they paid for her operation back from her?

Or is there two seperate insurance companies involved here?

[matthewpercyp]

Re: Unable to pay subrogated claim (AXA)

Morning! I was insured with Aviva and that is the company my wife sued. The operation was paid by AXA and they are looking to retrieve those costs from my wife's payout from Aviva...

[teaboy2]

Re: Unable to pay subrogated claim (AXA)

Right, well unfortunately an insured person is entitled to be ideminfied from his/her loss but is not entitled to make a profit from it.

In this case injury compensation was paid by your insurer to cover your wifes medical bills, your wife had already made a claim via AXA under the buisnesses healthcare plan, which means the injury compensation paid to her would have been 100% profit for your wife, that she would not have been entitled too. As such AXA are now claiming back from her what they paid her for her operation and aftercare etc. In short, under the law people are not entitled to bring two claims for the same 1 course of action.

Heres a link to a document that explains it more - http://www.cila.co.uk/files/Property...20Practice.pdf

[matthewpercyp]

Re: Unable to pay subrogated claim (AXA)

Hello and thank you so much for your prompt response. AXA are asking for £18k which my wife simply doesn't have. She has pretty much been on the minimum wage since she came out of hospital and her 'award' has gone towards keeping the household functioning (we both work but do not earn a great deal). Do we assume that AXA will issue a County Court summons and we will end up telling the whole sorry tale to a judge before agreeing some paltry monthly pay-back then?

[miliitant]

Re: Unable to pay subrogated claim (AXA)

This is silly

you need to send the axa letter to aviva

you dont pay. Your insurance company does everything, that is what you pay them for
A subrogation claim usually happens behind the scene. In most cases, the two insurance companies are going back and forth to verify what happened and what amounts have been paid out.

THE MOST THAT WILL HAPPEN TO YOU IS YOUR INSURANCE PREMIUMS WILL RISE

[wales01man]

Re: Unable to pay subrogated claim (AXA)

Looks like its going legal im sure advice on here would be to consult a solicitor who can handle claim you dont state how much was paid out in the second claim if it was less than the 18k can anyone say if they can claim more

[alham]

Re: Unable to pay subrogated claim (AXA)

I concur with militant - if your wife received any payout for her injuries it is her money. The fact that AXA (I spit on them from great height) paid for operation under another insurance policy should make no difference to you personally, it should be between the two insurance companies. This is the situation UNLESS you had two separate policies, say, that covered your salary, then if both paid out they will be entitled to claim back a proportion of payout, because , as teaboy pointed out above one can not profit from the accident.

[alham]

Re: Unable to pay subrogated claim (AXA)

AXA can't claim its money from your wife UNLESS when she sued your insurance company her payout included a payment for the operation.

[teaboy2]

Re: Unable to pay subrogated claim (AXA)

Guys, the personal injury claim compensation payout, always payouts to cover the cost of medical treatment as well as loss of earnings and damages for distress and emotional effects caused by the accident/injury.

The wife was not entitled to claim from Axa, and claim from OP's insurance as well for the same accident or same medical costs. She should have notified AXA and given them the OP's insurance companies details to AXA for AXA to sort out. Or she should not have involved AXA at all. You can not bring 2 insurance claims for the same 1 course of action - full stop! As such AXA are entitled to claim back what they paid out to the OP's wife for her operation, as the cost of that operationa nd other medical care needed would have been taken into account and covered by the OP's insurance company when they paid out the compensation to her.

If you were in a car accident that was another drivers fault, and you claimed compensation from the other drivers insurance for damage to your car, and cost of medical treatment for a broken arm or leg. Would you then also claim the same cost of medical treatment from your own healthcare insurance? No you wouldn't as your not legally entitled. It is a settled rule of law that only one claim for damages (or in this case one insurance payout claim) can be made arising from one cause of action (a “cause of action” being defined as the set of facts or circumstances that give rise to a claim in law).

The reasons for this are based in public policy. There is a public interest in avoiding any possibility of two courts reaching inconsistent decisions on the same facts and issues, in there being finality in litigation and in protecting citizens from being “vexed” more than once by what is really the same claim. The significance of this rule is that a second claim arising out of the same cause of action will be regarded as an abuse of process and will be struck out.

Hence the importance of making sure that both insured and uninsured losses are included in the claim. If a claim for either proceeds in isolation and results in a settlement or a judgment, a separate subsequent claim for the other will be prejudiced.

In this case both insurance companies have paid out to the OPs wife to cover her medical bills!

[miliitant]

Re: Unable to pay subrogated claim (AXA)

best course of action i would think is to contact aviva and get them to talk to axa to try and sort this all out by a gentlemens agreement

after all, thats why you pay for insurance

after two months, how can you say 100 % the accident caused the broken neck ??

thats just one example

[teaboy2]

Re: Unable to pay subrogated claim (AXA)

best course of action i would think is to contact aviva and get them to talk to axa to try and sort this all out by a gentlemens agreement

after all, thats why you pay for insurance

after two months, how can you say 100 % the accident caused the broken neck ??

thats just one example

Agreed, it would be the safest route to go down, and would likely prevent costly legal action. Though the money already paid to the OP's wife by AXA for medical bills would still have to be repaid, since the OP's own insurance payout for personal injury compensation would have included a sum to cover the medical bills also - Which is why axa are claiming back from the OP's wife what they paid out to her.

Broken Necks, which although sound like they would be obvious to spot, are not always so obvious, some people have lived with them for a lot longer before they found out their neck was broken. This guy had one for 40 years - http://www.bbc.co.uk/news/uk-wales-s...wales-17898487. So its quite possible that the OP's wife had one for 2 months before they found she had broken her neck, and of course the car accident is the most probably course of her broken neck.

[matthewpercyp]

Re: Unable to pay subrogated claim (AXA)

Thank you all so much for your replies. Her solicitors did offer to deal with AXA and pay them off from the claim but my wife decided to deal with it herself. The financial pressures of having been non-contributing for so long, however, meant that the share of the payout that should have gone to AXA went on household costs over the last few months. She is aware that she is in the wrong, she is just petrified that she will end up going to prison (I have advised that this is not the case). I know little of these sort of situations, but my best guess is that she will be taken to court by AXA. TBH, I am trying to soften the blow by getting a second (or third) opinion. She can show that her earnings have been hugely affected by the accident, hence the retention and subsequent disbursement of AXA's share. Any crumbs of comfort gratefully received.

[teaboy2]

Re: Unable to pay subrogated claim (AXA)

IT masy be best to write to AXA offering them an monthly repayment plan that is affordable to your wife and/or affordable to you both based on your income and expenditures as a couple. Atleast if they refuse and still take it to court you can show the judge that you were being reasonable and had attempted to settle with a monthly repayment plan based on what you could afford.

[miliitant]

Re: Unable to pay subrogated claim (AXA)

before anything

i would speak to your own insurance company to see if they can talk on your behalf