HB 1869 by Rep. Four Price (R-Amarillo) addresses problems arising under the Texas Supreme Court’s decision in Fortis Benefits v. Cantu, which eliminated the “made-whole” doctrine. That doctrine held that a health insurer is not entitled to subrogation of an injured insured’s recovery of medical expenses until the insured has been made whole. Under the SCOT’s ruling in Fortis, the insurer has a right of first recovery against the insured’s settlement or judgment, even before the insured’s economic damages have been reimbursed.
HB 1869 does not overturn Fortis and restore the made-whole doctrine, but it modifies the insurer’s subrogation claim by dividing the insured’s recovery between the insured and the insurer in a case in which the recovery is insufficient to fully reimburse the insured.
Rep. Four Price
