Rehabilitative and Habilitative Services (EHB) (Cont’d) Thiringer v. If the contract includes a subrogation provision, it must: Subrogation American • Make clear that the issuer is entitled only to excess after the enrollee is Motors Ins., fully compensated; and 91 WN 2d 215, • The Contract must not have any provision which would 588 P.2d 191 inappropriately require full reimbursement for all medical expenses. (1978) WAC The contract cannot unreasonably restrict or delay the payment of benefits. Delays are not justified because the expenses incurred, or
Rehabilitative and Habilitative Services (EHB) (Cont’d) Subrogation Thiringer v. American Motors Ins., 91 WN 2d 215, 588 P.2d 191 (1978) If the contract includes a subrogation provision, it must: • Make clear that the issuer is entitled only to excess after the enrollee is fully compensated; and • The Contract must not have any provision which would inappropriately require full reimbursement for all medical expenses. WAC The contract cannot unreasonably restrict or delay the payment of benefits. Delays are not justified because the expenses incurred, or
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