What are the subrogation rules for Georgia accident insurance claims?
It depends on who paid and what they paid. Health insurers and other benefit providers face a made-whole rule: O.C.G.A. § 33-24-56.1(b) allows reimbursement only if “the amount of the recovery exceeds the sum of all economic and noneconomic losses”, and it’s reduced by a pro rata share of attorney’s fees and litigation expenses. UM carriers have a statutory subrogation right under § 33-7-11(f). Workers’ comp, Medicare, Medicaid, and self-funded plans each have different rules.
By payer
| Payer | Source | Key limit |
|---|---|---|
| Health insurer, insured plan | § 33-24-56.1 | Made-whole test; share of fees |
| Self-funded ERISA plan | Plan terms; federal law | State rule may be preempted |
| Medicare | 42 U.S.C. § 1395y(b)(2) | Federal recovery |
| Medicaid | § 49-4-149 | State's lien |
| Workers' comp | § 34-9-11.1(b) | "Fully and completely compensated" |
| UM carrier | § 33-7-11(f) | Against the wrongdoer |
| Collision carrier | Policy | Includes your deductible |
| MedPay | Policy; § 33-24-56.1 may apply | Read it |
How the made-whole rule works
If a settlement doesn’t cover all your losses, a provider covered by § 33-24-56.1 has no right to reimbursement. Under (c), it “may seek a declaratory judgment” to determine what it may share. The statute speaks of the “amount allocated to those categories of damages in the settlement documents or judgment,” so settlement wording can matter.
Self-funded plans
FMC Corp. v. Holliday, 498 U.S. 52 (1990), held that ERISA preempts state anti-subrogation laws for self-funded plans. Ask for the plan document and summary, to see how it’s funded and what it claims.
Collision and the deductible
Your insurer pays your car’s damage and may then pursue the other driver. Ask whether your deductible is being pursued too. You may wish to avoid signing a release that blocks that.
Hospital liens
These differ from subrogation. A hospital or physician practice with a lien has rights under O.C.G.A. § 44-14-470, separate from any insurer.
Release problems
If your release destroys an insurer’s subrogation rights, a policy may treat that as a breach. Notify insurers before you sign. Under § 33-7-11(f), a UM carrier has a statutory right, so check what happens to UM before you sign any general release.
Getting a final number
Ask each payer for an itemized claim listing injury-related charges only, since unrelated charges can sneak in. Lawyers can negotiate. Agencies have a formal process.
General information about Georgia law as of November 2026. It is not legal advice and does not create an attorney-client relationship.