Subrogation in Georgia lets an insurer recover what it paid after a crash, but the state’s made-whole rule limits that right. Under O.C.G.A. § 33-24-56.1, an insurer generally cannot recoup payments until the injured person has been fully compensated.
The made-whole doctrine
Georgia codified the made-whole, or complete-compensation, rule in O.C.G.A. § 33-24-56.1. A health or disability benefit provider may seek reimbursement from a recovery only if the injured person has been fully compensated for all economic and non-economic losses. If a settlement does not fully cover those losses, the provider has no right of reimbursement, and a court can decide the question through a declaratory judgment.
Direct claims against the at-fault party
The statute also prohibits a medical or disability benefit provider from pursuing the at-fault driver directly for what it paid, and it bars naming such a provider as a co-payee on a settlement check. The provider’s remedy is limited to reimbursement from the insured’s recovery, subject to the made-whole limit.
Exceptions
Two important exceptions exist. Self-funded ERISA health plans, common through employers, may assert reimbursement rights under federal law that can override the state made-whole rule. And the uninsured motorist statute, O.C.G.A. § 33-7-11, grants a UM carrier its own right to pursue the at-fault driver despite the general prohibition.
The practical effect
Reimbursement amounts are also reduced to account for attorney’s fees. Because the rules turn on full compensation, a recovery that falls short of the losses can reduce or eliminate what a provider collects back.