A recent case which originated in St. Louis was overturned by the United States Supreme Court on April 18, 2017. The case, Coventry Health Care v. Nevils, involved a federal employee Plaintiff who received health benefits for an injury. The Plaintiff’s health coverage was governed by the Federal Employees Health Benefits Act (FEHBA).
Nevils settled the personal injury claim. The health insurer demanded its money back for health benefits it provided. Nevils argued that Missouri law did not allow subrogation from settlement in personal injury cases and that FEHBA did not preempt Missouri law. Missouri law has long held a person cannot assign their injury case to another person (or health insurance company).
The Missouri Supreme Court agreed, and the case advanced to the U.S. Supreme Court. After a few other procedural hurdles, the U.S. Supreme Court unanimously ruled this month that the FEHBA did, in fact, preempt Missouri state law. Here’s the scotus blog on the case.
Plaintiffs with personal injury cases in Missouri covered by a FEHBA plan have to pay back their insurers. This is bad as plaintiffs are already under-compensated in many cases, and this will just exacerbate this. Injured people pay premiums for years for health insurance coverage and should not have to pay back insurers.