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Bcbsm Subrogation PDF Details

Michigan residents who have health insurance through BCBSM should be aware of the company's subrogation policy. Subrogation is a process by which an insurance company recovers damages from a third party on behalf of its insured. In other words, if you are injured in an accident and your BCBSM health insurance pays for your medical expenses, the company may attempt to recover those costs from the person or organization responsible for the accident. While subrogation can be a helpful tool for insurers, it can also be frustrating for patients who are forced to deal with multiple claims and investigations. If you have questions about BCBSM subrogation or any other aspect of your health insurance policy, please contact an attorney experienced in this area of law.

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Question	Answer
Form Name	Bcbsm Subrogation
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	subrogation bcbsm com, bcbsm unit, anthem com subrogation, subrogation

12

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Office of the General Counsel Subrogation Department

232 S. Capitol Ave., L09A Lansing, Michigan 48933-1504 (517) 325-4658

FAX No. (877) 257-2012

E-mail: SubrogationUnit@bcbsm.com

BCBSM SUBROGATION UNIT QUESTIONNAIRE

FAX COMPLETED FORM TO 877-257-2012

Date	Client’s Name		Date of Birth

Contract # (9 digit number on BCBSM card)		Spouse (if on BCBSM policy)

BCBSM policy holder’s name (if different from the client’s name)			Date of Birth

Client’s phone number

Type of case (select one) Personal Injury

Product liability

Medical malpractice

Workers’ compensation

(Please fax the application if in Michigan)


	Motor vehicle accident	In what state did it occur?								In what state does the liable party live?
	Motorcycle accident	Was a vehicle involved? Yes					No
	Motorcycle accident	Was a vehicle involved? Yes					No

Other

Venue/Jurisdiction of cause of action

Date of injuryType of injury/area of body injured

NOTES:

Attorney name

Attorney law firm name

Attorney street address	City		State	Zip code

Attorney phone number		Attorney fax number


Insurance company name

Insurance adjuster name		Insurance claim number

Insurance company street address	City		State	Zip code

Insurance adjuster phone number		Insurance adjuster fax number

Date and type of next scheduled hearing date

FAX COMPLETED FORM TO 877-257-2012

Blue Cross Blue Shield is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association

WF 10345 AUG 11

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