To amend chapter 376, RSMo, by adding one new section relating to insurer's subrogation to rights of recovery of insured persons.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF MISSOURI,

AS FOLLOWS:

Section A. Chapter 376, RSMo, is amended by adding thereto one new section to be known as section 376.1100, to read as follows:

376.1100. 1. Every insurance company, health services corporation and health maintenance organization authorized to transact the business of providing health and accident insurance coverage in this state, hereinafter referred to as the insurer, shall have the right to be compensated as provided in subsections 2 and 3 of this section, with respect to any insured or member covered under a group policy, contract or certificate and to whom, or on behalf of whom, benefits are actually paid or services provided on account of claims made for hospital, surgical, medical or health care services expenses due to bodily injury sustained by such insured or member as a result of the negligence or act of another person or organization.

2. An insurer shall have the right to recover benefits actually paid to or on behalf of the injured insured or member from any judgment, settlement, compromise or reimbursement due the insured or member as a result of the negligence or act of another person or organization. When the insured or member engages legal representation to pursue recovery, the insurer shall be notified, and any legal claim or suit brought on behalf of an insured or member shall contain a provision that any recovery made as a result of such claim or suit shall be credited to the insurer in the amount of benefits actually paid to or on behalf of the insured or member.

3. If the injured insured or member does not pursue recovery from the liable party, and the insurer is put on notice from any source, such insurer shall be subrogated to the insured or member's right to bring suit against the liable party at the insurer's expense. If a suit brought by the insurer on behalf of an insured or member results in a monetary recovery in excess of the amount of benefits actually paid to or on behalf of the insured or member, the insurer shall have the right to recover its legal fees and costs from the excess, and the insured or member shall receive the balance.

4. Any amount of recovery made by an insurer under subsection 2 or 3 of this section shall be deducted from the amount of actual benefits paid under the group policy before the insurer next determines any change to the group policy holder's rates. This subsection shall only apply to groups whose ratings are based on the experience of that group.

5. Every policy providing group health and accident insurance coverage in this state shall contain the provision(s) that the insurer shall have the right to be compensated as provided in subsections 2 and 3 of this section. The form and content of such provision(s) shall be subject to the approval of the director of insurance.

6. The right of subrogation granted to a workers' compensation insurance carrier pursuant to section 287.150, RSMo, shall be considered to have priority over the rights of recovery created by this section.