§ 140.005.Payors' Recovery Limited

The operative cap, and the provision the chapter exists for.

Subsection (b) — no attorney. All payors’ combined share is the lesser of: one-half of the covered individual’s gross recovery; or the total cost of benefits paid as a direct result of the third party’s tortious conduct.

Subsection (c) — with an attorney. The same two figures, each less attorney’s fees and procurement costs as the fee provision determines.

The one-half ceiling is the heart of it. Whatever the plan paid, it cannot take more than half of what the injured person recovers — so the person injured always keeps at least half of the gross, before their own fees.

"All payors" is collective, which matters where several plans paid. The cap is on their combined share, not each of them, so multiple payors divide one half rather than taking one half each.

The lesser-of formulation means the plan never profits. If benefits paid were $10,000 and the recovery is $100,000, the payor takes $10,000 — not half.

Subsection (d) abolishes the made-whole doctrine for these recoveries. At common law a subrogee could not recover until the injured party had been fully compensated; the section says that does not apply.

That is a real loss for claimants and the counterweight to the cap. A person whose damages far exceed the available insurance is not made whole, and the payor still takes its share — but the share is bounded, which the made-whole rule alone would not have guaranteed either way.