§ 140.008.First-Party Recovery

A protection for the coverage the injured person bought themselves.

Subsection (a): a payor may not pursue a recovery against a covered individual’s first-party recovery.

First-party recovery means money from the individual’s own insurance rather than from the tortfeasor — chiefly uninsured and underinsured motorist coverage and medical payments coverage.

The principle is that a person who paid for their own coverage should keep its proceeds. They bought that protection with their own premiums, precisely against the risk that the person who injured them would be uninsured or underinsured.

Allowing a health plan to take it would transfer the benefit of premiums the injured person paid to an insurer that paid nothing for it.

Subsection (b) states the exception in exactly those terms: a payor may pursue UM/UIM or medical payments coverage only if the covered individual or the covered individual’s immediate family did not pay the premiums.

The premium is the test, not the policy. Where someone else paid — an employer’s auto policy, a commercial fleet policy covering a driver — the rationale disappears and the payor may reach it.

"Immediate family" widens the protection sensibly, covering the common case of a household policy in a parent’s or spouse’s name under which another family member is injured.

The exception is drawn narrowly: it names only those two coverages, so other first-party recoveries remain protected outright.