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Effective Subrogation Prevents Unnecessary Loss

As insurers and self-insured employers struggle to manage their expenses, it is ironic that billions of dollars are paid out unnecessarily each year because of badly managed claims. Generally, the

By Jay Garcia | Updated on February 09, 2006

As insurers and self-insured employers struggle to manage their expenses, it is ironic that billions of dollars are paid out unnecessarily each year because of badly managed claims. Generally, the claim management process consists of three phases: investigation, settlement, and payment. Yet, a fourth phase, recovery, lags behind or is often ignored, causing insurers to leave money on the table every year.

Recovery, or subrogation, is the process by which insurers or self-insured companies seek reimbursement of their claim losses from responsible third parties. Properly executed, subrogation can help payors recoup substantial amounts. Unfortunately, payors often fail to pursue recovery, either because they are unaware of the opportunities it affords or because they have concluded that the activity is too burdensome or costly for staff to pursue aggressively. Others may have programs in place that are ineffective.

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