Browse Definitions:
Definition

subrogation

Contributor(s): Matthew Haughn

Subrogation is a legal right that lets an insurance company seek to recover costs from any third party who is responsible for the damages. The term subrogation literally means one party is standing in the place of another party.

In healthcare insurance, subrogation involves recouping healthcare costs that are deemed the fault of an insured party other than the claimant. The insurance carrier accepts the financial burden of the claimant from an accident or injury and seeks repayment from the at-fault party.  For example, subrogation is practiced in cases involving workers’ compensation or personal injury resulting from doctor malpractice or the actions of others. The insurance company will pay the claimant as part of their policy, and then take legal action against the at-fault party to collect damages. The claimant may also have deductibles and copays reimbursed.

As healthcare costs rise steeply in the United States, health coverage companies are increasingly focused on eliminating costs for which they are not responsible. As a result, insurance companies sometimes contact customers with health conditions that may stem from the actions of other insured people. This contact is often in the form of a letter with a questionnaire designed to collect information that will help determine if the incident is an appropriate case for subrogation. The form may also request additional information required to complete the process.

Most cases involving questionable liability are investigated through insurance claims analysis. Large health coverage providers like Blue Cross Blue Shield often use third party companies to investigate subrogation. Equian, for example, is a medical expense management company which performs much of the investigation of subrogation cases for its 390 clients, with over 240 billion cases translating to $1.6 billion in annual savings for insurers.

This was last updated in June 2017

Continue Reading About subrogation

Start the conversation

Send me notifications when other members comment.

By submitting you agree to receive email from TechTarget and its partners. If you reside outside of the United States, you consent to having your personal data transferred to and processed in the United States. Privacy

Please create a username to comment.

-ADS BY GOOGLE

File Extensions and File Formats

Powered by:

SearchCompliance

  • internal audit (IA)

    An internal audit (IA) is an organizational initiative to monitor and analyze its own business operations in order to determine ...

  • pure risk (absolute risk)

    Pure risk, also called absolute risk, is a category of threat that is beyond human control and has only one possible outcome if ...

  • risk assessment

    Risk assessment is the identification of hazards that could negatively impact an organization's ability to conduct business.

SearchSecurity

  • phishing

    Phishing is a form of fraud in which an attacker masquerades as a reputable entity or person in email or other communication ...

  • vulnerability disclosure

    Vulnerability disclosure is the practice of publishing information about a computer security problem, and a type of policy that ...

  • incident response

    Incident response is an organized approach to addressing and managing the aftermath of a security breach or cyberattack, also ...

SearchHealthIT

SearchDisasterRecovery

  • business continuity and disaster recovery (BCDR)

    Business continuity and disaster recovery (BCDR) are closely related practices that describe an organization's preparation for ...

  • business continuity plan (BCP)

    A business continuity plan (BCP) is a document that consists of the critical information an organization needs to continue ...

  • call tree

    A call tree -- sometimes referred to as a phone tree -- is a telecommunications chain for notifying specific individuals of an ...

SearchStorage

  • flash memory

    Flash memory, also known as flash storage, is a type of nonvolatile memory that erases data in units called blocks.

  • NAND flash memory

    NAND flash memory is a type of nonvolatile storage technology that does not require power to retain data.

  • NOR flash memory

    NOR flash memory is one of two types of nonvolatile storage technologies.

SearchSolidStateStorage

  • hybrid hard disk drive (HDD)

    A hybrid hard disk drive is an electromechanical spinning hard disk that contains some amount of NAND Flash memory.

Close