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.

Please create a username to comment.

-ADS BY GOOGLE

Dateiendungen und Dateiformate

Gesponsert von:

SearchCompliance

  • PCI DSS (Payment Card Industry Data Security Standard)

    The Payment Card Industry Data Security Standard (PCI DSS) is a widely accepted set of policies and procedures intended to ...

  • risk management

    Risk management is the process of identifying, assessing and controlling threats to an organization's capital and earnings.

  • compliance framework

    A compliance framework is a structured set of guidelines that details an organization's processes for maintaining accordance with...

SearchSecurity

  • Trojan horse (computing)

    In computing, a Trojan horse is a program downloaded and installed on a computer that appears harmless, but is, in fact, ...

  • identity theft

    Identity theft, also known as identity fraud, is a crime in which an imposter obtains key pieces of personally identifiable ...

  • DNS over HTTPS (DoH)

    DNS over HTTPS (DoH) is a relatively new protocol that encrypts domain name system traffic by passing DNS queries through a ...

SearchHealthIT

  • telemedicine (telehealth)

    Telemedicine is the remote delivery of healthcare services, such as health assessments or consultations, over the ...

  • Project Nightingale

    Project Nightingale is a controversial partnership between Google and Ascension, the second largest health system in the United ...

  • medical practice management (MPM) software

    Medical practice management (MPM) software is a collection of computerized services used by healthcare professionals and ...

SearchDisasterRecovery

SearchStorage

  • M.2 SSD

    An M.2 SSD is a solid-state drive (SSD) that conforms to a computer industry specification and is used in internally mounted ...

  • kilobyte (KB or Kbyte)

    A kilobyte (KB or Kbyte) is a unit of measurement for computer memory or data storage used by mathematics and computer science ...

  • virtual memory

    Virtual memory is a memory management capability of an operating system (OS) that uses hardware and software to allow a computer ...

Close