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

File Extensions and File Formats

Powered by:

SearchCompliance

  • Whistleblower Protection Act

    The Whistleblower Protection Act of 1989 is a law that protects federal government employees in the United States from ...

  • smart contract

    A smart contract, also known as a cryptocontract, is a computer program that directly controls the transfer of digital currencies...

  • risk map (risk heat map)

    A risk map, also known as a risk heat map, is a data visualization tool for communicating specific risks an organization faces. A...

SearchSecurity

  • Payload (computing)

    The term payload, when used in the context of networking or telecommunications, is the data carried inside of a packet (or other ...

  • access control

    Access control is a security technique that regulates who or what can view or use resources in a computing environment.

  • ethical hacker

    An ethical hacker, also referred to as a white hat hacker, is an information security expert who systematically attempts to ...

SearchHealthIT

SearchDisasterRecovery

  • virtual disaster recovery

    Virtual disaster recovery is a type of DR that typically involves replication and allows a user to fail over to virtualized ...

  • tabletop exercise (TTX)

    A tabletop exercise (TTX) is a disaster preparedness activity that takes participants through the process of dealing with a ...

  • risk mitigation

    Risk mitigation is a strategy to prepare for and lessen the effects of threats faced by a data center.

SearchStorage

  • storage at the edge

    Storage at the edge is the collective methods and technologies that capture and retain digital information at the periphery of ...

  • Flash Storage

    Flash storage is any type of drive, repository or system that uses flash memory to keep data for an extended period of time.

  • optical disc

    An optical disc is an electronic data storage medium that can be written to and read from using a low-powered laser beam.

Close