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

SearchCompliance

  • 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...

  • internal audit (IA)

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

SearchSecurity

SearchHealthIT

  • Health IT (health information technology)

    Health IT (health information technology) is the area of IT involving the design, development, creation, use and maintenance of ...

  • fee-for-service (FFS)

    Fee-for-service (FFS) is a payment model in which doctors, hospitals, and medical practices charge separately for each service ...

  • biomedical informatics

    Biomedical informatics is the branch of health informatics that uses data to help clinicians, researchers and scientists improve ...

SearchDisasterRecovery

  • risk mitigation

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

  • ransomware recovery

    Ransomware recovery is the process of resuming options following a cyberattack that demands payment in exchange for unlocking ...

  • natural disaster recovery

    Natural disaster recovery is the process of recovering data and resuming business operations following a natural disaster.

SearchStorage

  • RAID 5

    RAID 5 is a redundant array of independent disks configuration that uses disk striping with parity.

  • non-volatile storage (NVS)

    Non-volatile storage (NVS) is a broad collection of technologies and devices that do not require a continuous power supply to ...

  • petabyte

    A petabyte is a measure of memory or data storage capacity that is equal to 2 to the 50th power of bytes.

Close