Subrogation

Subrogation in insurance is the process by which an insurance company that has paid a claim on behalf of its insured seeks to recover the amount of the claim from a third party who may be responsible for the loss or damage. In other words, subrogation allows the insurer to step into the shoes of its insured and seek reimbursement from another party.

For example, if you are involved in an auto accident and your insurance company pays for the damages to your car, your insurance company may then seek reimbursement from the other driver's insurance company, if the other driver was at fault for the accident.

Key features of subrogation include:

  • It is a common practice in the insurance industry to help reduce costs for insurers and their policyholders.
  • The insurance company may have the right to recover the amount of the claim, as well as any costs associated with pursuing the claim, such as legal fees.
  • The insurance company must have paid a claim on behalf of its insured in order to have the right to seek reimbursement through subrogation.
  • Subrogation can occur in various types of insurance claims, including property damage, personal injury, and healthcare claims.
  • The right to subrogation may be included in the insurance policy or may be granted by law in certain circumstances.
  • Subrogation can also be waived or limited by agreement between the parties involved, such as in a settlement agreement.

Next Up

Vision is the most commonly offered ancillary benefit in employer-sponsored plans — 89% of employers offer it nationally, higher than dental, higher than life insurance, and higher than any voluntary benefit. And yet vision is also one of the most underfunded benefits in the market.
Dental benefits are not your largest cost center. For most employers, dental represents a fraction of what medical costs per covered employee annually. But dental is one of the highest visibility benefits in your package: employees use it, notice it, and talk about it. When it’s good, it builds goodwill. When it’s inadequate (low maximums, no orthodontia, zero employer contribution) it registers as a signal that the employer isn’t invested in the total package.
How an employer funds its health plan sits quietly in the background of every benefits decision. Most CHROs and CFOs know their premium cost. Fewer understand the mechanics of how their plan is actually structured: who holds the risk, who administers the claims, how costs flow, and what flexibility, if any, they have to change any of it.