ChecklistGuro Insurance Claims Subrogation Workflow
Streamline your recovery process with our comprehensive Insurance Claims Subrogation Workflow. Designed to optimize error-free identification, investigation, and assignment of third-party liabilities, this automated process reduces leakage, accelerates reimbursement cycles, and ensures maximum recovery for complex insurance claims. Optimize your subrogation lifecycle today.
Start
Start of the Workflow/Process.
1. Retrieve Initial Claim Details
Fetch all details from the original Insurance Claim entry to identify potential third-party liability.
2. Identify Third-Party Policy Data
Search the Policy Data Model for any existing records related to the identified adverse driver/party.
3. Calculate Subrogation Recoverable Amount
Calculate the net amount recoverable by subtracting deductibles and processing fees from the total paid loss.
4. Create Subrogation Case
Generate a new entry in the Subrogation Case Data Model linked to the original claim.
5. Assign Investigation Task
Create a task for an Investigator to verify fault and gather evidence (police reports, photos).
6. Checklist: Evidence Verification
A checklist within the investigation task to ensure all necessary documents are attached to the case.
7. Update Liability Status
Update the Subrogation Case entry with the determined percentage of fault for the third party.
8. Retrieve Third-Party Insurer Contact
Fetch contact information and claims handling details for the identified adverse insurer.
9. Send Demand Letter
Send a formal demand for payment to the third-party insurer's claims adjuster.
10. Task: Monitor Response Deadline
Create a task to follow up if no response is received from the third-party insurer within 30 days.
11. Update Demand Status
Update the case record to reflect that a demand has been issued.
12. Retrieve Settlement Offers
Fetch any incoming payment offers or correspondence linked to the case.
13. Calculate Loss Variance
Compare the settlement offer against the calculated recoverable amount to determine if the offer is acceptable.
14. Task: Final Settlement Approval
Create a task for a Claims Manager to review and approve the settlement amount.
15. Update Case Outcome
Update the Subrogation Case entry to 'Closed' and record the final settlement amount.
16. Update Original Claim
Update the original Insurance Claim entry to reflect the recovered funds.
17. Calculate Total Recovered Monthly
Aggregate all closed subrogation entries to calculate the total monthly recovery amount for reporting.
18. Generate Subrogation Recovery Report
Create a performance report showing the ratio of recovered amounts vs. total claims paid.
19. Notify Claimant of Recovery
Send an email to the policyholder informing them that the deductible has been recovered.
20. Archive Closed Correspondence
Delete or move temporary internal notes that are no longer required after case closure.
End
End of the Workflow/Process.
Start of the Workflow/Process.
Fetch all details from the original Insurance Claim entry to identify potential third-party liability.
Search the Policy Data Model for any existing records related to the identified adverse driver/party.
Calculate the net amount recoverable by subtracting deductibles and processing fees from the total paid loss.
Generate a new entry in the Subrogation Case Data Model linked to the original claim.
Create a task for an Investigator to verify fault and gather evidence (police reports, photos).
A checklist within the investigation task to ensure all necessary documents are attached to the case.
Update the Subrogation Case entry with the determined percentage of fault for the third party.
Fetch contact information and claims handling details for the identified adverse insurer.
Send a formal demand for payment to the third-party insurer's claims adjuster.
Create a task to follow up if no response is received from the third-party insurer within 30 days.
Update the case record to reflect that a demand has been issued.
Fetch any incoming payment offers or correspondence linked to the case.
Compare the settlement offer against the calculated recoverable amount to determine if the offer is acceptable.
Create a task for a Claims Manager to review and approve the settlement amount.
Update the Subrogation Case entry to 'Closed' and record the final settlement amount.
Update the original Insurance Claim entry to reflect the recovered funds.
Aggregate all closed subrogation entries to calculate the total monthly recovery amount for reporting.
Create a performance report showing the ratio of recovered amounts vs. total claims paid.
Send an email to the policyholder informing them that the deductible has been recovered.
Delete or move temporary internal notes that are no longer required after case closure.
End of the Workflow/Process.
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