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Subrogation Letter Is Just First Step in Recovering Workers Comp Funds

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The Subrogation Letter Should Not Be Solely Relied Upon To Recover Workers Comp Payouts

A quick subrogation letter remains one of the stalwarts in recovering workers compensation funds back to a file whenever there is a responsible 3rd party involved in a Workers Comp accident.

carrier pigeons carrying worker comp subrogation letter
Wikimedia Public Use License – Carrier Pigeons

The best example is an auto accident with another driver at fault.  One has to watch saying “at fault”  as that has to be left up to the traffic court.   However, if the other party is ticketed for a violation, then they should at least be considered a responsible party.

I have recommended the Subrogation letter to the responsible 3rd party’s insurer as soon as possible with a certified return receipt letter.  One rather disturbing trend that we have seen in files over the last few years is the workers comp carrier is ignored when pursuing a reimbursement.

Was the workers compensation adjuster ignored on purpose?

A recommendation is now made that the adjuster email or call the 3rd party’s insurance claims adjuster every month to inquire on the file status and to make sure that the current adjuster knows there is a legitimate lien on any file disbursements to the injured worker by the 3rd party carrier.

Man reading subrogation letter on his computer
by StockUnlimited

Why?   Adjuster switch files often – it is the nature of the beast in the insurance industry.   Usually in an auto liability carrier’s online file, there is a blank or two about any liens on the file.

The workers compensation adjuster has to make the auto liability carrier’s “lien blanks’ are completed with the workers compensation insurer’s information.   The workers compensation adjusters often change,  also.  Tracking a reimbursement can become complicated as the online systems need to be relied upon very heavily.

Having a 30 day diary item to contact the auto liability adjuster (recommended by email) will enable the workers compensation insurer or TPA to keep up with who is on the file on both ends.

Over the years, I have had to provide general liability and auto liability adjusters with copies of the timely subrogation letter with the certified return receipt as a reminder of the lien on the file.

Of course, I started with an insurance all lines training and license, so I was not just a Workers Comp adjuster.  This training enabled me to track and follow the liability lien portion of the file.

When I first started adjusting all lines files, I was sent to what amounted to a subrogation camp.   The hotel fire alarm went off at 1:30 am until 5 am, so my absorption was a little slow and subrogation was what I thought at the time was an “outlier subject.”

As I have said often, most Workers Comp adjusters are now trained in just Work Comp adjusting.   That is OK, except when one has to put on their liability adjuster hat.

Employers should take on some of the responsibility and track the subrogation claim through their own Workers Comp subro diary on a claim.

Even if the Workers Comp carrier of TPA has a subrogation unit, a subrogation diary by the Workers Compensation adjuster and employer  is also recommended.

For more subrogation topics, click here for a full Google website search on subrogation.

The whole process starts but does not end with the subrogation letter.

 

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6 Responses

  1. Thanks for the marvelous posting! I genuinely enjoyed reading it,
    you’re a great author.I will make certain to bookmark your blog and definitely will come back
    in the future. I want to encourage that you continue your great writing, have a nice weekend!

  2. Hi there, for all time i used to check blog posts here early in the dawn, since i love to find out more and more. Do you have more info on subrogation?

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James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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