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.
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.
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.
©J&L Risk Management Inc Copyright Notice