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Subro SOS – At Least Document the Attempt

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My Subro SOS Mini rant for 2024

I try not to rant on mistakes that I see made during our premium, Mod, and clams reviews.  My Subro SOS mini rant (please excuse) for 2024 covers subrogation.   Yes, good old subrogation gets left behind when we have all became specialists leaving little to no generalists to have input on files.

Why Subro SOS Rant Now?

We usually see one or two mishandling subrogation mistakes per month.  Most of the “overlooked money left on the table” can be rectified notifying the possibly responsible third parties by letter, not email, during the Workers comp claim process.  I wrote about the subrogation pursual crisis during the pandemic.  See the prior link.

Having handled and reviewed thousands of claims, some of the main issues with claims handling seem to fade in and out on a cyclical nature – such as obtaining recorded statements or 24-hour three-point contact.

When The Adjuster Becomes the Claimant

Before the pandemic, complicated subrogation matters were not pursued by adjusters.  Now, subrogation of any type, especially auto accident claims can possibly return money to the file without a large amount of effort.  Not pursuing the partially/completely responsible third parties may leave a file with more paid than was necessary.  A simple letter may get the ball rolling.

Subrogation from an adjusting point of view is defined as substituting in another responsible party in an insurance claim.  I will not go into the process as below you will find links to a number of articles that will help avoid my future Subro SOS rants.

Subrogation

pic barn accident worker comp subro SOS
Creative Commons License – W Carter

Bottom Line

At a minimum, documenting the subrogation investigation answers many questions on any third party involvement. Many times, we see the adjuster check the No Subrogation Involved block.  An explanation of why no subrogation will avoid having a Subro SOS on your hands where the adjuster may have to retrace several steps for years in the past.

Remember that the subrogation money does not sit there waiting to be claimed.  If the policy has a limit of $30,000 and you come to the table after two years, the third-party policy may have been spent elsewhere.  Ok, so end of my Subro SOS rant.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management 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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