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Subrogation is your opportunity to conduct a causal investigation and identify property owners, individuals, responsible parties, or entities involved. Determine any contributing factors and establish if there is any contributory negligence, immediate cause, intervening cause, proximate cause or proximate consequence and establish any negligence.
If any legal cause is identified and can be proven it is possible to recover money you have paid for damages caused by a third party. If you are liable for a Workers’ Compensation claim, but not responsible for the actual injury, subrogation investigations may help you recover the funds you have paid to an injured employee. If your company decides to pursue subrogation, Stryker will work to recover the damages from the responsible party. Damages may involve costs paid by you and the insurance company. Costs paid by you usually means your deductible, but could include amounts over your policy limits not paid by your insurance company. This would depend on the laws in your state and the specific circumstances surrounding the loss.
Dependent on the laws in your state, you may be fully reimbursed for your deductible if:
- The other party was 100% at fault
- The other party paid the damages claimed in full
- There were no collection expenses (i.e. collection agency) to recover the money.
Often times though, it is not that simple. Based on the different factors that come into play, the calculation of the reimbursement amount can become quite complicated. The reimbursement of your deductible depends on several factors, including the amount recovered, the amount claimed (based on the amount the various parties were at fault), and state laws
Health insurers and lawyers working in the field of subrogation say there is a sharper interest by carriers in exploring all options to recover money paid out in medical claims that should have been paid by other payers like auto insurance companies or an employer’s workers’ compensation issuer. A major health insurer estimates that 0.5% to 1% of all the medical claims it pays for auto accidents should be covered by other entities. And a subrogation lawyer says that across the country on average, 3% to 5% of medical claims paid by insurers are the responsibility of other payers.
Stryker can assist you and your legal team with determining the feasibility of recovering money from a third party. Depending on your needs and the case, you may choose a cursory check of civil public records and a known employer. Or you may select a more extensive search of all known public records, as well as employers, creditors, banks and other financial institutions. We can put all of our investigative services to work on your case, including witness canvassing and statements. Our subrogation investigations are accurate and thorough. You can count on Stryker for a reliable assessment of a third party’s negligence.
Effective subrogation requires a thorough understanding of some of the more confusing legal terms we must all work with. Stryker has compiled a list of the various laws in every state dealing with whether the state is acontributory negligence state (bars recovery with only 1 percent of fault by the plaintiff) or a comparative negligence state (recovery by plaintiff is reduced or prohibited based on the percentage of fault attributed to the plaintiff), and whether the state is a pure comparative or modified comparative state. President and Founder, Stryker