Insurance · Loss Valuation and Settlement

What is 'subrogation' in insurance claims, and what is the adjuster's role?

  1. A Replacing a beneficiary
  2. B The insurer's right to step into the insured's shoes after paying a claim and pursue recovery from a third party legally responsible for the loss — the adjuster investigates third-party liability, preserves subrogation rights, and may handle initial recovery efforts before referring to subrogation specialists
  3. C Reducing the deductible
  4. D Reviewing policy terms

Why this is the answer

Subrogation is the legal doctrine allowing the insurer to recover the amount paid for a claim from a third party who caused the loss. Common subrogation scenarios: (1) Auto — insurer pays for collision damage to its insured; subrogates against the at-fault driver's insurance; (2) Property — insurer pays for fire damage caused by a contractor's negligence; subrogates against the contractor; (3) Slip-and-fall — workers comp insurer pays for employee injury caused by a third party's negligence; subrogates against that party. The adjuster's role: (1) Investigate for subrogation potential during claim handling — who else might be responsible? (2) Preserve evidence — photographs, statements, expert reports needed later; (3) Document third-party negligence and damages; (4) Have the insured sign a subrogation receipt confirming the insurer's rights; (5) For straightforward claims, may handle initial recovery directly; for complex matters, refer to subrogation specialists or attorneys. The recovered amount typically reimburses the insurer; if the recovery exceeds the insurer's payment, surplus goes to the insured (especially their deductible). The insured generally must cooperate with subrogation efforts and not release the third party without the insurer's consent. Effective subrogation can reduce net loss costs by 5-15% across an insurer's portfolio.
Source: NAIC Adjuster Subrogation

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