Insurance · General

What is 'subrogation' in insurance claims?

Correct answer

The insurer's right to recover from a responsible third party the amount paid to the insured — for example, if another driver caused an accident and the injured party's own insurer paid PIP benefits, the insurer can subrogate against the at-fault driver's insurer to recover those payments

  1. A The insured's right to appeal a claim denial
  2. B The insurer's right to recover from a responsible third party the amount paid to the insured — for example, if another driver caused an accident and the injured party's own insurer paid PIP benefits, the insurer can subrogate against the at-fault driver's insurer to recover those payments
  3. C The insured's obligation to cooperate with the investigation
  4. D The process of settling a claim below value

Why this is the answer

SUBROGATION: The insurer 'steps into the shoes' of the insured after paying a claim — acquiring the insured's legal right to recover from the responsible third party. EXAMPLE: Driver A causes accident; Driver B (insured) has collision coverage, which pays for vehicle repair. Driver B's insurer has subrogation rights against Driver A's liability insurer to recover the amount paid. IMPORTANCE TO ADJUSTERS: Always identify subrogation potential when settling claims; document the tortfeasor (at-fault party) information; preserve the insured's rights against the third party during the claim; do not settle in a way that waives subrogation rights without proper release; some states require the insured to participate in subrogation recovery efforts; WAIVER: If the insured releases the at-fault party before the insurer is reimbursed, the insured may be responsible for the loss.
Source: Insurance Adjuster — Claims Process, Subrogation

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