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WORKFLOW - INSURANCE

Subrogation Identification Workflow

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Quick Answer

The Subrogation Identification Workflow uses AI to detect third-party liability and recovery opportunities by analyzing claim documents, police reports, witness statements, and photos. AI identifies fault indicators, estimates recovery potential, and prioritizes high-value subrogation opportunities.

Definition

**Subrogation Identification Workflow** automates the detection of recovery opportunities that human adjusters might miss in high-volume claim environments. AI recognizes patterns indicating third-party fault and calculates cost-benefit of pursuing recovery.

Key Points

  • Analyzes claim documents for third-party liability indicators
  • Evaluates police reports and accident reconstruction data
  • Identifies manufacturer defects and product liability
  • Detects contractor/vendor negligence in property claims
  • Calculates recovery potential vs. pursuit costs
  • Prioritizes high-value opportunities (>$5K typical threshold)
  • Increases recovery rates by 20-30%
  • Flags opportunities within hours of FNOL

How It Works

1

Document Analysis

Analyze claim description, police report, witness statements, photos, and accident reconstruction data.

2

Fault Indicators

Identify third-party fault indicators: rear-end collision, traffic violations, intoxication, defective products, contractor negligence.

3

Liable Party Identification

Identify potentially liable parties: at-fault drivers, manufacturers, contractors, property owners, government entities.

4

Recovery Potential

Estimate potential recovery amount based on paid damages, expected future payments, and collectibility.

5

Cost-Benefit Analysis

Evaluate pursuit costs (legal fees, investigation, time) against potential recovery. Calculate expected value.

6

Priority Scoring

Score subrogation opportunity (1-10) based on recovery potential, evidence strength, and collectibility likelihood.

7

Evidence Preservation

Recommend immediate evidence preservation actions: photos, witness contact, scene documentation, vehicle impoundment.

8

Assignment & Notification

Assign to subrogation team if score exceeds threshold. Notify adjuster to preserve evidence and rights.

Common Subrogation Scenarios

  • Auto LiabilityAt-fault driver clearly responsible (rear-end, red light, DUI). Pursue recovery from at-fault party's insurer.
  • Product DefectsFire caused by defective appliance, tire failure causing accident. Pursue manufacturer/distributor.
  • Contractor NegligenceProperty damage from faulty workmanship, plumbing failure. Pursue contractor's general liability.
  • Property Owner LiabilityInjury from unsafe premises, falling objects. Pursue property owner's liability coverage.
  • Warranty SubrogationMechanical failure under warranty period. Pursue manufacturer for repair/replacement costs.