Subrogation Identification and Referral Worksheet

Identifies third-party liability and recovery opportunities on a claim and routes eligible matters to the subrogation unit with supporting evidence.

Submission Notice

• Purpose of submission
• Claim number
• Line of business
• What happens after I submit?

Claim Overview

• Date of loss
• State or province of loss
• Brief loss description
  Summarize what happened in 2-5 sentences, focusing on observable facts and known parties.
• Estimated paid amount
  Enter the current paid amount if known. Use dollars or the claim currency standard.
• Open reserve amount
  Enter the current reserve amount if known.

Third-Party Liability Review

• Is a third party potentially responsible?
• Third-party type
• Basis for liability
• Is there a recovery opportunity?
• Recovery rationale
  Explain why recovery is or is not likely, using facts, witness statements, police reports, contracts, or other evidence.

Evidence and Supporting Documentation

• Evidence available
• Evidence summary
  Briefly describe what each attachment shows and how it supports liability or damages.
• Supporting files
  Upload relevant documents, images, or reports.

Referral Decision and Assignment

• Refer to subrogation unit?
• Referral priority
• Recommended next step
  Note any immediate action such as preservation letter, demand package, vendor notice, or further investigation.
• Referral owner
  Name or team responsible for follow-up after referral.

Audit Trail and Attestation

• Submitted by
• Submitter role
• Submission date
• Attestation