Loading...
operations

Subrogation Identification and Referral Worksheet

A subrogation referral worksheet for identifying third-party liability, attaching supporting evidence, and routing the claim to the subrogation unit. Use it to capture the facts needed for recovery without overcollecting PII.

Trusted by frontline teams 15 years of frontline software AI customization in seconds

Built for: Insurance Claims · Property And Casualty · Workers' Compensation · Risk Management

Overview

The Subrogation Identification and Referral Worksheet is a claim referral form for spotting third-party liability, summarizing the recovery theory, and sending the file to the subrogation unit with the evidence needed to act. It is designed for claims workflows where a recoverable loss may exist but the recovery team needs a clean handoff with the claim number, loss date, liability basis, evidence types, estimated recovery amount, and contact details for follow-up.

Use this template when a claim suggests another party may be responsible for all or part of the loss, and you want a consistent way to capture the facts before evidence gets scattered across emails and notes. It is especially useful for auto, property, workers' compensation, and specialty claims where early referral can improve recovery chances. The form also supports progressive disclosure, so you can ask for more detail only when a third party is known or when specific evidence exists.

Do not use it as a general claim intake form or as a substitute for full claim documentation. If there is no credible third-party liability theory, a referral worksheet adds noise and can create unnecessary PII collection. Keep the required fields limited to what the subrogation unit actually needs, and include a clear submission confirmation so the referrer knows the file has been routed.

Standards & compliance context

  • Keep the form aligned with GDPR Article 5 by collecting only the claim and contact data needed for referral and recovery.
  • Use the minimum-necessary principle for any health-related or workers' compensation claim details so the referral does not expose unnecessary sensitive information.
  • If the worksheet is used in a regulated claims process, preserve an audit trail of who submitted the referral, what evidence was attached, and when it was routed.
  • If any field may contain personal data, include a clear disclosure about how the information will be used and who will receive it.

General regulatory context for orientation only — verify current requirements with counsel or the relevant agency before relying on this template for compliance.

What's inside this template

Referral Overview

This section identifies the claim and frames why the referral is being made so the recovery team can triage it quickly.

  • Why are you referring this claim? (required)
  • Claim Number (required)
  • Date of Loss (required)
  • Referral Date (required)
  • Line of Business (required)

Third-Party Liability Indicators

This section captures the facts that suggest another party may be responsible and whether the liable party is already known.

  • Primary liability basis (required)
  • Is a responsible third party known? (required)
  • Third-Party Name
  • Third-Party Role
  • Liability Summary (required)

Evidence and Recovery Support

This section shows what proof is available and how strong the recovery opportunity appears before the file is reviewed.

  • Available evidence (required)
  • Upload supporting evidence

    Upload documents, photos, or reports that support the referral.

  • Estimated Recovery Amount

    Best estimate of the amount that may be recoverable.

  • Recovery Confidence (required)

Referral Routing and Contact

This section makes sure the referral reaches the right team and gives them a person to contact if details are missing.

  • Your Name (required)
  • Your Department (required)
  • Your Work Email (required)
  • Your Work Phone
  • Referral Priority (required)
  • Additional Notes

Consent and Submission

This section confirms the referrer understands how the information will be used and attests that the submission is accurate.

  • I understand this form may collect claim-related PII and supporting documents needed for subrogation review. (required)
  • I confirm the information provided is accurate to the best of my knowledge. (required)

How to use this template

  1. 1. Set up the referral overview fields with claim number, loss date, referral date, and line of business so the subrogation unit can identify the file immediately.
  2. 2. Configure the liability section to ask only for the third-party details that apply, using conditional logic to show name and role fields only when a third party is known.
  3. 3. Add evidence fields that match the claim type, such as photos, reports, statements, or invoices, and require file uploads only for the documents needed to evaluate recovery.
  4. 4. Route the submission to the subrogation unit or designated reviewer and capture referrer contact details so follow-up questions can be resolved without reopening the claim file.
  5. 5. Review the estimated recovery amount, confidence level, and notes before submission to make sure the referral is actionable and not just a suspicion.
  6. 6. After submission, log the referral in your audit trail and assign next steps for evidence gaps, legal review, or recovery pursuit.

Best practices

  • Mark only the fields that are truly required, and keep optional fields available for supporting detail without blocking submission.
  • Use conditional logic to hide third-party name and role fields until the referrer confirms that a liable party is known.
  • Ask for evidence types with multi-select options and use file upload fields for documents, not free-text descriptions of attachments.
  • Keep the estimated recovery amount as a numeric field and separate it from the liability narrative so reviewers can compare estimate versus support.
  • Include a clear line explaining what happens after submission, including who receives the referral and how follow-up will occur.
  • Limit PII to the minimum necessary for routing and recovery, and avoid collecting sensitive identifiers that the subrogation unit does not need.
  • Use a submission attestation so the referrer confirms the facts are accurate to the best of their knowledge and the evidence is complete.

What this template typically catches

Issues teams running this template most often surface in practice:

The liability basis is too vague to support a recovery review.
The claim number or loss date is missing, which slows routing and lookup.
The estimated recovery amount is entered without any evidence or rationale.
The wrong evidence type is attached, such as narrative notes instead of source documents.
Too much PII is collected in the notes field instead of only what the subrogation team needs.
The third-party name is left blank even though the party is known.
The referrer forgets to include contact details, creating delays in follow-up.

Common use cases

Auto Claims Adjuster Referral
An auto adjuster identifies a likely at-fault driver and uses the worksheet to capture the claim number, liability basis, photos, and police report before sending the file to subrogation.
Property Damage From Contractor Negligence
A property claim handler documents contractor involvement, attaches inspection photos and invoices, and routes the referral so the recovery team can evaluate third-party liability.
Workers' Compensation Third-Party Review
A workers' compensation specialist records a potential third-party cause, adds incident statements and medical-related support only as needed, and sends the case for recovery review.
High-Value Supervisor Escalation
A claims supervisor uses the worksheet to escalate a large loss with partial recovery potential, ensuring the subrogation unit receives a consistent summary and evidence package.

Frequently asked questions

What is this worksheet used for?

This worksheet is used to flag a claim for possible subrogation, document why a third party may be responsible, and send the matter to the subrogation unit with the supporting evidence. It helps standardize referrals so adjusters and recovery teams get the same core facts every time. The template is focused on claim recovery, not on general claim intake.

When should a claim be referred for subrogation review?

Use it as soon as a third-party liability theory appears credible, such as a vehicle collision, property damage caused by a contractor, or a product-related loss. Early referral matters because evidence can disappear and deadlines can be missed. If liability is still unclear, the worksheet can still be used to capture the known facts and route the file for review.

Who should complete the referral worksheet?

It is typically completed by an adjuster, claim handler, investigator, or supervisor who has enough facts to identify the loss and the possible responsible party. The person completing it should be able to summarize the liability basis and attach the available evidence. The subrogation unit then uses the referral to decide whether to pursue recovery.

What evidence should be attached?

Attach the documents or files that support the liability theory and recovery amount, such as photos, incident reports, statements, repair estimates, invoices, or correspondence. Use conditional logic or progressive disclosure so only relevant evidence types are requested for the claim line of business. Avoid attaching unnecessary PII or unrelated claim materials.

How often should this be used?

Use it every time a claim presents a possible third-party recovery opportunity, rather than relying on ad hoc emails or notes. A consistent referral process makes it easier to track audit trail, follow up on missing evidence, and measure referral quality. It also reduces the risk that recoverable claims are overlooked.

What are the most common mistakes when filling it out?

Common mistakes include leaving the liability basis too vague, entering an estimated recovery amount without any support, and forgetting to include the claim number or loss date. Another frequent issue is collecting more PII than the subrogation team actually needs. The worksheet should keep required fields limited to the minimum necessary for referral.

Can this be customized for different claim types?

Yes. You can tailor the evidence fields, liability indicators, and routing questions for auto, property, workers' compensation, or specialty claims. Conditional logic is especially useful when different lines of business require different evidence or different referral thresholds. Keep the structure consistent so the subrogation unit can review referrals quickly.

How does this compare with sending a referral by email?

An email thread is easy to start but hard to standardize, search, and audit. This worksheet creates a repeatable intake format with required fields, validation, and a clear submission attestation. That makes it easier to track what was submitted, what evidence was included, and what still needs follow-up.

What happens after I submit it?

After submission, the referral should route to the subrogation unit or designated reviewer with the attached evidence and contact details for follow-up. The reviewer can then assess liability, request missing documentation, or decline the referral if recovery is not viable. The form should clearly state this handoff so the submitter knows the next step.

Go deeper on the topic

Related concepts
  • A standard operating procedure (SOP) is a documented, step-by-step procedure for a repeatable task — the written version of "how we do this here." Good SOPs...
  • Workforce management (WFM) is the operational discipline of getting the right employees, with the right skills, in the right place, at the right time — and...
  • A daily huddle is a brief (10–15 minute) standing meeting held at the start of a shift or workday to align the team on priorities, surface issues, and...
  • A deskless worker is any employee whose job happens without a desk, a company laptop, or a fixed workstation. They're roughly 80% of the global workforce —...
Related guides

Ready to use this template?

Get started with MangoApps and use Subrogation Identification and Referral Worksheet with your team — pricing built for small business.

Get Started