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Claims Subrogation & Litigation Management

Stay on the top of potential subrogation opportunities & litigation for claims warranting further action towards settlement

Initiate multiple subrogation and litigation cases on claims either automatically through business rules OR manually, with end-to-end case management designed especially for handling insurance claims operations, having specialized workflows and tasks for relevant users - legal, finance, adjusters & more.

Overview of Claims Subrogation & Litigation

Subrogation in insurance is a legal right the insurance company holds to legally pursue a third-party responsible for the damages caused to the insured. When an insurance company pays you the amount you claimed in a situation where the third party was responsible for the damage in question, you subrogate your rights to the insurance company. However, after a claim is paid, insurance companies often neglect to pursue their subrogation right or do so with faulty subrogation practices. This means insurers often do not collect on subrogation opportunities or spend so much money in the collection effort that the result does not have a significant positive impact on their bottom line.

The litigation process in insurance is one another area in which insurance companies are struggling over the past so many years. Litigation is a process which the insured or insurers would like to initiate if either of the parties involved is not happy with the claim settlement offer. Litigation case management helps attorneys manage clients and case information, providing a streamlined process to keep track of paperwork, share information among attorneys, ease automated processes and make billing more efficient and accurate.

Targeted Market Challenges

  • Many insurers rely on claims adjusters to refer the claims to the subrogation department, which requires manual effort and leaves the door open to errors in judgment or lack of motivation.
  • In addition to adjusters’ claim handlers and other staff who initially record a customer’s claim can contribute to missed opportunities. If specific, critical information is not captured at the time of claim intake, claim adjusters may not recognize subrogation potential.
  • In many cases, the claims system rules to identify subrogation potential are static or are hard-coded in the process, leading to missed opportunities.
  • No proactive reminders or alerts to follow up with the third parties & other key parties involved resulting in falling behind the necessary communication cycle on claims that have high chances of winning.
  • Litigation case management solutions are quite generic, and not insurance industry-focused, which do not improve collaboration or reduce legal expenses with minimum or zero data analytics & business intelligence.
  • When insurance executives looked to their case management and technology providers to find their best attorneys suited to work on a given claim, they were all surprised to find out that they did not have the answer.

Key Features

  • Automatic Subrogation Initiation
    • Start subrogation automatically where there is a potential opportunity of recovery, without relying on adjusters to report to the subrogation department.
    • Built-in subrogation rules to auto-calculate the recovery amount based on complexity of the claim, negligence % of the third party & complex state laws.
    • Reminders & communication module to stay on the top of key follow-ups with relevant parties.
  • Arbitration & Payment Integration
    • Initiate the arbitration process on subrogation if any of the parties involved are not satisfied with the subrogation offer.
    • Integrated with core financial module giving a full view of all payments or recoveries processed on each subrogation cases.
    • Configure subrogation & arbitration processes for different LoBs as required.
  • Litigation Case Management
    • Specialized & configurable litigation case management for insurance vertical for different LoBs
    • Specialized focussed sites for legal departments to closely collaborate on each litigation case with adjusters.
    • Powerful legal companies search allowing insurers to search for the best fit of legal experts at a first place saving unnecessary legal expenses incurred.

Subrogation & Litigation Application Impacts

  • Improves CX - By passing the benefits of subrogation recoveries to end customers as a customer settlement bonus, it improves the customer experience in the claim settlement process.
  • Reduced Cost - Appointing the best legal team or subrogation team at the right time of claims workflow, helps to reduce the additional overhead expenses, thereby reducing the overall claim cost.
  • Reduced Time - Automated & configurable subrogation & litigation management allows a faster decision-making process, reducing the overall turnaround time.
  • Market competitiveness - By implementing the right combination of process optimization and technology, insurers can significantly increase the bottom-line impact (revenue) as well as an area of real competitive advantage in the market.

Appcino's Connected Claims Insurance Suite

Appcino's Connected Claims Operation Suite of apps offers a complete claims management solution built on Appian. The multiple applications part of this suite includes FNoL intake, adjudication & settlement (multiple LoBs), fraud case management (integration with existing specialized fraud systems), field inspection management, subrogation, litigation case management, and claim finances management (reserves, payment, recoveries). It also comes with multi-channel customer service and process mining apps helping insurers to monitor and improve their claims processes continuously.