Status Use Case

Description

The Status Services are to exchange status messages.  (Currently only for Subrogation)

Actors

  • Third Party Intermediaries (includes Software Companies): Any company that develops software, databases and/or services related to the subrogation settlement process, subrogation data communications and/or subrogation data consolidation. DDDDDD

  • Subrogation Vendors: Businesses that provide collection services.

  • Alternative Dispute Resolution Companies: Businesses that facilitate subrogation settlements through other than the traditional legal process. 

  • Subrogation Attorneys: Entities that provide legal services relating to subrogation resolution.

  • Third Party Administrators: Businesses that handle the claim administration from first notice of loss through subrogation. 

  • Subrogation Investigators: Businesses that investigate potential claims and provide their findings and assessments to the insurer.

  • Insurance Carriers: Property and Casualty insurers in one or multiple lines of business

Business Segments

  • One or many Claim File Inquiries

  • Claim File Status Report(s) for one or many claim files

  • Subrogation Parties Information and Settlement Proposals exchange

  • Subrogation Arbitration Filing

  • Subrogation Arbitration Response to Filing

  • Subrogation Additional Information to Arbitrator

  • Subrogation Decision

What are the Industry Benefits for Using Status Services?

  • Establishment of an accurate and efficient industry standard - by and for industry participants - to be used in the creation and industry standard implementation of electronic messaging for subrogation assignments, status requests and reports, and invoices and remittance messaging.
  • XML electronic messages provide capability and flexibility for smaller-scale organizations and applications.
  • Facilitates the integration of subrogation messages exchange.
  • Eliminates redundant data entry and other manual processes which allows for improved integration of subrogation information across applications.
  • Management of the standard by CIECA streamlines development, approval, revision, enhancement and publication.
  • An accurate and efficient subrogation process.
  • Improved accuracy and efficiency through an understanding and use of subrogation industry standards.
  • Establish accurate and efficient messages for subrogation claim resolution. 
  • Allows for control and variations in the steps and processes followed to reach claim resolution.
  • Reducing cycle time by decreasing the number of days needed to settle the subrogation claim.
  • Increased access to accurate information in exchanges and subsequent exchanges.
  • This will enable insurers to gain a much better understanding and management of their subrogation process. 

What Triggers the need for using Status Services?

Send Subrogation assignment to a carrier, subrogation vendor, investigative vendor, or subrogation Attorney

or

Send Subrogation demand to responsible party

or

Alternative Dispute Resolution Vendor send alternative dispute resolution package to responsible party

or 

Subrogation Vendors findings sent to demanding party

or

Inquiry Request to the vendor for additional information 

or

Exchange information between the demanding party and/or Subrogation Vendor and Responsible party after the demand has been made

Pre-Conditions

Before using <Message Name> Services, please review implementation guides between business partners for security and privacy.

Workflows

 Subrogation from assignment through resolution

View Workflows

Outcome

Dispute resolution 

    

Status Solutions in CIECA

Subrogation Status

This is the Subrogation Status Request message.  Subrogation Vendors findings is sent in a message to the Demanding Party, may also be a request for additional information from the Demanding Party, and may also include a recommendation.  This may include a recommendation for settlement, arbitration, litigation, or to close the file; and may also be a request for additional information. 

Subrogation Inquiry

This is the Subrogation Inquiry Request message.  The inquiry message may be used to send requested and/or additional information to the vendor (subrogation, investigative, and arbitrator/mediator) or to request a status on one or multiple files. 

Subrogation Demand Exchanges Status

The Subrogation Demand Status message is to exchange information between the Demanding Party and Responsible Party after the Demand has been made. 

Status Responses

These message(s) are confirmation of receipt messages back to the party sending the message.