The purpose of this report is to begin committee work on the formats needed to allow electronic subrogation messages in the property casualty insurance industry. We are asking for responses and feedback from insurance carriers, subrogation vendors, subrogation investigators, subrogation attorneys, third party intermediaries, and software companies regarding all communications needed to complete the subrogation business within the property and casualty industry.
The objective will be to establish communication framework by identifying relationships to existing data elements, data flows, and connection points. This information will then be assembled to develop transmission formats that will enable the many facets and messages the systems need for electronic resolution of subrogation claims.
Develop standard formatting that will enable electronic subrogation communication for the property and casualty insurance industry and all related stakeholders. This development will create the tools for participants to enable bi-directional communication of data and messaging capability between all parties.
Scope & Objectives
The Subrogation Committee will focus on:
- Providing transmission formats for the assignment for subrogation investigation and resolution.
- Providing Industry definitions for all entities involved in this process.
- Providing Industry definitions for formats and messaging elements.
- Establishing relationships to existing data elements.
- Determining the benefits to all industry segments.
- Developing a standard formatting for data communications.
- Providing a format to facilitate the resolution of subrogation claims.
- Developing the tools and formats for completing the resolution of subrogation claims and surrounding efforts to complete the research.
- Establishing Subrogation Implementation Guide(s).
- Developing new message types, code lists and/or fields (as needed) to facilitate subrogation processing and claims.
- Messages will include the full spectrum of the subrogation assignment for investigation, subrogation resolution assignment, status requesting and reporting, and settlement resolution.
- To incorporate all potential business entities in the business processes
- To work within the Committee to establish goals and timelines
- To provide an open working relationship with the Committee within the antitrust guidelines.
- To work with X12 and their membership to ensure the messages developed meet the needs of all parties.
Industry Segments Affected
- Insurance Carriers – Property and Casualty insurers in one or multiple lines of business
- Subrogation Investigators – Businesses that investigate potential claims and provide their findings and assessments to the insurer.
- Third Party Administrators – Businesses that handle the claim administration from first notice of loss through subrogation.
- Subrogation Attorneys – Entities that provide legal services relating to subrogation resolution.
- Alternative Dispute Resolution Companies – Businesses that facilitate subrogation settlements through other than the traditional legal process.
- Subrogation Vendors – Businesses that provide collection services.
- 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.