Every move matters: A smarter approach to subrogation
In healthcare subrogation, every decision is strategic. The difference between partial recovery and optimal results often comes down to anticipating the next move — and the one after that. With rising claim complexity, evolving regulations, and increasingly aggressive opposing counsel, the board is never static.
We understand that subrogation is not just about reclaiming dollars—it’s about safeguarding the integrity of your plan, ensuring operational efficiency, and protecting member trust. Our legal approach integrates deep subject matter expertise with forward-looking strategy, so no matter how complex the matter, you retain the advantage from the initial notice to final resolution.
Our best-in-class legal team draws on decades of subrogation experience, gained through years of resolving matters for health plans nationwide. We’ve learned firsthand what works—and what doesn’t—when addressing complex recovery challenges, and we apply that insight to craft strategies that consistently deliver stronger outcomes for our clients.
1. Strategic subrogation approach
- Negotiation Advantage – We identify leverage points early, remove settlement obstacles, and secure favorable terms before disputes escalate. This reduces cycle times, minimizes costs, and accelerates cash flow.
- Multi-Jurisdiction Case Management – State laws vary widely. We coordinate strategies across multiple jurisdictions to ensure consistency, protect enforceability, and maintain compliance—without losing speed or momentum.
- Plan Language Optimization – Strong plan language is your best opening move. We review and refine it to strengthen enforceability, increase recovery value, and close loopholes that could weaken your position in arbitration or litigation.
- Complex and High-Exposure Case Oversight – When financial exposure or legal complexity is high, we deploy targeted resources to reduce risk, protect plan assets, and ensure critical claims receive focused attention from our most experienced legal professionals.
- Mass Tort Coordination – High-volume, high-value matters demand structure and foresight. We collaborate seamlessly with external legal partners to manage scale, ensure consistency, and maximize recovery opportunities across related claims.
- Legislative and Case Law Monitoring – The legal environment shifts constantly. We proactively track emerging legislation, regulatory updates, and precedent-setting rulings so our strategies evolve ahead of the changes, not in reaction to them.
2. Why this matters for health plans
The subrogation environment has become more challenging and less forgiving. Delayed action can mean diminished recoveries. A poorly structured plan document can undermine enforceability. Gaps in multi-jurisdictional strategy can leave money on the table. These are not hypothetical risks—they are real challenges health plans face every day.
That’s why choosing the right partner matters. Carelon Subrogation’s legal team combines the tactical precision of seasoned litigators with the strategic foresight of industry specialists. We don’t just react to the game—we set the pace, dictate the terms, and ensure your position is protected at every stage.
For executives, that translates to confidence: confidence that every case is handled with rigor, every opportunity for recovery is pursued, and every decision is made with your plan’s financial and reputational interests in mind.
