In insurance, timely identification of subrogation opportunities is critical to maximizing recoveries and minimizing loss ratios. Traditional processes relied on adjusters to manually review claims and identify signals such as police reports, liability indicators, or third-party involvement. This manual approach often introduced delays and inconsistencies, resulting in missed recoveries. By using Decisions, a leading insurer was able to automate the identification of subrogation signals at scale while ensuring speed, accuracy, and compliance.
Challenge
Before adopting Decisions, the company faced several key challenges:
- Heavy reliance on adjuster judgment to flag subrogation opportunities.
- Delays in identifying signals, causing missed recovery windows.
- Inconsistent recognition of relevant claim details across teams.
- High administrative overhead in monitoring claim files for potential subrogation triggers.
These issues resulted in financial leakage, reduced recovery potential, and operational inefficiencies.
Solution
The insurer implemented Decisions as a rules-driven automation platform to modernize subrogation detection.
- Automated parsing of claim data and supporting documents.
- Rules-based signal detection logic to identify accident types, liability notes, or third-party involvement.
- Alerts and automated workflows to notify subrogation specialists of flagged cases.
- Dashboards and reporting to monitor claims flagged for subrogation and track recovery progress.