Subrogation

Octave Blue Cross and Blue Shield makes our members' health-care financing needs a priority. When our members are injured, we ensure their medical bills are paid according to their policy, even if the injury fault lies with another person or party.

What is subrogation?

In health insurance, subrogation refers to the legal right of an insurance company — after payment of a loss — to recover monies from the responsible party's insurance carrier. For Octave Blue Cross, it refers to those times when another insurance carrier may be responsible for payment of medical care. For instance, when an injury occurs because of an accident in which someone other than the plan member is at fault, the insurance carrier of that individual may be responsible for the payment of the plan member's medical treatment. In those cases, Octave Blue Cross may be entitled to recover the value of the services from the other carrier. However, we will pay for the medical treatment of our members immediately, so that our members are not burdened by waiting for the responsible party to pay.

Octave Blue Cross uses Equian|Trover Solutions, Inc. to help in recovering subrogation claims. Equian|Trover Solutions, Inc. is an independent company that operates separately from Octave Blue Cross and is solely responsible for assisting in the recovery of subrogation claims. If you or a covered family member are injured in an accident, you will receive a letter from Equian|Trover Solutions, Inc. that asks for you to call their Customer Service department to provide details regarding how the injury occurred. If the injury was caused by someone else, on another party’s property or in an automobile accident, Equian|Trover, Solutions, Inc. will contact the responsible party and request reimbursement to Octave Blue Cross for the cost of the medical care provided because of the injury.

A successful subrogation program helps Octave Blue Cross keep the cost of healthcare reasonable for you and your employer. We appreciate your cooperation with Equian|Trover Solutions, Inc.