ERISA subrogation claims are worth a lot of money to an insurance company. Thus, companies often use an algorithm to search for possible subrogation opportunities. When they identify a possible claim, they begin an investigation. They will request information from you about the nature of the claim and third-party involvement.
If the investigation finds a likelihood of third-party liability and expected recovery, they will open a subrogation case. The health plan may pursue subrogation cases or hire a vendor or a third-party administrator to handle the claim.
Under ERISA, an insurance company may only obtain "appropriate equitable relief." Most often, this means that the insurance company may place an equitable lien on the funds from your recovery. The equitable lien gives the insurance company priority over those funds.
However, they may not receive a judgment against your general assets or consequential or punitive damages. A court has the discretion to order other equitable remedies, including a constructive trust, injunction, restitution, or reinstatement.