Deductible recovery to the policyholder

How do we return the policyholder's share of a subrogation recovery, with the share computed under the policy and the state's rule and the payee verified before payment?

Compute the share by rule and pay to a verified payee. When subrogation recovers money on a claim, Callvu reads the recovery and the claim (the deductible the policyholder paid, the amounts the carrier paid, the recovery costs), computes the policyholder's share under the policy's subrogation condition and the state's rule (a full deductible first, or a pro rata share after costs), routes an exception to the subrogation specialist in the Decision Desk, verifies the payee and the payment details on a secure screen with the policyholder, pays, and writes the recovery allocation and the payment to the claims system.

In scopeSimpleCallvu moves: decide, write back

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Last updated November 7, 2026.

The problem today

The carrier recovered in full from the other insurer and returned the deductible eleven months later, after the complaint.

Today, without Callvu

Subrogation recovers money from the at-fault party. The recovery posts to the claim. Nobody computes the policyholder's share because the subrogation unit measures recoveries, not refunds. The policyholder, who paid the deductible out of pocket, asks months later, and the state's regulator asks after that.

The policy's subrogation condition and the state's rules decide the share: many states and the NAIC's guidance require the insured's deductible to be reimbursed from a recovery, either first (the made-whole approach) or pro rata with the carrier after recovery costs, and some set a period from the recovery to the reimbursement. The computation is a formula on figures the claim already holds, and the payee is the policyholder of record.

Returning a deductible is one of the few moments a claim makes a policyholder glad they have this carrier.

How it runs

From the requestto the system of record.

A subrogation recovery posts to a claim on which the policyholder paid a deductible. Callvu opens the recovery allocation on the claim.

Policyholder: Confirms the payee and payment details on a secure screen and receives the share.
Subrogation specialist: Decides exceptions in the Decision Desk.
Callvu: Reads the recovery, computes the share, verifies the payee, pays and writes back.

Read the claim and the recovery
The deductible the policyholder paid, the amounts the carrier paid, the recovery amount and the recovery costs (collection fees, arbitration costs), and the policy's subrogation condition are read from the claims system; a partial recovery or a recovery in installments is flagged.
Compute the share
The policyholder's share is computed under the policy condition and the state's rule for the policy's state: the deductible first from a full recovery, or a pro rata share of a partial recovery after the allowed costs, with the method recorded; an earlier partial reimbursement is netted.
Decide exceptions
A standard computation pays by rule; a recovery in installments, a disputed cost allocation, a policyholder with a lien or an open balance on the claim, or a payee that differs from the policyholder of record goes to the subrogation specialist in the Decision Desk with only the allowed outcomes.
Verify the payee, pay and write back
The policyholder confirms the payee and the payment method on a secure screen (an electronic transfer with the details captured there, or a check to the address of record), the payment is made within the state's period where one applies, and the allocation, the method, the payment and the explanation sent to the policyholder are written to the claims system.

Where it ends: The policyholder's share was computed under the policy and the state's rule the day the recovery posted, paid to a verified payee, and recorded on the claim with the method. The Decision Trace shows the figures, the method and any exception decision; the Audit Trace shows the payee confirmation, the payment and the write. The Callvu moves in this process are decide and write back.

Runtime enforcement

What is enforcedwhile the work runs.

The regulations preloaded in Callvu Studio and the bank's own policies, applied as steps that run, not lines in a binder. A step that breaks a rule does not run, so a completed run was compliant.

Regulations

State subrogation and deductible reimbursement rules (for example NAIC Model Unfair Claims Settlement Practices Regulation and state regulations such as California 10 CCR 2695.7(q), New York 11 NYCRR 216.7): Where a carrier recovers from a third party on a claim on which the insured paid a deductible, the insured's deductible must be reimbursed from the recovery, either in full before the carrier retains anything or pro rata after recovery costs as the state and the policy provide, and several states require the reimbursement within a period of the recovery (for example thirty days) and a written explanation of a pro rata allocation.
The policy's subrogation and transfer of recovery rights condition: The condition sets whether the insured is made whole first or shares pro rata with the carrier, and whether the costs of recovery are deducted before the split; the computation reads the policy's form.
Payment and payee verification (state prompt payment rules, Reg E for electronic payments to consumers): A payment to a consumer by electronic transfer is subject to the authorization and error rules, and the carrier's payee verification policy applies before funds leave.

Company policies

The allocation runs the day the recovery posts; no refund waits for the policyholder to ask.
The method (made whole first or pro rata) comes from the policy's form and the state's rule, and is recorded.
The payee is verified on a secure screen with the policyholder before payment.
The claims system holds the allocation and the payment.

Controls

Automatic open on the recovery posting.
Share computation with the method recorded.
Decision Desk for exceptions.
Secure payee verification.
Payment within the state's period.
Claims system write with the explanation.

Clocks and deadlines

Reimbursement: Within the state's period from the recovery where one applies, commonly thirty days.
Payee confirmation reminder: On the carrier's schedule until the policyholder confirms.

Documents and checks

The recovery and the claim figures
The computation with the method
The payee confirmation
The payment and the explanation to the policyholder
The claims system record

In the Decision Trace

The figures and the method applied.
Any exception decision and the person.

In the Audit Trace

The recovery posting and the open.
The payee confirmation and the payment with time.
The write.

The handoff

Between the front doorand the back office.

The front door

The policyholder meets the process in the payee confirmation and the explanation, in any channel.

The back office

The subrogation specialist sees only exceptions; the claim shows the allocation.

The Decision Desk

An installment recovery, a disputed cost allocation, an open balance or a payee different from the policyholder of record goes to the subrogation specialist in the Decision Desk with the computation and only the allowed outcomes: pay as computed, pay an adjusted share with the reason, or hold with the reason.

Proof

In scope.Proof at scale, not one process at a time.

The kind of process Callvu runs in production for customers in this industry. Ask for a reference on this exact process. The results below are the industry's published proof; each claim code links to its record on agents.callvu.com.

Phoenix put more than 100 processes live in under 3 months.

Across Callvu customers

More than 1,000 processes are live across Callvu customers.

Across Callvu customers

Questions

What buyers ask next,answered plainly.

How is the policyholder's share computed?

Under the policy's subrogation condition and the state's rule: the deductible first from a full recovery, or a pro rata share of a partial recovery after the allowed costs, with the method recorded on the claim.

When is it paid?

Within the state's period from the recovery where one applies, after the policyholder confirms the payee on a secure screen.

What if the recovery comes in installments?

The case flags it and the subrogation specialist decides the allocation in the Decision Desk.

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