Final answer:
When insured is at fault, CSR reviews the claim and initiates the subrogation process. They gather evidence and send a subrogation demand to the adverse carrier for reimbursement.
Step-by-step explanation:
When a subrogation demand is made by an adverse carrier, CSR (Customer Service Representative) in an insurance company would typically review the details of the claim to determine if the insured is at fault. If the insured is found to be at fault, the CSR will initiate the subrogation process. Subrogation is the legal process by which the insurance company recovers the amount it paid out in claim from the responsible party or their insurance company.
The CSR will gather all relevant documents and evidence related to the claim, such as police reports, witness statements, and photos. They will then send a subrogation demand to the adverse carrier, which is the other party's insurance company, requesting reimbursement for the amount paid out in claim.
If the adverse carrier accepts the subrogation demand, they will reimburse the insurance company for the claim amount. However, if the adverse carrier disputes the subrogation demand or refuses to pay, further legal action may be necessary.