Subrogation Form
Subrogation is the legal right that allows Blue Cross Blue Shield of Wyoming to pursue reimbursement for paid claims from a third party that is liable for an accident or injury to Wyoming members.
The following form helps us collect detailed information to determine if another party is financially responsible for the treatment provided to Wyoming members.
Important! If you received a letter from BCBSWY and have already returned the questionnaire or responded by other means, you do not need to complete this form. Thank you for your cooperation and assistance.