A workers' comp waiver of subrogation is a document that states that you are waiving your right for your insurer to seek compensation from a third party. Downloadable forms for eFiling, Divorces, and Suites Affecting the Parent-Child Relationship, Child Support, Hail Claims, Legal, LegalEase, and Passports.Workers' compensation and employers' liability policy will provide a waiver of subrogation in favor of. City. Grantor's insurance is not applicable in the event of a claim. Enrolling in a Superior HealthPlan Medicaid, CHIP, Medicare or Health Insurance Marketplace plan. Finding a provider that accepts Superior HealthPlan. Numbers of which shall be filled in on the Proposal Form. No claim will be made to CENTER for payment to cover costs incurred in the preparation of the submission of the Application or any other associated costs. 11. A "Waiver of Subrogation Endorsement" in favor of the. State shall be a part of each policy for coverages listed in A and B above.