Address of Insurance Company — Enter the insurance company's complete mailing address. If insurance benefits were paid on your behalf, then you must account for subrogation in the event you collect any money on your case.MWL also offers our File Referral Forms in PDF format. Just click on the File Referral Form link below relating to your file type to open the form. Subrogation is a common process in which your insurance company gives you money for your damages upfront, then goes up against the defendant for reimbursement. Here is an insurance subrogation case from the U.S. Southern District of Texas, Houston Division. Subrogation Depends on the Intent of the Parties As Expressed in the Lease Agreement. National Union Fire Insurance Co. of Pittsburgh, PA, where, in the context of a subrogation claim against the primary carrier, the Texas Supreme. For example, let's assume you are injured in a car wreck that was someone else's fault and your health insurance company paid your emergency room bill. Addresses. Premium payments.