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Subrogation Case Referral

We specialize in handling all third-party liability situations. This includes auto-accidents, workers' compensation, slip-and-fall, product liability, and medical malpractice. Please provide as much information as possible and click on the Send Referral button below.

Your Information

All fields are optional unless marked required.
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Insurance Membership

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Group Type (required)
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Subscriber and Patient Information

Subscriber

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Patient

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Accident-Related Information

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Accident Type (required)
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Responsible Party or Employer

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Patient's Attorney

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Additional Information

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Supporting Documents

If you have supporting documents for this referral, you may either convert them to Adobe Acrobat PDFs and email them to us, or fax copies of the documents to us.

Email: mrcadmin@meridianresource.com