Insurance Settlements

Description

Effective Approaches for Settling Cases

Insurance Settlements (previously known as Insurance Settlement Handbook) opens long-locked doors to insurance claims departments, giving you an insider’s look at the settlement process. Discover in days what most plaintiff’s attorneys take years to learn. Veteran claims personnel reveal how to:

• Demonstrate to the adjuster that you know what you are doing
• Determine when and what to say for maximum impact
• Help the adjuster sell your client’s damages to his superiors
• Draft effective demand letters
• Evaluate soft tissue injuries
• Prove pain and suffering
• Break cases free from common logjams
• Get realistic offers from adjusters
• Counter common insurance settlement tactics
• Value cases using traditional insurance company techniques
• Obtain top dollar

Insider tips from seasoned adjusters, claims managers, and top plaintiff’s attorneys are loaded into this two-volume book. Just a few of the effective approaches for settling include:

Damages

“Adjusters will pay an extra $500 to $1000 for pain and suffering for every day spent in a hospital (excluding diagnostic time). Most attorneys fail to request this sum.”

Valuation

“During case evaluation, most insurance carriers will first calculate their exposure at what they call ‘dripping wet,’ without other considerations like prior injuries, comparative negligence, contribution by other defendants, amount of insurance available, etc. This formula is expressed as follows…”

Investigation

“Policy limits demands which are designed to determine the policy limit amounts are frequently counter-productive. Seldom will the demand result in divulgence of the policy limits. A more productive approach is to simply…”

Negotiations

“The supervisor and adjuster will not be moved because you think this claim is ‘different’ or you are ‘going to file a complaint.’ You will either have to bring your demand within the norm or justify more.”

Bad Faith

“Often defense counsel will refuse to produce certain documents in the claim file, or other company documents. Insist the defendant provide an itemized list of each document and form in the file, along with sufficient descriptions of each document. You will need this information to support a motion to compel production of the documents.”

Coverage Disputes

“Coverage questions involving only the policy issued by the carrier involved are often troublesome to the plaintiff because the plaintiff will never be notified of the coverage dispute. The plaintiff’s notice will probably be by inference, when no settlement offers are forthcoming.”

Settlement Authority

“The bigger the exposure, the more levels through which the files must pass. At each level, the person reviewing the file will be judged in part by the quality of the file that is allowed to move upward.”

Evaluation

“In reality, frequently no evaluation at all is done by the carrier until a demand for settlement is made by the plaintiff. The carrier’s offer is more a reaction to the demand than an independent evaluation.”

This comprehensive insider’s guide to the insurance settlement process, Insurance Settlementsgathers the experience of more than 25 veteran claims managers, attorneys, medical experts, adjusters and others, and turns it to your advantage. Learn how to settle more efficiently and for top dollar.

ABBREVIATED TABLE OF CONTENTS

I CLAIMS HANDLING
1 HOW INSURANCE COMPANIES PROCESS CLAIMS
2 THE CLAIMS REVIEW PROCESS: HOW TO WIN CLAIMS AND INFLUENCE CLAIMS ADJUSTERS
3 ASPECTS OF CLAIMS FREQUENTLY QUESTIONED BY ADJUSTERS
3A SPOTTING AND COUNTERING ADJUSTER “DIRTY TRICKS”

II VALUING CLAIMS
4 MANAGING THE CLIENT’S EXPECTATION II VALUING CLAIMS
5 HOW INSURANCE COMPANIES VALUE CLAIMS
6 DETERMINING AND PROVING ECONOMIC DAMAGES
7 [RESERVED]
8 HOW RESERVES ARE ESTABLISHED
8A QUESTIONS TO ASK INSURANCE EXPERTS
9 PROVING PAIN AND SUFFERING
10 HANDLING PREEXISTING AND SUBSEQUENT INJURIES
11 PROVING HEDONIC DAMAGES
12 USING EXPERTS IN VALUING AND SETTLING CLAIMS
12A HARNESSING THE INTERNET AS A CLAIM EVALUATION AND SETTLEMENT TOOL
12B USING FOCUS GROUPS AND MOCK TRIALS AS TOOLS FOR PERSONAL INJURY CLAIM EVALUATION

III EVALUATING COVERAGE
13 DETERMINING COVERAGE AND OBTAINING POLICY LIMITS
13A QUESTIONS TO ASSESS COVERAGE PROBLEMS
14 WHAT TO DO WHEN LIABILITY IS DENIED
14A HOMEOWNER’S INSURANCE COVERAGE FOR MOLD CLAIMS

IV DOCUMENTING CLAIMS
15 DRAFTING EFFECTIVE DEMAND LETTERS AND SETTLEMENT BROCHURES
16 WHAT ADJUSTERS NEED TO SETTLE CLAIMS
17 CHIROPRACTIC TREATMENT IN SOFT TISSUE INJURY CASES
18 ATTORNEYS’ GUIDE TO MEDICAL RECORDS
18A COUNTERING DEFENSE INDEPENDENT MEDICAL EXAMINATIONS
19 COMMON MISTAKES MADE BY PLAINTIFFS’ ATTORNEYS IN DOCUMENTING CLAIMS
20 ANALYZING OPINION LETTERS: A PHYSICIAN’S INSIGHTS ON THE QUALITY OF MEDICAL REPORTS

V EFFECTIVE NEGOTIATION
21 NEGOTIATING INSURANCE CLAIMS
22 ESTABLISHING BAD FAITH
23 HOW TO NEGOTIATE WITH INSURANCE COMPANIES AND AVOID SETTLEMENT DELAYS
24 MAXIMIZING DAMAGES IN SMALL PERSONAL INJURY CASES
25 TWENTY-SIX TIPS FROM SEASONED CLAIMS ADJUSTERS
25A MEDIATION TIPS FOR PERSONAL INJURY COUNSEL

VI EFFICIENT SETTLEMENT
26 EVALUATING SETTLEMENT OFFERS
26A SETTLEMENT ETHICS
27 STRUCTURED SETTLEMENTS: OPPORTUNITIES, PROBLEMS AND BENEFITS
28 APPRAISAL OF INSURANCE CLAIMS
29 SOLVING COMMON SETTLEMENT PROBLEMS
29A HANDLING INFLATED AND OTHER LIENS

VII SPECIFIC TYPES OF CASES
30 EVALUATION OF SOFT TISSUE INJURY CLAIMS
31 EVALUATING AND SETTLING MEDICAL MALPRACTICE CLAIMS
31A INVESTIGATING CELL PHONE USE IN VEHICLE LIABILITY CLAIM RECOVERIES
32 SETTLING AUTO ACCIDENT CASES
33 AVOIDING AND RESOLVING THE CLASSICALLY WEAK CASE
34 TRAUMA & POST TRAUMATIC STRESS DISORDER (PTSD): A BRIEF PRIMER FOR CIVIL LITIGATION
35 STACKING UN/UNDERINSURED MOTORIST COVERAGES
35A INVESTIGATING SLIP AND FALL CLAIMS
36 INVESTIGATING AND LITIGATING NURSING HOME ABUSE
37 INVESTIGATING AND EVALUATING THE PRODUCT LIABILITY CLAIM
38 INVESTIGATING FALSE ARREST CLAIMS
39 INVESTIGATING NEGLIGENT SECURITY CLAIMS IN PURSUING DAMAGES FOR CRIME VICTIMS
40 INVESTIGATING WORKPLACE VIOLENCE CLAIMS
41 SEXUAL MOLESTATION CLAIMS: LIABILITY AND COVERAGE ISSUES
42 HOW TO COMBAT SMALLER AND SMALLER SETTLEMENT OFFERS IN MINOR IMPACT SOFT TISSUE INJURY CASES

ABOUT THE AUTHORS

Ronald V. Miller, Jr. received his bachelor’s degree in finance from Loyola College. He then attended the University of Baltimore School of Law, graduating magna cum laude. While at the University of Baltimore, Mr. Miller was chosen as the Executive Editor of the University of Baltimore Law Review and was elected to the Heuisler Honor Society. In 2006, he was chosen as one of the forty elite lawyers in Maryland by SmartCEO, which made the selection after contacting thousands of Maryland attorneys and asking them to assess whom they believed to be the top attorneys in Maryland. Mr. Miller is also a member of the Million Dollar Advocates Forum, a prestigious group of trial lawyers in the United States with membership limited to attorneys who have won million and multi-million dollar verdicts, awards, and settlements.

Mr. Miller is able to evaluate insurance issues from the perspectives of both the plaintiff and the insurance company. His practice initially focused representing pharmaceutical companies. He handled cases around the country for companies such as Bayer and GlaxoSmithKline, as well as for various insurance companies. His practice now focuses on representing personal injury clients in Maryland who have been injured as the result of motor vehicle accidents, defective products, or medical malpractice. Mr. Miller is also a Professor at the University of Baltimore School of Law, where he teaches insurance law.

Kevin M. Quinley is Senior Vice President of Risk Services for MEDMARC Insurance Company and Hamilton Resources Corp., Fairfax, VA. He has a BA degree from Wake Forest University and an MA degree from the College of William and Mary. He holds the Chartered Property & Casualty Underwriter (CPCU) designation and specialty designations from the American Insurance Institute in Risk Management (ARM), in Claims (AIC), in Reinsurance (ARe) and in Management (AIM).

A Contributing Editor of Claims Magazine, Kevin co-authored the Insurance Institute’s AIC 33 textbook on WORKERS COMPENSATION CLAIMS and INDUSTRIAL LOW BACK PAIN published by the Michie Company.

The author of over 300 published articles and six books, his articles have appeared in publications including Business Insurance, The National Underwriter, Risk Management, Occupational Safety & Health, Best’s Review, CPCU Journal, Insurance Settlement Journal, and For the Defense. He is the author of TIME MANAGEMENT FOR CLAIM PROFESSIONALS, CLAIM MANAGEMENT, THE QUALITY PLAN, LITIGATION MANAGEMENT, and WINNING STRATEGIES FOR NEGOTIATING CLAIMS. His sixth book, MANAGING PRODUCT LIABILITY RISKS was just published in early 1998.

He teaches classes in insurance, claims, and risk management for the Washington D.C. Chapter of the Society of CPCU. He is a past President of the Washington D.C. Chapter of CPCU. He is a frequent writer and speaker on topics relating to risk management and claims-handling. He can be reached via the Internet at [email protected].