mEDIaTIng a propErTY InsuranCE CLaIm
Mediation & Arbitration Section
Chairs: Kari Metzger - Metzger Law Group P.A. & Jim Matulis - Matulis Law & Mediation
It all comes down
to thinking about,
and preparing for,
the mediation …
I
t had been a very long day.
I had just returned to the
office after conducting
an Examination Under Oath
on a large hurricane claim. I was
tired. I was hungry. And I had over
100 e-mails to read.
I scanned through my incoming
pleadings. And there it was: an
Order of Referral to Mediation.
Great. Now I had to prepare
for that.
As a younger lawyer (a long time
ago), I never really appreciated the
mediation conference. Why can’t
you just go in there and give them
a number, and if they don’t take
it, you walk? Simple. To the point.
No fuss.
As I got older, I realized there
was so much more to the process.
The nuances of negotiation. The
politics in both rooms, and between
each side. And the ability to talk to
the other side to learn about their
case, and yours. Over time, I began
to love the process. So I no longer
litigate insurance claims, I mediate
them. Here are some lessons I have
learned as a mediator.
Documentation
I cannot stress how important
it is for the insured to document
the claim. Do it early. Do it often.
before
the mediation.
Insurance companies want — and
require — pictures, repair and
replace ment estimates, and receipts.
Having these documents, and
having them in the claim file early,
helps the adjuster in getting more
authority to pay the claim.
Most insurers will have meetings
with the adjuster/litigation
representative, and/or the defense
attorney, in advance of the
mediation conference. This is when
they discuss the authority to be
given for the mediation. The more
the adjuster can answer questions
about the damages, and the more
documentation she is able to show
from the claim file, the more
authority will be provided.
Now, on the insurer side, I would
also tell you that you need to read
the documentation. Countless
mediations have ground to a stop
so that the claim representative
could read through documentation
previously submitted by the insured.
Analyze the Coverage Issues
and the Damages Before
the Mediation
Of course, before we even try
to calculate the true damages,
the parties must understand the
coverage issues. For the carrier, that
means detailed coverage position
letters. The insured must understand
the carrier’s position on what is
covered, and what is not. And
more importantly, why. And …
in English please.
I think it is important for the
insured to break down the damages
in detail and under the specific
coverage provisions in the policy.
The insured should set forth what
is being claimed for the Structure,
Contents, Extra Expense and
Business Interruption, ALE
(Additional Living Expenses), and
the consequential and “bad faith”
damages as well as fees and costs.
Again, the parties may never agree,
but at least you can break down
the claims into different elements
to see what can be done, even if
it means resolving some of the
claims, but not all.
It all comes down to thinking
about, and
preparing for,
the mediation
… before the
mediation.
Author: Gerald T.
Albrecht - Albrecht
Mediation
Services
CHeCk out ouR gReAt SeCtIon LunCHeonS & CLeS! visit www.hillsbar.com.
50
JAN - FEB 2019
|
HCBA LAWYER