Not everyone in insurance understands claims litigation. I wanted to summarize the process in under 10 minutes while also giving you just enough perspective to think independently about where things are headed. Here’s a quick summary of each step:
Incident occurs
Claimant hires an attorney
Claimant seeks treatment for injuries
Plaintiff Attorney notifies insurer
Adjuster and Plaintiff Attorney colloborate on the claim, but typically cannot resolve it due to differing valuations
Plaintiff attorney files the lawsuit
Insurer hires Defense Attorney to defend the lawsuit, starting with responding to the Complaint and Discovery
Defense Attorney creates lengthy Case Evaluation memo
Defense Attorney executes Case Plan, such as interviews, experts, and depositions
Defense Attorney and Adjuster balance the events with this case amongst the events occuring on their significant amount of other cases, with the older cases typically drawing most of their attention.
Mediation
At each of these steps, Defense Attorney drafts oftentimes lengthy memos about the events and how they impacted the Case Evaluation. Because claims litigation occurs in email exclusively, the Adjuster must manually update the claims system with this information.
At some point, Defense Attorney and Plaintiff Attorney engage in substantive negotiations, and case is resolved.
In the podcast, I ask a question: is this a good process? I’ll answer that question in detail in later posts, but in the meantime, I empowered you to answer it for yourself.
Insurers and Defense Attorneys have answered this question. I refer you to our resources page and in particular the Suite 200 2024 Defense Counsel Study. I highlighted the following questions that the study asked of claims professionals and attorneys:
Do cases settle later than necessary?
Why?
Should the Defense Attorney make the first offer?
Why?
Are Insurers and Defense Attorneys aligned?
Why?
Does the work Defense Attorneys do have value (impact the outcome) to insurers?
Thanks,
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