0 how to pursue and win the complex claim rims 2012 – philadelphia, pa wednesday, april 18, 2012...
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How To Pursue and Win the Complex Claim
RIMS 2012 – Philadelphia, PA
Wednesday, April 18, 2012 Ty Childress,
Partner, Jones DayLos Angeles, CA
[email protected](213) 243-2422
John FrantzVice President and Associate General Counsel
Verizon [email protected]
(908) 559-5731
Sheila Small Assistant Treasurer, Risk Management
Verizon [email protected]
(908) 559-5829
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THE MEMBERS OF THE TEAMTHE RISK MANAGER
POTENTIAL STRENGTHS Understands the policy and underwriting
history Has a good grasp of the business
relationship with the insurer Can help assess impact of this claim on
overall insurance relationship
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THE MEMBERS OF THE TEAMTHE RISK MANAGER
POTENTIAL WEAKNESSES Less willing to pursue aggressive strategy if it
involves conflict with professional relationships
Less attuned to legal arguments Less knowledge of how similar claims are
being handled by other policyholders (Over)concern of premium impact on claim
pursuit
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THE MEMBERS OF THE TEAMTHE IN-HOUSE ATTORNEY
POTENTIAL STRENGTHS Can offer perspective of overall business
objectives of client Brings understanding of legal issues and legal
strategy Early integration in policy negotiations can
enhance coverage Can monitor cost-effectiveness of alternative
strategies
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THE MEMBERS OF THE TEAMTHE IN-HOUSE ATTORNEY
POTENTIAL WEAKNESSES Often focused on liability claims and brings
defense oriented perspective‑ Coverage claim not always perceived as high
profile within company Workload limitations Lack of insurance expertise
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THE MEMBERS OF THE TEAMTHE OUTSIDE COUNSEL
POTENTIAL STRENGTHS Legal expertise in insurance issues More familiar with insurer negotiating strategy Able to marshal resources quickly Not encumbered with internal company
politics
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THE MEMBERS OF THE TEAMTHE OUTSIDE COUNSEL
POTENTIAL WEAKNESSES Not as sensitized to internal company needs May be less sensitive to impact to business
relationship with insurer Can let case take on a “life of its own” if not
monitored
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THE MEMBERS OF THE TEAMTHE BROKER
POTENTIAL STRENGTHS Familiarity with insurance industry Potential commercial leverage
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THE MEMBERS OF THE TEAMTHE BROKER
POTENTIAL WEAKNESSES Generally not privileged communications Not familiar with legal issues Not sensitive to internal company objectives
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DEVELOPING THE STRATEGYUnderstanding The Underlying Claim
What is the exposure? One-time or recurring issue? What potential arguments in the coverage
claim could be inconsistent with underlying defense?
Timing considerations
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DEVELOPING THE STRATEGYUnderstanding The Coverage
What coverage is potentially implicated? Were these exposures discussed during
underwriting process? Other parties’ coverage available?
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DEVELOPING THE STRATEGYUnderstanding The Company’s Objectives
Is this a bet-the-company exposure? Need for a defense? Is company prepared to fully assert its legal
rights?
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TENDERING THE CLAIMWho?
By risk manager, in-house counsel, or outside counsel?
What message is sent? Who is your “company witness”?
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TENDERING THE CLAIMWhich Policies?
All policies? Third party’s policies versus company’s own
policies? “Targeted tender”
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TENDERING THE CLAIMHow?
Is there a risk of a forum battle? Do you sue simultaneously? Do you ask for specific acts or just
precautionary notice?
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NEGOTIATING THE CLAIMRole of Risk Manager
Can use outside counsel as “bad cop” to push insurer to negotiating table
Can offer perspective on overall insurance relationship
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NEGOTIATING THE CLAIMRole of In-House Counsel
Uniquely situated to balance legal strengths, costs, and company objectives
Can facilitate team communications
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NEGOTIATING THE CLAIMRole of Outside Counsel
Can aggressively advocate company’s legal rights
Can develop legal plan to maximize exit strategy opportunities
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LITIGATING THE CLAIMRole of Outside Counsel
Brings legal expertise and resources to bear
Full understanding of procedural aspects of litigation
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LITIGATING THE CLAIMRole of In-House Counsel
Monitors proper internal and external resource allocation
Coordinates underlying claim strategy with coverage strategy
Can help translate legal process to client constituencies
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LITIGATING THE CLAIMRole of Risk Manager
Serves as critical company witness
Can monitor insurer conduct to assess future role of insurer in program
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SETTLING THE CLAIMThe Outside Counsel
Identify important timing issues for leverage
After filing suit?
After critical threshold motions decided?
After witnesses deposed?
On courthouse steps?
On appeal?
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SETTLING THE CLAIMThe Outside Counsel
Identify personality of mediator needed
Develop mini-trial presentation to show other side’s decisionmakers
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SETTLING THE CLAIMThe Risk Manager
Identify other side’s decisionmakers
May be able to add business elements to settlement
Identify renewal issues, impact on other claims
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SETTLING THE CLAIMThe In-House Counsel
Has broadest perspective on underlying claim legal strategy, coverage legal strategy, costs
Important internal advocate for claim team decisions
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CONCLUDING THOUGHTSRisk Manager Perspective
Establish relationships with key insurer personnel Maintain close working ties with Legal Department
In-House Legal Perspective Anticipate company exposures when negotiating
coverage Persistence matters
Outside Counsel Perspective Acknowledge team members’ strengths and
weaknesses Provide real-time practical guidance and expertise