Client Relations, Expectations and Confidentiality

Chris CarucciMatt Morrison

© CLM Litigation Management Institute 2013. All rights reserved. The course material presented herein does not represent the views or opinions of any of the individual faculty members or instructors or of any of the companies or entities with which they may be employed or affiliated. Nothing in the course materials presented should be construed as legal or professional advice or the rendering of a legal or professional opinion on any specific factual situation. Always seek appropriate legal and professional business advice in the context of specific cases.

Goals of the Course Understand the roles and responsibilities that

each member of the team (counsel, insured, carrier) plays in the claim litigation process

Know how developing effective communication strategies favorably affects results

Appreciate resolution strategy development and its import

Goals of the Course

Understand the impact of litigation management

Understand why costs including expenses and case results matter

Agenda

Client Relations Communication Case Development and Strategy Litigation Management Impact of Costs and Case Results

Client Relations

What do we mean by “Client Relations”?

Client Relations

What are some ways to encourage positive client relations?

What are some examples of creating negative client relations?

Client Relations

Client expectations Critical to discover what the client’s definition

of success is Critical to understand the client’s definition of

success Manage the client’s expectations

Client RelationsImportance of strong relationship between defense counsel and the claim representative Key component in achieving a good result on

the claim Increases the potential for future business for

defense counsel from the claims examiner/company

Increases the potential for future business for defense counsel from other sources

Client Relations

Who comprises the “team” in a litigated claim and what are their roles and responsibilities? Defense counsel Insured Carrier

Client Relations

What is the tri-partite relationship? What ethical issues does this relationship

present? What is the duty of confidentiality owed by

defense counsel to the insured?

Communication

Timely Frequent Comprehensive (anticipate and understand

what information is important to the carrier)

Communication

Methods of communication Email Phone Reports

Communication

What does the insurance company do with the information you provide them with during the pendency of the claim/litigation?

Communication Reports provided must conform to LitigationGuidelines in terms of content and timeliness.

Reporting timeframes and required content within guidelines are built around client’s internal SOPs and best practices for litigation management. For example, Initial Case Assessment is required from counsel within 45 days because all litigated claims must be conferenced internally within 60 days.

Communication It is the responsibility of a claim handler to

establish and maintain accurate reserves in a timely fashion.

New information must be provided in a timely fashion.

Information from counsel assists claim handler with reserving process.

Case Development and Strategy

“If you don’t know where you are going, you might wind up someplace else.”

— Yogi Berra

Case Development and Strategy

In the first 90 days of the case, develop a “roadmap” for the claim. Critical to the appropriate handling of the

matter Frequent communication with the carrier in

order to develop case strategy Agree with the claims representative on what

constitutes “success” for this claim

Case Development and Strategy

Information Gathering Obtain from the claims representative all

information they have relative to the claim Meet with the insured Identify external sources

Case Development and Strategy

What information does the claimsrepresentative want and expect to know

during the first 90 days of the case?

Case Development and Strategy

Expectation that defense counsel will continue to keep the claims representativeapprised of all significant developments.

What constitutes a “significant” development?

Case Development and StrategyMediation Mediation should not be agreed to without

the consent of the claims representative. A mediator should not be selected without

the consent of the claims representative. Do not commit to in-person attendance by

the claims representative without authority. Provide mediation brief to the claims

representative prior to exchanging with other parties.

Trial

Be sure to communicate trial date as soon as it is received. Communication should be in writing.

Ensure that pre-trial reports are timely. Ensure that pre-trial reports are prepared in

accordance with the carrier’s requirements.

Litigation Management

What is Litigation Management?

Litigation Management

The CLM defines litigation management as:“The implementation of comprehensive strategies in order to achieve favorable claim resolutions and efficiency in either the litigation process or pre-litigation dispute resolution. Effective litigation management will yield measurable data aimed toward providing fiscal predictability in the litigation process and which facilitates informed strategic decision-making for future litigation planning.”

Litigation Management

Essentials of Litigation ManagementCollaboration

Fully utilize the expertise of counsel and claim professional

Timely and Accurate Information “No Surprises”

Analysis and Advice Overall Litigation Strategy “Settle or Try” Evaluation

Litigation Management

Litigation Guidelines A framework for collaboration with counsel

designed to bring about the best possible defense for the insured in an efficient and effective manner.

Establish client expectations/service level agreement.

Outlines reporting and billing expectations.

Impact of Costs and Case ResultsLoss Cost TriangleUnallocated Loss Adjusting Expense (ULAE) — claim department overhead, IT costs, salaries, etc.

Allocated Loss Adjusting Expense (ALAE) — claim handling expenses allocated directly to a specific claim including, investigators, independent adjusters, attorneys, experts, etc.

Indemnity — loss payments including settlements and verdicts.

External Factors — legal environment, regulatory environment, economy, customers and stakeholders.

Impact of Costs and Case Results

ULAE

ALAE

Indemnity

Focus is on what we can control: ALAE & Indemnity (Total Loss Costs)

Legal Climate Regulatory Climate

Economy Customers

Shareholders

Impact of Costs and Case ResultsClaim Department performance is evaluated based upon total loss costs.Key Metrics

Cycle time Total expense per closed file Total indemnity per closed file Method of disposition

This underscores the importance of formulating a litigation plan at the outset.

Impact of Costs and Case Results Why is it important? Loss and expense payments factor into loss histories

of insureds Impact rates and renewals Impact actuarial analysis and projections Impact business strategies

Loss and expense ratios are key components of combined operating ratio (COR)

COR is a key indicator of profitability and a key component of return on equity (ROE)

Client Relations, Expectations and Confidentiality

Chris CarucciMatt Morrison