Fraud and insurance claims are synonymous. Early investigation through SIU, recorded statements, ISO searches, underwriting details, independent medical examinations, medical record reviews and agency files are all tools for the claims professional and panel counsel in the endless pursuit of the facts. Expenses related to fraudulent claims—from presentment to ultimate coverage determination—can …
ALFA International Publications
Introduction
Much has been written recently on the topic of “humanizing” the insurance carrier in its interactions with its policyholders. This concept has also been discussed when the company denies a claim for benefits and a lawsuit follows, often alleging that the company is liable for extra-contractual first-party and third-party “bad faith” damages. Given that a successful plaintiff may be ab…
Socially Inflated Jury Verdicts, Plaintiff’s Efforts to Attain the Nuclear Verdict, and Defense Strategies in Combating It
Social Inflation – What is it?
A term used to describe increased loss costs stemming from claims far more severe than what could be anticipated under the usual scope of economic inflation and claims trends.
When insurance coverage becomes more expensive because o…
Agents continue to be a vital part of the insurance industry. They are subject to potential liability for their own negligence as it relates to their obligations to their clients, who are potential insureds. Moreover, the negligence of an agent can be imputed to insurance companies on whose behalf they market, sell and procure policies. The traditional relationship between an independent agent and…
With the exponential rise in nuclear verdicts, defense counsel and clients need to work together to develop tools to rein in these extreme results. Plaintiff attorneys are becoming more and more sophisticated in preparing their cases, starting early to develop case themes and push cases forward by executing a well-orchestrated plan. Early investment on the defense side is critical to defending hig…
As Bob Dylan famously sang, “The Times They Are A-Changin’ ” and such a notion could not be more true for Florida's legal landscape. Historically, Florida has garnered a less-than-ideal reputation among those defending tort-based litigation, however, both Chambers of Florida’s Legislature recently passed comprehensive tort-reform (“HB 837/SB 236”).1 Indeed, on Friday, March 24, 2023, Governor DeSa…
The term “going green” is everywhere these days. A large portion of going green will involve developing and maintaining a renewable energy model. Such models can significantly slow the growth of global warming. The World Health Organization (WHO) has theorized that failure to properly negate climate change and its effects would lead to as many as 250,000 deaths per year from malnutrition, malaria,…
For more than one hundred years, highway vehicles have been powered by internal combustion engines that burn gasoline or diesel fuel. In the last 20 years, however, vehicles powered by alternative fuels have proliferated, viewed as a means of reducing the world’s dependence on fossil fuels, lowering fuel costs, and lessening environmental pollution. The most widely used alternative vehicle fuel is…
The ready availability of construction equipment and the materials used to construct projects is critical to construction project delivery in every corner of the world. Whether by pandemic, inflation, war, protective tariffs or increased competition for a finite supply, scarcity of parts and materials and their price volatility have triggered project delays, and worse still, project cancellations.…
The “process of Creative Destruction is the essential fact about capitalism.”
Joseph SchumpeterCapitalism, Socialism, and Democracy
Over the past decade, society, its members, and the economy have undergone what seem to be unprecedented shocks, changes, transitions, and disruptions. Brexit, the “Great Recession” triggered by the mortgage-backed securities meltdown, Covid-19, immigration, the war…