Denying liability  Claims      

 

 

 

Chapter 14

What to Do When Liability is Denied

Introduction

[A] Determining Why the Claim Was Denied

    1. Information Required from the Client
    2. Contracting the Agent
    3. Writing the insurance company To Obtain Information
    4. Sample: Letter to Insurance Company Requesting information as to Reason for Denial of Liability

[B] Assessing the Potential Claim

    1. Breach of contract
    2. Checklist : Elements of Breach of Contract
    3. Bad faith
    4. Checklist Of Bad Faith
    5. Fraud
    6. Negligence

[C] Pre- Suit Investigation

    1. Insurance Department Records
    2. Government and Court Records

[D] Discovery

    1. Interrogatories
    2. Contentions
    3. Request for Production of Documents
    4. The internal Claims File
    5. Agent's File
    6. Underwriting File
    7. Training and Marketing Material
    8. Bonus Programs
    9. Complaint Records
    10. Depositions
    1. Agent
    2. Claims Personnel
    3. No Lose Question

[E] Trail Strategy

    1. Voir Dire
    2. Opening Statement
    3. Order of Witnesses
    4. Closing Argument

 

*****Lecture seminar for this course is 2.0 hours for Continuing Education (CE) This course  provides the adjuster with inside information relating  to attorneys weakness and attorneys strategies  they will us when a claim is denied.  This is an essential  course for adjusters to know  the legal process when denying insurance claims .  Course study for a Professional Designation  requires 6 hours study time.

 

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