Attorneys offer insurers advice for navigating complex claims

"There are little, inexpensive things that can be done to set up the claim for better success down the road."

Partners from the defense litigation firm Wilson Elser will mount a presentation during the upcoming Complex Claims & Litigation Forum that includes logical, methodical steps for working through a claim to reach a resolution that makes the most sense from a legal and business perspective. (Credit: Maxim_Kazmin/Adobe Stock)

Addressing complex claims is a time-consuming, costly, multi-faceted process that requires a diverse range of insurance professionals. These claims often involve large losses, multiple parties, more than one insurers or reinsurer, and expensive litigation.

The upcoming Complex Claims & Litigation Forum will provide a wealth of presentations, thought leadership, and case studies on the topic while offering innovative insights and solutions for key players within the insurance industry.

Workshops are a major segment of the event agenda. During one such workshop, three partners from Wilson Elser Moskowitz Edelman & Dicker (Wilson Elser) will share perspective as part of a presentation titled, “Take It From Me: A Lawyer’s View on the Mistakes Insurers Make in Complex Claims.” The attorneys plan to share best practices for setting up a claim for resolution and then delve into the mistakes claims professionals can make and how to avoid them.

“For me, a complex claim is anything that is out of the ordinary. That may be a large value claim, a unique set of facts leading to the claim, or unique a personality that would make the claim more complex than it needs to be,” Wilson Elser Partner Mark Severino said recently about the material he plans to share during the upcoming Complex Claims & Litigation Forum workshop, which Severino will present alongside Wilson Elser colleagues Sheri Thome and Jorge Ramirez. “There are little, inexpensive things that can be done to set up the claim for better success down the road.”

Severino has been defending unique and complex claims and trying cases since he started practicing law in 2009. His areas of focus are aviation, transportation, and high-exposure general liability, but he enjoys taking on the more unusual claims whenever they come in the door. Specifically, he represents major domestic airlines, fixed-base operators, aircraft and aircraft parts manufacturers, and general aviation operators in matters ranging from minor injuries to catastrophic injuries and wrongful death claims.

Workshop attendees will learn how early action can make a difference in how a matter settles, Sheri Thome added.

“Complex claims involve more than one claimant, serious injuries, and/or jurisdictional concerns,” said Thome, who has 29 years of experience in handling large complex cases in varied practice areas, including significant experience in managing litigation and professional risk. As the regional managing partner of the Wilson Elser’s Las Vegas office, Thome focuses her practice in the areas of employment defense, professional liability defense, insurance coverage advice and insurance litigation. She also handles sophisticated commercial cases.

“Proactive claims handling can ultimately save the carrier money, so carriers should not be afraid of early investigation expense,” said Jorge Ramirez, partner at Wilson Elsner. “Complex claims often generate runaway verdicts, so early and effective claims handling can prevent some of that risk.”

Ramirez’ litigation experience includes cases involving contract disputes, trade infringement and collection matters. With 25 years of experience handling all kinds of complex tort claims with significant jury trial experience, Ramirez also worked in house for two major insurance companies. His insurance litigation experience encompasses matters involving insurers’ subrogation rights and declaratory relief actions. He focuses his practice in the areas of general liability, professional liability, product liability, construction defects, workers’ compensation, surety liability, municipal liability and business litigation.

So what can insurers do to curb complex claims?

It’s important to recognize that managing complex claims presents an enormous challenge for insurance companies. That’s why Severino says it’s important to have personal contact with the insured (or claimant) when possible and get out ahead of the claim before it becomes a problem. Furthermore, to navigate complex claims, you need to be open minded and have trust in your defense counsel.

“Don’t get married to a position or valuation as those may change as the claim evolves,” Severino said. “We always strive to be proactive and take necessary steps to assure the insured and insurer are set up for the best possible outcome.”

This trio agreed that curbing complex claims is about proactive claims handling, early investigation and early use of proper experts.

“Knowing the intricacies of the jurisdiction is critical,” Ramirez said. “It also entails involving defense counsel early in the pre-litigation process.”

For Thome, focusing on researching the jurisdiction’s jury pool, bench and bar is paramount. “Also, don’t be afraid to incur costs at the front end that may save you money on the back end,” she said.

In the end, they concluded, complex claims require a key understanding of the risks and issues involved throughout the entire process.

ALM’s Complex Claims & Litigation Forum, happening in Las Vegas Feb. 26-28, 2024, is designed to help insurers and litigators Prevent, Prepare and Prevail in complex claims cases and emerging risks. This event will spotlight a winning mix of thought-leadership presentations, actionable case-studies, and closed-door peer-sharing. Follow this link to find out more and register.

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