Learning Objectives

Coverage

Coverage…it’s what insureds pay for, so why are there so many questions to answer when a claim is tendered? While the education on coverage truly lasts an entire career, this session will provide participants with key coverage concepts to consider that will strengthen their foundation in topics such as communicating their coverage position, definitions, contractual indemnification, and defense obligations.

After completion, participants will be able to:

• Understand essential elements to consider when evaluating coverage and the importance of issuing a timely position. These may include case law, jurisdiction, choice of law, intent, independent counsel, and estoppel.
• Identify key clauses in the General Liability, Business Auto and Workers’ Comp policies that frame a coverage analysis.
• Reconcile the differences between the duty to defend versus the duty to indemnify and the named insured versus the additional insured.
• Respond to tenders by third parties based on contractual indemnification obligations, common law, or additional insured status.
• Recognize implications of improper coding of the coverage within a claim system.

Disposition

Claims professionals put a significant amount of time and effort into preparing their claims for resolution. As such, their goal is to achieve the best possible outcome. They not only want this for their company, but also themselves, as there is a tremendous satisfaction in seeing the results of all that hard work. This course teaches claims professionals proven techniques that will help them understand how to achieve that goal.

After completion, participants will be able to:

• Prepare a claim for resolution.
• Be confident in their claims resolution skills and evaluation.
• Understand their role in the negotiation process.
• Understand why negotiation is much more than trading offers.
• Know when to take an aggressive versus a passive approach.
• Deal with difficult plaintiff attorneys.
• Break through an impasse.
• Recognize when to walk away.
• Know how to “close the deal.”

Evaluation

Knowing how to appropriately evaluate a claim is critical to the success of any claims professional, but it’s also a skill that relies on many different skill sets. The evaluation courses will focus on all aspects of claims evaluation, including analyzing facts and evidence, factoring in the law, and evaluating injury and damages. Courses will also address reserving philosophies and identifying settlement values and ranges.

After completion, participants will be able to:

• Know how to evaluate the various components of a claim including the facts, law, evidence, injury, and damages.
• Understand the different types of reserving philosophies, and how best to reserve a claim.
• Identify a settlement value or a settlement range for a particular claim.

Investigation

Investigation is a core skill for all claims professionals. Successful claims professionals must learn how to dig beyond the surface to discover the facts relevant to resolution of the claim. Because there is not an unlimited amount of time that can be dedicated to claim investigation, claims professionals must also know how to focus their investigation so they can uncover facts in a timely manner.

After completion, participants will be able to:

• Recognize what information is and isn't needed for an investigation in order to successfully evaluate, negotiate and settle a claim in a timely manner.
• Identify obstacles that might delay an investigation and utilize effective strategies for dealing with potential consequences.
• Understand the importance of effectively communicating with all interested parties during the investigation process.
• Conduct a thorough investigation that is specific to a particular type of claim.

Litigation Management and Control

It is often said that only lawyers benefit from litigation. Although sometimes true, in some cases litigation may be the only way to resolve a claim. It is essential for claims professionals to understand the litigation process and the roles of the parties, lawyers, and judge. This knowledge will allow them to know when litigation is necessary and to effectively manage and control the litigated matters, achieving the best possible outcome. This course will demystify the various stages of the litigation process and provide participants with a thorough understanding of the key components involved in most lawsuits, strategic advantages that can be gained or lost at various points, and the background they need to take control and effectively manage litigation.

After completion, participants will be able to:

• Understand why litigation may be necessary.
• Know the typical stages of litigated cases and how they may differ depending upon the nature of the claim.
• Foresee and/or recognize the strategic advantages that can be obtained (or lost) in each stage of litigation.
• Identify critical points when leverage can be maximized.
• Appreciate the importance of establishing control over the process.
• Understand the judge’s role in the litigation and the assistance he or she can give.
• Gain confidence in taking control and effectively managing litigation.