Schedule/Sessions

Breakfast

Keynote Speaker

SESSION 1 - Session 1 - A Rescission: How to Remain in Good Faith When Voiding the Insurance Policy

• Speakers:

• Michael Handler, Forsberg & Umlauf PS

• Natalie Jean-Felix, Munich Re Specialty Insurance

• Dennis Madea, Chubb

The path through rescission of an insurance policy is fraught with perils, even for insurers that are attempting to proceed in the utmost good faith.  The panelists will offer a “road map” through the process, pointing out the crucial junctures for an insurer to avoid breach of contract and potential extracontractual liability.
 
Each panelist will address their experiences, practial pointers and “lessons learned” in a chronological walk-through of hypothetical recission scenarios, encompassing initial investigation, litigation, and court’s affirmance thereof.  The timeline begins with (1) pro-active steps the insurer can take during the application and policy delivery process; continues with (2) the insurer’s receipt and investigation of information relating to a particular claim; then (3) developing and considering the information needed to make a timely rescission decision; and ultimately (4) litigation strategies, from bifurcation of proceedings and protective orders, for getting judicial approval as a matter of law.

For additional information please refer to hand-outs located to the right of this page under "Details."

 

SESSION 1 - Session 1 - B Avoiding the Trap of 3rd Party Contractor Fraud: Don't Make a Disaster Any Worse

• Speakers:

• Jeanine Clark, Margolis Edelstein

• Robert A. Luskin, Chartwell Law Offices

• Erik Sikorski, Builders Insurance Group

Whether you are an adjuster in the field, SIU, outside counsel, or home office supervisor, there is seldom a more helpless feeling than the phone call alerting of a disaster, water loss or casualty loss and finding out that what started out as a very simple claim has now exploded into a huge disaster.  While there is no sure fire way to prevent people from being taken advantage of, there are steps that can be taken to avoid the consequences and stay ahead of the curve to minimize risk and keep your customers, insureds and clients happier.  This interactive program will provide a roadmap and practical tips that can be used regardless of the type of casualty loss to avoid and combat contractor fraud and submission of fraudulent bills and claims.  Additional practical tips will be provided on how to handle assignments of benefits, collusion and submission of duplicate charge

For additional information please refer to hand-outs located to the right of this page under "Details."
 

SESSION 1 - Session 1 - C Ethics of Investigating A Potential Fraud Claim. . . It Takes a Team

• Speakers:

• Sari Marmur, Travelers

• Patricia Trombetta, Bonezzi Switzer Polito & Perry

• Donna Willis, State Farm

Claim professionals must understand and meet the ethical standards of their profession when investigating any claim.  During the investigation of a potentially fraudulent claim, claim professionals also must understand how to work ethically with the other professionals who form part of the team such as attorneys who provide legal advice and experts who may provide analysis and expert opinions. If at the conclusion of the claim investigation the insurer determines the claim is fraudulent, the decision to deny the claim may result in a lawsuit and scrutiny of all aspects of the investigation.
 
Conducting a thorough investigation of a potential fraud claim may involve a team of professionals including an insurance adjuster, a Special Investigation Unit professional, retained experts and an attorney advising the insurer. Understanding each team member’s role in the investigation, the ethical considerations for each, and how they interact during the investigation of an insured’s potentially fraudulent claim will provide a framework to ensure that the investigation rests on a strong ethical foundation and culminates in the best decision after a thorough consideration of the facts. 
 
For additional information please refer to hand-outs located to the right of this page under "Details."

SESSION 1 - Session 1 - D Post-Suit Claims: The Cart Before the Horse and Something in Between

• Speakers:

• Michael Bowler, Curotech Specialty

• Janice C. Buchman, Butler Weihmuller Katz Craig LLP

• Mike Gates, PLS Claims

A first-party property insurer thoroughly investigates the policyholder’s claim as submitted. As the insurer requests, the policyholder confirms that it has provided all information, documentation and testimony it intends to provide to support its claim.  The policyholder also requests a written decision regarding its claim immediately.  After receipt of such confirmation and completion of its investigation; the insurer denies the claim. The policyholder then sues for breach of contract. During the breach of contract suit, is the policyholder entitled to present a different claim than the one presented prior to bringing suit?   Should the policyholder be precluded from submitting any evidence in support of its claim for breach of contract on a claim that was not previously submitted?   Should the policyholder be allowed to present new theories for its claim?  What about new facts?  Shouldn’t the breach of contract claim concern only whether there is coverage for the claim that was actually presented by the policyholder, and then denied by the insurer?  These questions lead us to consider strategies designed to avoid the potential for being forced to defend an action for breach of contract on an insurance claim that was never presented to the insurer to investigate.

For additional information please refer to hand-outs located to the right of this page under "Details."


 

Break

SESSION 2 - Session 2 - A Lawyer And Insurer Beware - A Continuing Duty of Good Faith

• Speakers:

• John B. Drummy, Kightlinger & Gray LLP

• Mark Hanna, Mouledoux, Bland, Legrand & Brackett

• Steven LaForge, Nationwide Insurance Company

• R. Wade Vandiver, Vandiver Law & Mediation, PLLC

Litigation is generally considered an adversarial process in which the behavior of the parties and their representatives is subject only to the rules of procedure applicable in the court and, as to attorneys, the rules of professional conduct.  For various perceived policy reasons, however, it has been held that the duty of good faith owed by an insurer to its insureds and, in some states, to third-party claimants, continues after litigation commences.  This program will include a survey of the law including the types of post-filing conduct that has been held admissible to prove a claim of bad faith and/or breach of statutory provisions relating to claim practices and/or consumer protection.  The program will then focus on the continuing duty in the context of catastrophe claims, the unique problems presented by the application of the duty in the context of third-party claims and, last but not least, as applied in the State of Florida.

For additional information please refer to hand-outs located to the right of this page under "Details."

 

SESSION 2 - Session 2 - B Raise Your Right Hand, Pinocchio: Effective Interview Techniques for Fraud Investigation

• Speakers:

• Guy ("Sandy") Burnette, Guy E. Burnette, PA

• Cathy Gicker, Self Employed

• Michael Markey, Chubb

• Gene A. Weisberg, GladstoneWeisberg ALC

The success of defending a fraudulent claim depends upon the information gathered during the course of the intensive SIU/Claim investigation.   Many times a statement, either recorded or written, has been conducted by the claim adjuster prior to the SIU referral.   Reviewing the contents of these statements allows the SIU investigator an opportunity to uncover potential misrepresentations, as well as to prepare for subsequent statements or Examinations Under Oath. The key to a successful defense is an in-depth and substantive statement which must be timely, and methodically directed to uncovering the “truth”.   Coupled with the other investigations on loss data, background information and inspections of the loss site, the statement commits a claimant or insured to their version of the facts.  When a fraud is uncovered, this allows the SIU/Claim investigator the ability to deny a claim without fear of breach of contract or bad faith suits. In-person statements are always preferable, but being able to discern the truth just by listening to a recorded statement or reviewing a transcript gives the properly prepared interviewer a unique perspective to assess the statement content.   The presentation will focus on the process of conducting interviews by recognizing words, phrases and physical signals which indicate potential untruthfulness. Participants will interact with the presenters and gain an awareness of the keys to building a solid defense to a potentially fraudulent claim.

For additional information please refer to hand-outs located to the right of this page under "Details."

 

SESSION 2 - Session 2 - C Laying Down the Law: Coverage Challenges in Law Enforcement Liability Forms

• Speakers:

• David Bachman, AmTrust Financial Services

• Adam Fleischer, BatesCarey LLP

• Darren Lossia, Direct Claim Solution

• Rodney Lynch, Genesis Underwriting Management Company

In recent years, the insurance industry has seen an exponential increase in claims against city and county police, local law enforcement, and those public entities working with such law enforcement officials.  This panel first presents an overview of law enforcement coverage and the fascinating reasons for such growth of law enforcement claims, including factors such as the numerous newly created and well-funded civic organizations dedicated to the reexamination and challenge of individual legal proceedings and evidentiary disputes that had been put to rest years ago—and that were never priced for in issuing policies.
 
Once the panel has presented the new realities of Law Enforcement Liability coverage, the panel will walk through specific coverage challenges presented by this new crop of claims, with an emphasis on cutting edge claims handling issues that stretch across many types of coverages.  This will include discussion of independent counsel issues, conflicts between defendants and trigger amid multi-year wrongful acts.  The panel will end with practical pointers for the claims handler in all of us.

For additional information please refer to hand-outs located to the right of this page under "Details."

 

SESSION 2 - Session 2 - D Maintaining Good Faith Communications & Disclosures with Insureds and Third Parties

• Speakers:

• Dan Brunson, Freeman Mathis & Gary, LLP

• Christopher Greene, Canal Insurance Company

• Karen Karabinos, Drew Eckl & Farnham

• David M. O'Connor, O'Connor & Associates, LLC

An adjuster handling insurance claims is faced with making coverage issues and documenting the progression of the claim via various documentation requirements from its employer. Such tasks necessarily include numerous communications with the insured as well as third parties requesting information.  An adjuster’s communications can result in bad faith claims being filed against the carrier.  Therefore. by maintaining good faith communications with insureds and third parties, bad faith claims can be avoided.

For additional information please refer to hand-outs located to the right of this page under "Details."

 

Break

SESSION 3 - Session 3 - A Current Battlegrounds in Defective Construction Coverage Disputes

• Speakers:

• Susan Byron, Self Employed

• Robert Darroch, Goodman McGuffey LLP

• Barbara O'Donnell, Sulloway & Hollis, P.L.L.C.

• Keith Phillips, AXIS Specialty US Services, Inc.

Understanding and staying abreast of the evolving legal landscape governing defective construction coverage disputes and practical approaches and challenges in pursuing risk transfer and contribution remedies.

For additional information please refer to hand-outs located to the right of this page under "Details."

 

SESSION 3 - Session 3 - B Gazing into the Crystal Ball of Experience: An Advanced Course on Tactical Analysis, Logistics, Preparation and Execution of Actions for Civil Recovery

• Speakers:

• Frank Goldstein, Goldstein Law Group

• Carol LaDuke, Allstate Insurance Company

• Wade Wickre, PricewaterhouseCoopers

This is an advanced course which focuses on the tactical analysis; foresight and preparation needed when contemplating the investigation of fraudulent schemes with an eye towards civil recovery. Step-by-Step guidance for those who wish to make a successful recovery of benefits wrongfully paid and/or who wish to stop the unnecessary “bleeding.”

For additional information please refer to hand-outs located to the right of this page under "Details."

 

SESSION 3 - Session 3 - C Coverage Litigation: The Attorney-Client Privilege and Work Product Doctrine

• Speakers:

• Joshua Kranz, Everest Re Group, Ltd.

• Michael Markett, Liberty Mutual Canada

• Marc Voses, Clyde & Co

One of the thornier issues that arise in litigation is the application of the Attorney-Client Privilege and Work Product Doctrine.  The analysis of whether a communication or document should be afforded the protection provided by the Privilege and Doctrine is not as simple as identifying an attorney’s involvement in the communication or document in question.  Further complicating the analysis is the fact that these issues have not been resolved uniformly by courts.  When disputes arise concerning the application of the Privilege or Doctrine in insurance coverage litigation, the sensitivities involved are multiplied. 
 
This experienced panel of two in-house lawyers and one law firm attorney will provide participants with a foundation concerning the Attorney-Client Privilege and Work Product Doctrine.  In addition, the Panel will address disputes over the application of the Attorney-Client Privilege and Work Product Doctrine that arise in the context of coverage litigation, with an analysis of recent case law on the subject.  The panel will also recommend some best practices that insurers can utilize before, during and after a request is made for potentially privileged communications and documents. 

For additional information please refer to hand-outs located to the right of this page under "Details."
 

SESSION 3 - Session 3 - D Preparing the Company Witness for a Bad Faith Deposition

• Speakers:

• Edward Carlton, Quilling, Selander, Lownds, Winslett, & Moser, P.C.

• Paul Garrison, Infinity Insurance Company

• Sarannah McMurtry, First Acceptance Insurance Company, Inc.

• David Mercer, Butler Weihmuller Katz Craig LLP

Witness preparation is one of the most important tasks a lawyer can perform.   Witness preparation in bad faith cases is especially important because of the potential risk/exposure involved in such cases.  It is commonly believed by many experienced trial counsel that insurance litigation cases are won or lost on the testimony of the company witnesses. This presentation will provide a road map and explore some of the key elements necessary to prepare the company witness for a bad faith deposition.  The program will address common fears, strengths and weaknesses of company witnesses and provide practical recommendations in what is necessary to prepare this witness to testify truthfully; to be able to effectively present the truth; and to survive the examination by opposing counsel. 

For additional information please refer to hand-outs located to the right of this page under "Details."



 

Networking Lunch

SESSION 4 - When Insurance Bad Faith, Coverage and Fraud Collide: A Detailed Case Study

• Speakers:

• Stephanie Glickauf, Goodman McGuffey LLP

• Daniel Jaeger, Chubb

• Jonathan M. Kuller, Self Employed

• Deborah Molitz, Self Employed

• Kevin Quinley, Quinley Risk Associates, LLC

• Matthew J. Smith, Coalition Against Insurance Fraud

• Joanne Zimolzak, Dentons

Claims management solutions are tailored to the facts of the specific casualty or property loss at issue.  Often on the surface, solutions jump off the page, and the path forward to resolution is clear.  There are those unique claim situations, however, calling for the insurer and retained counsel to promote a robust but flexible approach to settlement when confronted with facts that combine the disparate elements of coverage, uncertain claim handling practices, and opportunities for fraud.
 
The detailed case study accompanying this presentation dives into a fact pattern that hits and highlights current bad faith, fraud, and coverage trends and topics arising from a complex claim response to a catastrophic and consequential insurance event.            

For additional information please refer to hand-outs located to the right of this page under "Details."