This article was written with the assistance of AI and edited by Angela Sabarese.
In a recent CLM webinar, titled, “The Good, the Bad, and the Ugly: Navigating Ethics and Professionalism in Claims and Litigation Management,” Gina Sabatino, Chartwell Law; Jonathan Pruitt, Addison Riley, LLC; and James Shea, Miles Mediation & Arbitration, shared their insights on best practices for handling and managing claims and litigation.
The discussion centered on proper claim evaluation from inception through potential litigation, emphasizing the critical importance of establishing correct dates of loss maintaining clear communication with insureds, and conducting thorough initial investigations. The experts highlighted how many policyholders are first-time filers who need guidance through the complex claims process.
A Balancing Act: Protecting Carriers While Maintaining Good Faith
A central theme throughout the presentation was the balance between protecting insurance carriers while maintaining good faith in claim adjustments. As Sabatino noted, "We want to be adjusting these claims in good faith, trying to find coverage without…being taken advantage of." This approach requires careful documentation, timely communication, and proper expert selection.
Pruitt emphasized the importance of selecting qualified experts who provide honest assessments rather than predetermined outcomes. "The right expert is not the expert who puts on paper what you want them to put on paper. The right expert is the expert who tells you how screwed you are," he stated. He also emphasized the customer service aspect, reminding adjusters to "never lose sight on the fact that they are your customer."
The panel addressed technical aspects, including ACV versus RCV estimates, virtual versus in-person inspections, and the evolving legal landscape around claim handling requirements. Shea concluded with mediation best practices, emphasizing preparation and maintaining professionalism throughout the process.
The webinar provided practical guidance for litigation adjusters and claims professionals navigating the complex intersection of ethics, professionalism, and effective claims management.