{"id":894463,"date":"2018-06-28T11:14:26","date_gmt":"2018-06-28T17:14:26","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=894463"},"modified":"2018-06-28T11:14:26","modified_gmt":"2018-06-28T17:14:26","slug":"insurance-coverage-litigation-insurer-policyholder-perspectives","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-litigation-insurer-policyholder-perspectives\/","title":{"rendered":"Insurance Coverage Litigation \u2013 Insurer And Policyholder Perspectives"},"content":{"rendered":"<p>Mark Miller | <a href=\"http:\/\/www.mondaq.com\/unitedstates\/x\/712066\/Insurance\/Insurance+Coverage+Litigation+Insurer+and+Policyholder+Perspectives\" target=\"_blank\" rel=\"noopener\">Miller Friel PLLC<\/a> | June 19, 2018<\/p>\n<p>Insurance Coverage litigation may be, by some, considered a last resort. That is, a process to enter into when all other avenues of settlement have failed. In certain situations, however, insurers file early declaratory judgment actions. In others, policyholders sue soon after receipt of a denial of coverage letter. There appear to be other considerations at play.<\/p>\n<p>The stakes can be high for both insurers and policyholders, and the perspectives on litigation from both the insurer and policyholder perspectives are seldom discussed together. Here, two insurance coverage litigation adversaries candidly discuss what factors and considerations should go into insurance coverage litigation.<\/p>\n<p>To understand better what goes into insurance coverage litigation cases, we put together a panel of two insurance trial experts in the field,\u00a0Deborah L. Stein\u00a0of\u00a0Simpson Thatcher, (addressing the insurance company side of the equation), and\u00a0Mark E. Miller\u00a0of\u00a0Miller Friel\u00a0(addressing the policyholder side of the equation). The full course is available from\u00a0PLI\u00a0and the PowerPoint for the presentation is linked here.\u00a0Insurance Coverage Litigation PLI<\/p>\n<p>Six topics were covered:<\/p>\n<ul>\n<li>Pre-Litigation \u2013 what goes on prior to filing suit;<\/li>\n<li>Filing a Complaint \u2013 what drives the decision;<\/li>\n<li>Motions to Dismiss \u2013 valuable to both sides;<\/li>\n<li>Discovery \u2013 using it effectively;<\/li>\n<li>Summary Judgement \u2013 a critical juncture;<\/li>\n<li>Trial \u2013 best practices and perspectives.<\/li>\n<\/ul>\n<p>At the risk of oversimplifying, here are some of the highlights on the competing policyholder \/ insurer perspectives on insurance coverage litigation:<\/p>\n<h3><strong>1. Pre-Litigation \u2013 what goes on prior to filing suit<\/strong><\/h3>\n<table border=\"1\" width=\"100%\" cellspacing=\"1\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"50%\"><strong>INSURER PERSPECTIVE<\/strong><\/td>\n<td valign=\"top\"><strong>POLICYHOLDER PERSPECTIVE<\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Compile information;<br \/>\nCorrespond with policyholder;<br \/>\nEvaluate dispute, jurisdiction, timing of claim issues.<\/td>\n<td valign=\"top\">Full evaluation of the claim \u2013 law, facts;<br \/>\nSend well-drafted letters to insurers refuting denials;<br \/>\nCompliance with policy conditions, even if waived;<br \/>\nDevelop strategy to maximize recovery.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><strong>2. Filing a Complaint \u2013 what drives the decision<\/strong><\/h3>\n<table border=\"1\" width=\"100%\" cellspacing=\"1\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"50%\"><strong>INSURER PERSPECTIVE<\/strong><\/td>\n<td valign=\"top\"><strong>POLICYHOLDER PERSPECTIVE<\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Issue of first impression;<br \/>\nHow clean are facts and law;<br \/>\nDuty to defend law;<br \/>\nBurdens;<br \/>\nDuty to indemnify law;<br \/>\nCoverage issues vs. valuation issues;<br \/>\nJurisdiction.<\/td>\n<td valign=\"top\">Key question \u2013 will filing suit maximize legal recovery. Look at:<br \/>\na) Choice of law;<br \/>\nb) Law of jurisdiction<br \/>\nc) Risk of being sued first<br \/>\nd) Insurer reputation<br \/>\ne) Insurer conduct \/ bad faith<br \/>\nf) Reasons for denial (potentially legitimate vs. industry custom and practice;<br \/>\ng) Overall case strategy.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><strong>3. Motions to Dismiss \u2013 valuable to both sides<\/strong><\/h3>\n<table border=\"1\" width=\"100%\" cellspacing=\"1\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"50%\"><strong>INSURER PERSPECTIVE<\/strong><\/td>\n<td valign=\"top\"><strong>POLICYHOLDER PERSPECTIVE<\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Case specific \u2013 be selective in filing;<br \/>\nPossible filings for:<br \/>\na) Jurisdictional and standing issues;<br \/>\nb) Whether claimant is an insured;<br \/>\nc) Timing of injury (outside of period);<br \/>\nd) Undisputed law and facts;<br \/>\ne) Bad faith;<br \/>\nf) Statutory claims handling causes of action.<\/td>\n<td valign=\"top\">File if insurer filed suit in wrong jurisdiction;<br \/>\nCare taken so complaints cannot be dismissed.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><strong>4. Discovery \u0096 using it effectively<\/strong><\/h3>\n<table border=\"1\" width=\"100%\" cellspacing=\"1\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"50%\"><strong>INSURER PERSPECTIVE<\/strong><\/td>\n<td valign=\"top\"><strong>POLICYHOLDER PERSPECTIVE<\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Build your defenses and themes from the discovery you produce and obtain, but don&#8217;t force a story;<br \/>\nDocument Requests \u2013 think about types of documents you need; request further documents in depositions;<br \/>\nInterrogatories \u2013 Use strategically (identification of documents, witnesses, facts); untargeted interrogatories not helpful;<br \/>\nRFAs \u2013 look for discrete admissions; use for authentication;<br \/>\nDepositions \u2013 usually the most effective tool; prepare, prepare, prepare; remember that you are still discovering.<\/td>\n<td valign=\"top\">Focus Discovery on elements of proof at trial;<br \/>\nOffensive Discovery \u2013 use it to build the story of improper denial; don&#8217;t waste time taking 30(b)(6) depositions;<br \/>\nDefensive Discovery \u2013 this is where cases are lost; prepare witnesses properly, as insurance issues are too complex to understand without preparation; pay extra attention to those that know about insurance (risk managers and brokers);<br \/>\nKnow the rules; be prepared;<br \/>\nRecognize that no document has ever spoken for itself;<br \/>\nThink about what documents you need authenticated, and what documents you don&#8217;t.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><strong>5. Summary Judgement \u2013 a critical juncture<\/strong><\/h3>\n<table border=\"1\" width=\"100%\" cellspacing=\"1\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"50%\"><strong>INSURER PERSPECTIVE<\/strong><\/td>\n<td valign=\"top\"><strong>POLICYHOLDER PERSPECTIVE<\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Frame issues wisely;<br \/>\nConsider purpose: resolve dispute, avoid trial; knock out claims; obtain direction from court;<br \/>\nEvaluate facts and law;<br \/>\nKnow undisputed facts necessary for motion;<br \/>\nBe true to record; don&#8217;t overreach.<\/td>\n<td valign=\"top\">Overall goal is to get to trial;<br \/>\nConsider proactive motions such as duty to defend motions;<br \/>\nMotions and responses need to be drafted so the Court comes to the conclusion that you are right;<br \/>\nInsurance jargon and insurance complexities are not your friend.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><strong>6. Trial \u2013 best practices and perspectives<\/strong><\/h3>\n<table border=\"1\" width=\"100%\" cellspacing=\"1\" cellpadding=\"5\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"50%\"><strong>INSURER PERSPECTIVE<\/strong><\/td>\n<td valign=\"top\"><strong>POLICYHOLDER PERSPECTIVE<\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">&#8220;Your trial presentation wasn&#8217;t complicated enough,&#8221; said no one ever;<br \/>\nFocus;<br \/>\nKeep it simple;<br \/>\nKnow elements and evidence; consider burdens;<br \/>\nPrepare order of proof;<br \/>\nRemember the big picture;<br \/>\nHumanize witnesses; don&#8217;t be over-technical and don&#8217;t stretch;<br \/>\nDon&#8217;t overuse documents.<\/td>\n<td valign=\"top\">Trial preparation starts on day one, as everything that is done is for the purpose of trial;<br \/>\nDevelop case theme based on discovery;<br \/>\nSimplify case to its essential elements and tell your story;<br \/>\nSimplify;<br \/>\nBe likable, interesting, and nice;<br \/>\nYou are painting a picture. You decide what to put on the canvas. Opponent will try and mess up your beautiful painting. Don&#8217;t let this happen.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Although there is enough material on any one of these topics to fill an entire CLE course, this CLE is a good start for in house counsel faced with the task of managing either insurance coverage litigation or an insurance claim. Moreover, policyholders seldom get the insurance company counsel perspective, which is always valuable when assessing a claim. All that and more can be found in this course.<\/p>\n<p>The most important information I got from presenting this course is:<\/p>\n<ol>\n<li>Claim denials can be reversed, but sending a nasty letter will not do the trick.<\/li>\n<li>Rather, well-crafted letters rebutting each and every error made in an insurer&#8217;s denial letter is the way to go. This requires mastery of the facts and law.<\/li>\n<li>Prepare for trial from the moment you become aware of the claim.<\/li>\n<li>Letters are drafted for the Court.<\/li>\n<li>There are ample opportunities to make mistakes, and policyholder self-inflicted wounds are the most common way that insurance coverage cases are lost.<\/li>\n<li>Develop your story, and refine that story through discovery.<\/li>\n<li>Push for trial. If an insurer wants to settle, they know who to call.<\/li>\n<li>When preparing for trial, think about painting a picture for the judge and jury. You decide what colors to use, and what to put into the record. Insurers will try and mess up your painting. Don&#8217;t let them.<\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Mark Miller | Miller Friel PLLC | June 19, 2018 Insurance Coverage litigation may be, by some, considered a last resort. That is, a process to enter into when all other avenues of settlement have failed. In certain situations, however, insurers file early declaratory judgment actions. In others, policyholders sue soon after receipt of a&hellip; <a class=\"more-link\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-litigation-insurer-policyholder-perspectives\/\">Continue reading <span class=\"screen-reader-text\">Insurance Coverage Litigation \u2013 Insurer And Policyholder Perspectives<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[9914],"tags":[9895,10387],"class_list":["post-894463","post","type-post","status-publish","format-standard","hentry","category-insurance-coverage","tag-advise-consult","tag-insurance-coverage-litigation","entry"],"jetpack_publicize_connections":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Insurance Coverage Litigation \u2013 Insurer And Policyholder Perspectives - Advise &amp; 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