ZALMA’S INSURANCE FRAUD LETTER

As I have previously mentioned, my insurance consulting/expert witness business is not just to help you with my own experience and research but to direct you to others that, in my opinion, can supply additional pertinent information.

I sincerely appreciate most of my fellow consulting/expert witness professional colleagues.  However, I do not normally “advertise” for them!  Here is an exception.

As an insurance attorney you may find even the multitude of free writings of Barry Zalma, Esq, CFE of Culver City, California to be most interesting and helpful.  Not only are current cases and issues discussed by Barry, but he is also the author of several books.  Being in touch with Barry from time to time, I consider him a friend.

For a starter, you may subscribe to the e-mail version of  “Zalma Insurance Fraud Letter” at http://www.zalma.com/ZILF-CURRENT.htm.

The “Zalma On Insurance” blog address is http://zalma.com/blog.

Oh and by the way… Billy Akin, CPCU, ARM still offers you a free consultation with an initial frank and honest opinion on your insurance cases!

How may we help you?

Note: Information in these blogs is not intended to replace any legal or financial professional information.

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SOME RECOMMENDATIONS TO HELP YOU

My insurance consulting/expert witness business includes helping you find  answers to your concerns, in addition to using my research and half century experience  in  the insurance business.

I would like to recommend to you a newsletter coming from a Buffalo, New York law firm.  It is replete with discussions of coverage issues and case law, with a flavoring  of  humorous history.  Having appreciated this publication for some time, I have obtained permission  from Dan Kohane to share this with you.

(1)  You are invited to subscribe to this free e-mail publication “Coverage Pointers” by using the following  contact:

Dan D. Kohane
Hurwitz & Fine, P.C.
1300 Liberty Building
Buffalo, NY 14202

Offfice: 716.849.8942

E-Mail:  ddk@hurwitzfine.com
H&F Website:  www.hurwitzfine.com

(2)  This fine law firm is having a series of webinars that you, and/or your associates might want to join. This from the latest “Coverage Pointers”:

 “A Special Request for Claims Professionals: Would you have an interest in helping our folks in better understanding the insurance business?  We know it’s really important for our lawyers to understand your business and we want to schedule a series of webinars where our lawyers can learn from you.  We want to expose our lawyers to the business of insurance.  How do YOU evaluate cases?  How are reserves set and how can we better assist you in setting reserves and altering them as the case develops? How do you factor in costs and expenses? How does underwriting factor into our handing of your files? Why is budgeting so important?  What about timely reporting?  What and when do you need it?  What issues are you addressing for cyber security and how can we help in our practices?

We are planning to schedule a series of webinars-like our newsletter-at no cost- but intended to better educate us all.  If you would be interested in participating and have a topic in mind, please e-mail me (Mr. Dan Kohane  ddk@hurwitzfine.com.)

We will do all the work in scheduling and planning the event and no written materials will be required of you, unless you have something you would like to share.  We are very excited about this undertaking and are enthusiastic about your involvement, which is integral.

Our plan to begin the program in June, so please send me your notes so we can set our schedule. If CE credit is important to you, let us know and we will try to work that into our programming.”

I recommend this source to you.  We  need all the help we can get in comprehending the complexities of the insurance industry.

How may we help you?

Note: Information in these blogs is not intended to replace any legal or financial professional information.

HOW WE CAN HELP YOU! (Part 3)

attorneyA bit more good basic advice for attorneys using insurance consultant/expert witnesses.  From my personal, professional experience I say this is “right on”!

“Experience is a critical aspect of a consultant’s background”, says Frank A.  Chapman, V.P. and Risk Manager for  Enterprise Products Co. in Houston. He prefers someone who has at least 10 years of experience and knows about risk management, insurance company workings and the brokerage business, as well as the historical trends in policy language and what any changes mean.

  Mr. Chapman also looks for consultants with good communication skills“You don’t want one that is too technically oriented so that he can’t get the point he wants to make across to a juror.” he said.

Because using the right consultant is important, Mr. Chapman advises choosing one with a CPCU or ARM designation.  “That at least gives you the feeling they know the basic concepts of insurance,” he said.

But don’t rely solely on those designations, he cautioned.  “You must look beyond their credentials,” he said.  It’s important, Mr. Chapman said, to read copies of any depositions the consultant gave in prior cases, to review a list of cases in which the consultant participated and to know those cases’ outcomes.

Finally, Mr. Chapman added, it’s important to listen to a legal consultant who thinks your case is not solid and advises you to settle, even if you disagree.

“Don’t hire someone who will simply dance to you tune,” he said.

How may we help you?

Above information: Copyright Crain Communications, Inc. Reproduced and condensed by Professional Consultants & Services, Inc., with permission, Business Insurance, March 16, 1998.

Note: Information in these blogs is not intended to replace any legal or financial professional information.

HOW WE CAN HELP YOU! (Part 2)

Some additional quotations concerning the benefit of using an insurance consultant/expert witness. With a couple of decades in the business, I could not have said it better!

“Consultants can testify on such topics as whether an agent or broker breached professional ethics, or whether an insurer dealt fairly with a policyholder,”  said Jim Marshall, Executive VP of  Siver Insurance Consultants in St. Petersburg, Florida.

Legal consultants “deal with a real conflict, with specific facts and policies at issue,” said Mr. Marshall, who does both traditional risk management consulting and legal consulting.  Legal consultants are hired when “litigation either has been commenced or is expected to be commenced,” he added.

Mr. Marshall continues,  “ A consultant’s expert testimony can cover such areas as what the parties generally expect from a type of policy, how certain policy language developed, the history of a type of policy and what the phrases in the policy mean.
smart

Although a coverage attorney may be experienced in many insurance issues, a legal consultant still can provide the attorney added insight.

“Many of the lawyers involved with coverage problems don’t understand insurance policies,” said Frank A.  Chapman, V.P. and Risk Manager for  Enterprise Products Co. in Houston.  “Something about an insurance policy is viewed as a mystique to the legal profession,” he added.

The consultant also performs work a broker cannot.  Their work “is superior to any work product I have seen from the broker community”, said Don   McLaughlin Risk Manager for Butler Manufacturing Co. in Kansas City, MO.  He added:  “What we’re dealing with here is a higher level of knowledge that you can’t get anywhere else.”

But consultants can help only if they are the proper ones for the job.  Not every consultant is suited for every case.  Some experts don’t really know the particular topic at issue, so they end up learning it “at your peril,” said Mr. Chapman.  He said he hires four or five consultants a year for litigation.

Chalres Schropp, a partner with Schropp, Buell & Elligett in Tampa, Florida, said the consultant must be an expert in the precise issue involved. “People don’t know everything about everything,” he said.  “They have an area of expertise, just as lawyers do.”

How may we help you?

Note: Information in these blogs is not intended to replace any legal or financial professional information.

Above information: Copyright Crain Communications, Inc. Reproduced and condensed by Professional Consultants & Services, Inc., with permission, Business Insurance, March 16, 1998., March 16, 1998.

HOW WE CAN HELP YOU! (Part 1)

legalexpertWith permission to reprint from the publishers of “Business Insurance” periodical, I offer the following testimonials as to how we can help you:

The legal consultant, often called the litigation support consultant, is hired by and works for the coverage counsel.  Consultants work less frequently for insurers in their disputes against policyholders.

 For those attorneys who have hired the consultants, they have proven to be a valuable addition to their litigation team, often strengthening the case so the insurer settles the case on better terms than if no consultant were used.

“You must have a consultant that can advise and assist your coverage counsel,” said Frank A. Chapman, V.P.  and risk manager for Enterprise Products Co., in Houston.

 Another risk manager, Don McLaughlin, director of risk management for Butler Manufacturing Co. in Kansas City, MO agrees on the importance of using a consultant. “He can usually help in putting together the case because the attorneys don’t have a firm grasp on the underlying issues of insurance,” he said.

The legal consultant can perform two roles.  First, he or she advises the attorney in developing a litigation strategy, including which people to depose, what questions to ask and how to respond to the insurer’s discovery strategy.  In this capacity, the consultant is a behind-the-scenes expert whose existence may be unknown to the opponent.

But a more common role is as an expert witness.  Here, the consultant will testify in a pretrial deposition and at trial.

“I’m there to testify on custom and practice in the insurance and risk management industry,” said Donald Malecki, chairman and chief executive officer of consulting firm Donald S. Malecki & Associates in Cincinnati.

Anna Engh, a partner with the Washington firm of Covington & Burling and a policy holder attorney, said she hires consultants to help the jury “understand the issues from the perspective of custom and practice of the insurance industry.”

Chris Bechhold, a partner with Thompson, Heine & Flory in Cincinnati who represents insurers in litigation with policyholders, says a policyholder’s expert “makes the difference between winning and not winning.”

As a result, if the policy holder brings in an expert, he feels the need to counter with his own.  “If I cannot effectively counter with my own expert, I have a problem,” he said.

How may we help you?

Note: Information in these blogs is not intended to replace any legal or financial professional information.

Copyright Crain Communications, Inc. Reproduced and condensed by Professional Consultants & Services, Inc., with permission, Business Insurance, March 16, 1998.

Insurance Saves Santa

We kept thinking we would see this on a national newscast, but have not. Wanted you to be aware of this significant recent event. Nice for good little girls and boys, but probably took business away from insurance attorneys!

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A POLICY FOR SAINT NICHOLAS

T’was the night before Christmas, and all through the land,
Few coverage advisors were still in demand.
The policies still showed on both desk and on screen.
My eyes only open with thanks to caffeine.

Most company’s adjusters had left for the day;
And most coverage lawyers had little to say.
It was surely the moment to turn out the light,
Shut down the computer, put work out of sight.

Then the phone started chirping, it startled my poise,
not the typical ring-tone, but an odd sounding noise.
It jingled like sleigh bells, instead of a “ding,”
I knew I must answer, despite everything.

A Christmas Eve caller? What could be the need?
But the sound of the music, would just not recede.
I was really not looking for Christmas Eve banter,
Imagine my shock when the caller was Santa!

“I need some advice, sir” said a somber Saint Nick,
“My Christmas Eve Policy is three inches thick.”
I don’t mean to bother, but I’m wrought with confusion
“I don’t understand this new ‘Gifting Exclusion.'”

“A products exclusion? A chimney one too?
Elf employment exception, I’m screwed through and through.
Just what is still covered? I sure am confounded,
With all of these issues, I fear that I’m grounded.”

“I want you to help me, I fear a disclaimer.
This policy’s scary; I need you to tame her.
We must surely save Christmas, for good girls and boys,
And Amazon won’t refund “squat” on the toys.

I am sure you’d imagine how hard it would be
To secure for Saint Nick a late night policy,
Without coverage gaps, so that Santa could fly,
To save Christmas Day, we were destined to try.

“Exclusions begone! Limitations not there!
We’ll provide him his coverage, no need to beware.”
And so it was written, and Santa could jet,
And Christmas was saved, the best Yuletide yet.

On cold winter night, when you’re hearing his jingle,
When the children are sleeping and in comes Kris Kringle,
Remember that coverage protected his flight,
Happy Christmas to all, and to all a good night.

This was greatly edited, due to your Monday rush. Let me know if you would like full copy, from newsletter of Hurwitz & Fine, P.C in Buffaloe, NY. HAPPY NEW YEAR!

How may we help you?

Note: Information in these blogs is not intended to replace any legal or financial professional information.

LPSE DIXIT…“HE, HIMSELF, SAID IT”

Why does your expert witness hold an opinion that he/she does?  Can it be supported by competent documentation or appropriate experience, or is it to be believed simply because “lpse dixit?”

With only one year of high school Latin, I was surprised to learn tfisthe meaning of “lpse dixit” as being “He, himself, said it”, a phrase coined by the Roman Politician Marcus Tullius Cicero.  In other words, is the only reason for a certain opinion simply “because I said so?”  Such a reason might well be an appropriate statement by a disciplining parent to a small child, but not so with a discerning judge or a caring jury.

Neither your expert witness, nor you as an astute attorney, should presume listeners will accept arbitrary assertions without questions, simply because the expert said so.  By the time an expert witness is asked to express opinions in a case, there should be, must be, ample testimony to which the expert can apply his experience, training and/or research.  Otherwise, expressed opinions can return to haunt an expert witness.

Although a long-time personal conviction of mine, this concept was recently brought to my attention by an article first appearing on the “Expert Witness Research Blog.”  Let me know if you would like a copy of the summary of a New Mexico product liability case that dramatically demonstrates this warning by quickly contacting me at bakinpcs@aol.com.

How may we help you?

Note: Information in these blogs is not intended to replace any legal or financial professional information.