After our group was formed and identified by the inside press as the market leader, traditional insurance companies who had been fleecing us for years began lowering their rates in an effort get some of us back. They also removed some of their exclusions. While it is good to see the industry recognize that we are not bad risks after all it took a mighty undertaking to get that recognition and without us standing firm together it would be soon lost.

NEW MEMBERS AND RENEWALS SINCE JUNE 30, 2007

J.R. Farnham Claims Service, LLC		Joseph		Farnham
McMillan Claims Service of Montrose		Dave		Byrne
Vaughn & Associates Adjusting Services, I		Peter		Vaughn
Connor Claim Specialists		David		Moore
Customized Claims Service, LLC		Jack		Howlett
Ability Insurance Claim Service, Inc.		Kathleen		Davidoff
Legacy Claim Services, LLC		Tony		Ellis
Shafrath, James Lee		Jim		Shafrath
Cook Claims Services, Inc		David		Cook
Inland Northwest Truck Claims		Art		Cockburn
SK Adjusting, LLC		Scott		Lampman
Schifrin, Gagnon & Dickey, Inc.		Peter		Schifrin
American Claims Bureau, Inc.		Alan		Nagel
St. Louis Casualty Claims, LLC		Chris		Schaefer
Claims Advantage, Inc.		James		Barbieri
Claiborne Business Services		Haden		Claiborne
West Alabama Claim Service, Inc.		Jim		Duncan

CPLIC'S FIRST POLICYHOLDER: CSM CORPORATION, DBA MIDLAND CLAIMS SERVICE!
Their policy number for that year is CP40001-01 and it became effective 09/30/04-09/30/05.  It's still the same policy number but the -01 has changed to -03 since it is their third year with us.

 

Below are some pictures of Mike Marsh of Midland Claims along with his Dad and Michael, exhibiting their certificates.

     


CPLIC CLAIMS DEPARTMENT NOTES:

Members are not always cognizant of the short response times to legal papers. And we can’t blame this on just the property folks.

 

In most cases you will know about a situation that would likely involve a suit and would have already put us on notice. We still need to have any legal papers the day you receive them. Below are the advantages: 

 

1)      We can consult with you about whether to accept the service by mail.

2)      We have time to evaluate the allegations to determine if an answer or some other responsive pleading is appropriate.

3)      We have time to select the best local counsel for your needs.

4)      We have time to determine whether an early settlement is the best option.

5)      We have time to tender and follow-up if appropriate.

Please do not “sit” on legal papers in hopes of being granted a free dismissal. You may jeopardize your rights to a legal dismissal.

THE FOLLOWING IS AN ACTUAL CPLIC MEMBER CLAIM SCENARIO FOR YOUR REVIEW:

One of our original members handled a general liability investigation for one of their insurance company clients.

 

The attorney for the plaintiff made allegations against the adjuster but did not name him as a defendant. The insurance company client advised our member to put his E & O carrier on notice in January.

 

Our member did not feel that the allegations would amount to anything and did not put us on notice. The member’s policy was renewed in May, four months later, without mention of the claim.

 

When discovery heated up, our member was noticed for deposition and served with a document production request in July, two months after the policy renewed. At that time the claim was reported to us.

 

Our policy requires the claim to be made and reported during the same policy period even though the event may have happened earlier. Since in this case the reporting requirement was not met the scenario was referred to the claims committee with the member remaining anonymous. After due consideration and research the committee recommended that the claim be denied. The Board of Directors approved that recommendation and the member was so notified.

 

OF NOTE TO CPLIC MEMBERS: THE FOLLOWING IS AN EXCELLENT ARTICLE FROM ONLINE ROUGH NOTES CONCERNING "ADJUSTERS ERRORS AND OMMISSION".  
http://www.roughnotes.com/imp_cybercast/Archives/v004_September2007/index.htm

ALSO OF NOTE:  KEN JOHNS HAS CO-AUTHORED AN EXCELLENT ARTICLE TITLED "EXCESS INSURANCE & SPECIAL DISABILITY (2ND INJURY) TRUST FUND REPORTING"   IT IS A FAIRLY LONG ARTICLE, SO IF YOU WISH TO RECEIVE IT, PLEASE EMAIL TMOSS@TENCO.COM AND REQUEST SAME. 
HERE ARE THE FIRST FEW PARAGRAPHS OF THE ARTICLE:

 

 

 

 

 

 

Handling claims as a Third Party Administrator (TPA) places greater obligations on the adjuster than simply handling field assignments for insurance companies.

 

Many organizations using Third Party Administrators have risk managers. These risk managers, or people in their offices, are the TPA’s main contact. Many of these people have little or no experience in the claims field. Even those that do have claims experience, tend to be tied up in other administrative problems common to risk management departments. This places a greater burden upon the TPA, because there may be no one knowledgeable reviewing their work.

 

Two of the areas that give rise to errors and omissions claims for TPAs are reporting to excess carriers and reporting and collecting second injury trust fund payments. This paper will deal with these two issues.
                                                                                        

**********CPLIC RISK MANAGEMENT WEBSITE SECTION FINALLY HERE!**********