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December 11, 2018 Book Review

Resolving Insurance Claim Disputes before Trial, Timothy H. Penn and Judith F. Goodman, Editors

Reviewed by Russell S. Buhite

In this comprehensive book designed as a resource for attorneys and claims professionals alike, the authors provide valuable assistance in describing the various alternative dispute mechanisms available for all types of disputes, from automobile liability claims through life, health, disability, professional liability, and workers’ compensation matters. It provides a practical guide to the alternative dispute resolution (ADR) process that considers everything from choice of the proper mediator and mediation strategies to drafting agreements.

Resolving Insurance Claim Disputes before Trial begins with a thorough discussion of arbitration and appraisal in the insurance context and follows that with an introduction to the insurance mediation and ethical issues involved in both arbitration and mediation. The compendium addresses such important topics as how to break an impasse at mediation and the duties of disclosure in both arbitration and mediation. The book also provides a helpful discussion regarding ADR options and strategy for international business transactions.

The treatise’s authors next give more specific advice useful for seasoned litigators and claims personnel handling specific litigated matters. In discussing ADR in automobile liability claims, the authors offer helpful pointers on how to select the proper mediator, manage client expectations, and present the best case from the standpoints of both plaintiff and defendant. Regarding commercial general liability claims, the book describes the more detailed coverage law that often comes into play in making strategic ADR choices. The authors also offer opinions as to how to use coverage analysis in the context of the underlying facts in the most effective way to reach consensus in settlement.

Regarding life, health, and disability claim disputes, special ADR considerations discussed involve the timing of when to utilize options and whether ERISA is involved in the claim. Mediation selection tips involve the specialized experience and personalities of mediators. With construction claims, among other key pointers, the authors describe the need to aggregate parties in mediations among owner/developers, general contractors, and subcontractors along with their respective insurance representatives. As to products liability cases where the parties choose ADR, the authors offer helpful tips regarding the pros and cons of joint sessions and opening statements in mediation. The strategies involved in mediating professional liability claims are also discussed, and the description of how best to prepare clients for mediation is particularly helpful.

Finally, the authors discuss particularly unique ADR involved in property insurance claims and workers’ compensation matters. Regarding property insurance appraisal, the authors provide useful advice about the scope of this unique mechanism, the appraisal format and procedures, forms of an award, and the award’s enforcement. The chapter also describes in detail how to prosecute a property insurance arbitration from beginning to end. Considering workers’ compensation cases, the authors describe varying mediation and settlement conference procedures in several different venues and the practical considerations for handling different ADR mechanisms, from client and lawyer preparation through enforcement of mediation settlement agreements.

To order Resolving Insurance Claim Disputes before Trial, go to https://www.americanbar.org/products/inv/book/313723009/ or call 1-800-285-2221.

Regular price: $149.95; TIPS Member price: 119.95.

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Reviewed by Russell S. Buhite

Russell S. Buhite is a shareholder in the Seattle, Washington, office of Ogletree, Deakins, Nash, Smoak & Stewart, P.C., where he focuses his practice on life, health, and disability insurance coverage litigation, as well as myriad ERISA matters. He is a former chair of TIPS’s Federal Involvement in Insurance Regulation Modernization and Health Care Reform Task Force, current vice-chair of the Health and Disability Insurance Committee, and a member of the TortSource editorial board. He may be reached at [email protected].