How to Evaluate and Effectuate Settlements?
- Scott Silver – P.L., Attorney, MKRS Law
- Crystal Chancey – Claims Manager, Publix Super Markets, Inc.
- Darin Grimm – Summit Consulting
When it comes to claims handling, we all want the same things. Everyone wants the case settled. Everyone wants the claimant treated with empathy and respect. Everyone wants the right dollar amount agreed upon.
If only it were that simple.
The problem is that all claims are unique. Relatable, yes, but each claim carries individual complexities. From legalities to ethics, there are several obstacles to consider. The main thing is to manage the details carefully, accurately, and within the right order.
Below is a breakdown of guidance to help leverage settlements:
Best Practices
During the first notices of loss, adjusters aren’t given a lot of control. What they can control is the approach in handling a claim. Adjusters have the responsibility to collect the information. They have a significant amount of influence in the way a claim is cared for. Completing a timely and thorough investigation can help drive effective negotiations, and potential settlement options.
Working a claim in a systematic fashion can help drive settlements faster. The good thing is that adjusters work with a network of resources. There are plenty of connections to lean on, but none more important than the parties representing an injured worker. For best results, reach out as early as possible once a claim has been opened.
During the claim, it is best advised to determine a possible need for a recorded statement. Ask questions as early and as often during the process and keep a record of all details provided. Finally, once you are in contact with claimant representation, make sure to confirm you are speaking with the right parties.
When Considering a Denial
For adjusters contemplating denials, three essential steps are needed leading up to its filing:
- Make sure all the necessary information is present to form and support proper denial and defense.
- Use a 120-day provision period to submit denial.
- If in doubt, seek guidance from counsel.
When to Identify Opportunities
- Before and after counsel and litigation
- Before and after surgical recommendation
- Before and after maximum medical improvement (MMI)
- Before and after potential exposure to PTD becomes ripe
- Before and after MSA/CMS considerations become ripe
Settling With Unrepresented Claimants
During resolution opportunities, it is important to explain that counsel will be retained for preparing documents. Settling should occur without a hearing. In this process, describe any medical implications and make sure offers and agreements are fair. Keep in mind that the earlier you settle a claim, the less it should cost in the long run.