C111 Chapter 5 Advanced Loss Adjusting


 
  1. To resolve the claim in a fair and equitable way. Pg. 03
  2. Negotiating styles can roughly be broken into two main divisions:
    • rights-based negotiation where one party will lose and the other one will win;
    • interest-based negotiation where cooperation is stressed and each party is expected to make concessions to the other in order to eventually answer to both parties' needs.
  3. Negotiators use repetition to help people remain focused. Pg. 04
  4. The adjuster can express his empathy for the injuries sustained “...I’m sorry this has happened...” but avoid indicating you know how it feels. Pg. 09
  5. Reactive devaluation occurs when the other party interprets your first settlement offer as being the lower end of the settlement range and will react by looking for a larger number. Pg. 10
  6. When negotiations break down or the claim was denied, mediation is possible instead of litigation. Pg. 11
  7. The mediator must be neutral and skilled in negotiation, communication, interviewing, and counselling. Pg. 14
  8. Loss adjuster can act as the insurer’s representative during mediation proceedings. Pg. 15
  9. The adjuster should have the authority to agree to a settlement in mediation, otherwise another representative will have to be brought in (with the authority) and much time and effort would have been wasted. Pg. 15
  10. Litigation council is most comfortable with the adversarial system and may not adapt well to the co-operative nature of mediation. Pg. 16
  11. Council participates in negotiation, interprets information, and provides feedback as necessary. Pg. 16
  12. The mediation agreement sets out all the terms and conditions of the mediation, including confidentiality. Such items as:
    • Who will pay the costs
    • What will happen if mediation is cancelled
    • Issues of confidentiality
    • Other terms that may be a source of contention later. Pg. 17
  13. Expert witness testimony tends to carry more weight if opposing council may question them. Refusing to allow opposing questions will cast suspicion on the testimony given. Pg. 20
  14. Mediators use separate, private, side meetings in mediation known as caucusing. Pg. 20
  15. “Jackpot syndrome” occurs when a claimant feels they have a very good case and can secure a larger settlement at trial. This is a problem because it is a disincentive to the claimant to continue with mediation. Pg. 22
  16. 3 options available should negotiations break down:
    • Neutral evaluation.
    • Arbitration.
    • Litigation. Pg. 22
  17. Surveillance evidence should be disclosed in the mediation summary and sent to counsel ahead of time. Pg. 20
  18. Two approaches in caucusing are commonly used:
    • everything discussed can be revealed to the group as a whole;
    • everything revealed is confidential unless agreed that it can be shared with the group;
      • promise of confidentiality encourages participants to disclose information fully;
      • Each party may lose if goes to litigation; legal fees are not usually recovered;
      • each party assesses the current situation and what their chances of success would be in court;
      • claims rep have an opportunity to reflect on what was said.