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Proof of Loss as a Tool to Resolve Disputed Property Claims

First Party Property losses such as stolen construction tools and equipment, should be a straight forward claim. You send in documents to support the value of your claim, and then you expect to be paid by your property insurer. Typically, the claim is paid but sometimes things get derailed. Your property insurer may dispute the value of your claim or disagree with some other issue regarding the facts of the loss or insurance coverage. It becomes an endless circle of move and counter move, similar to playing a chess game, where you are hoping for an immediate victory but knowing you are up against a powerful player (your property insurer).

Increasing Cost of Automobile Claims – Automobile Black Boxes and Economic Damages

California auto insurance rates are going up due to the escalating cost of claims. On average, insurers are paying out $1.14 for every $1.00 of premium they collect. Increased traffic on roadways, distracted drivers, escalating medical costs, rising repair costs, and finally, economic damages from severe auto injuries, are the reasons for these increased claim costs.

2015 Insurance Legal Case Update From SDV Law

1. Capital City Real Estate LLC v. Certain Underwriters at Lloyd’s, London – U.S. Court of Appeals for Fourth Circuit, June 10, 2015 788 F.3d 375 (4th Cir. 2015)

Importance of Case: The case addresses a common issue presented by additional insured claims – whether extrinsic evidence can be utilized to determine an insurer’s duty to defend as opposed to simply the allegations contained in the “four corners” of the complaint. The Fourth Circuit decided to allow extrinsic evidence in evaluating an insurer’s duty to defend.

Workers’ Compensation Red Flags and Fraud

There are hundreds of thousands of active workers’ compensation claims in California. During the fiscal year 2013-2014, the California Fraud Division identified 5,729 suspected fraud cases. Of those, only 248 cases were sent to prosecuting authorities (County District Attorneys). For those convicted at trial or who entered a plea bargain, what were the penalties? Not as harsh as you would think.

Workers’ Compensation – First Aid

As you know, workers’ compensation costs and your Experience Modification Rate (EMR) are two key components of any competitive bid. Multiple small claims (below $7,001) can, and often do, adversely affect your EMR more than one very large claim.

Accordingly, when thinking about how to reduce your premiums and EMR, one of the primary goals should be to legally keep First Aid claims off of your claims history. Here is a road map to help you succeed in reducing your premiums and EMR through the use of a first aid strategy.