Volume 37, Issue 01

Stay The Course of Reasonable Claims Handling: Part II of a Deep Dive on Bad Faith

Source: Jennifer Martin and Paul S. White - CLM Magazine (Page 20) Social inflation is on the rise, increasing public mistrust of large corporations and insurance companies, and the possibility of bad-faith exposure. Proactive claims management diminishes extra-contractual exposure, whereas poor claims handling can undermind a correct coverage decision. Duty of Good Faith and Fair Dealing An insurer's breach of the duty of good faith and fair dealing typically arises from one of more of the following acts or omissions: Failing to affirm or deny coverage or reserve rights within a reasonable time. Failing to make a good faith attempt to promptly, fairly, and equitably settle a claim when liability is reasonably clear... Read full article here Share:

Customer Sues Dunkin Donuts Over ‘Exploding’ Toilet in Florida

Source: Staff - Insurance Journal ORLANDO, Fla. (AP) — A customer has filed a negligence lawsuit against Dunkin`, claiming he was injured by an exploding toilet at one of the coffee chain`s locations in central Florida. Paul Kerouac is seeking more than $100,000 in a lawsuit filed Wednesday in state court in Orlando, claiming he suffered “severe and long term injuries” following the explosion of a toilet in the men`s room of a Dunkin` location in Winter Park, Florida, a year ago. After the explosion left Kerouac covered in human feces, urine and debris, he walked out of the men’s room seeking help from workers and the store’s manager, according to the lawsuit. An employee told him that they were aware of the “problem with the toilet” since there had been previous incidents, the lawsuit says, without diving into further details about the explosion... Read full article here Share:

Insurance Fraud: Victimless Crime? Think Again: CLM 2023 Focus Session Explores Types of Schemes, Why They Matter, and the Lack of Consequences for Perpetrators

Source: Staff - CLM The average person may think insurance fraud does not hurt anyone, but the 2023 CLM Focus Conference session, “Victimless Crime? Think Again: Insurance Fraud and Understanding the Issues,” showed its audience otherwise. Presenters Andy Guerra, director of construction defect and litigation, Charles Taylor Adjusting & Technical Services; Bryant Hall, casualty general adjuster, Engle Martin; Jennifer Provost, partner, Wood Smith Henning & Berman LLP; and Nick Sansone, attorney, Turner, O’Mara, Donnelly & Petrycki PC, discussed what fraud is, the different types of fraud, how it impacts the industry, and why it is not a crime without victims. Insurance fraud, according to the panelists, costs anywhere from an astonishing $40 billion to $60 billion per year—not including... Read full article here Share:

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