Risk Retention Services is more than a claims TPA. Its personnel have legal degrees, advanced accounting degrees, and a myriad of business and legal experience allowing it to pursue, not just defend claims.
Every once in a while, an insurer goes too far in denying a claim or makes an unrealistic settlement offer on a business interruption or property claim. Our clients have come to rely upon Risk Retention Services as its advocate in such circumstances.
Risk Retention Services has the staff and expertise to advocate for its clients either as a consultant, litigation manager, or as an agent to recover sums due to it. This includes advocating on behalf of the insured for coverage, and a myriad of other examples:
Bad Faith. RRS helped its client recover $600,000 from an insurer in a construction defect case by aggressively working with the client’s litigation counsel to pursue coverage that had been denied by the insurer.
Legal Malpractice. RRS helped its client recover $400,000 in a legal malpractice suit. After a comprehensive investigation in a products liability case, it was determined that there was no liability. The assigned attorney seemed ready to go, and understood the nature of the defense, the product, and the evidence in support of the defense. However, one year before the trial, that attorney quit the firm, and another partner took over.
Although the new attorney professed to have been well prepared for trial, he failed to call essential witnesses, failed to prepare for the trial, and lost at trial. With the assistance of Risk Retention Services, a legal malpractice attorney was retained, and a case was brought against the new attorney.
In spite of a vigorous defense by the attorney and law firm, we were able to prevail at trial, resulting in a judgment of over $400,000 in damages for the client.
Property/Business Interruption Insurance. Recently, a client lost a manufacturing plant to fire. While the insurer paid for the direct cost of rebuilding, the client also suffered a substantial loss of business.
After reviewing our client’s business records, the insurer offered $172,500. When the client tried to negotiate for a better offer, the insurer refused, placing the matter into arbitration.
The client then retained RRS. RRS carefully reviewed the policy, and the books and records of the client. It used an on-staff attorney and an on-staff accountant familiar with real-world business accounting. After preparing an exhaustive report, the insurer finally began increasing its offer. Finally, shortly before the arbitration, the insurer offered over $900,000 to settle the claim, an increase of $700,000.
RRS achieved this result with a thorough examination of the facts and careful reading of the insurance policy and its terms. The insurance company hired a forensic accountant to prepare their arbitration claim who calculated a loss of about $500,000 – over a $300,000 increase, but RRS pressed for more and eventually negotiated the $900,000 settlement.
Coverage Claims. In days gone by, insurers worked with their customers and found coverage where the insured reasonably expected coverage to exist. Now, it seems that more and more insurers are spending as much time and effort denying coverage (despite accepting the premium payments) as they do in defending them.
Sometimes, the insurer relies on a tortured reading of its policy. At other times they rely on ambiguous wording in the policy. In such cases, often the insurer is just plain wrong.
The first step in coverage analysis is to have a professional review the policy and understand the facts of the case. This process is often document intensive, not only for the policy itself, but also in determining the true nature of the claim for which coverage is being denied.
RRS personnel are expert in reviewing policy language and the court decisions that have interpreted such policies in the various states. We can help you make the best arguments possible for obtaining coverage and maximizing your recovery.
