claims win case study

Mediation contribution request disputed

Propel empowers clients through skilled advocacy.

Challenge

Propel’s advocacy team became involved in discussions with a carrier following a request of the client to contribute a large percentage of funds at an upcoming mediation. The carrier assessed the value of the matter at no more than $1M and requested that the client contribute 50% of any settlement offers in excess of that amount. The advocates met with the carrier to discuss the request for contribution and the reasoning behind the decision. The carrier took the position that the $1M primary policy would cover all alleged damages, but the excess policy which would cover the remaining settlement funds excluded punitive damages. The adjuster stated the claim was indefensible, would be costly to litigate, and would likely result in a very high verdict with punitive damages assessed if the matter went to trial. The carrier defended its position and contribution request, referencing the reservation of rights previously issued which explained the potential excess exposure. 

Propel Claims

Taking Advocacy and Customer Service to New Heights.

solution

Our advocates jumped in to explain why the request was entirely inappropriate: the carrier’s assessment of punitive damages was arbitrarily decided; settlement negotiations during mediations are offers made in consideration of a disputed claim and do not include punitive damages; and the carrier owed a duty to protect its insured from excess exposure when the matter can be settled within the available limits of insurance. The advocate was familiar with the history of the file and directed the carrier to review prior demands which, if accepted, would have settled the matter for a lower amount.

Result

The carrier rescinded the contribution request and proceeded with the mediation. Ultimately, the matter settled for $2.3M, fully funded by the carrier, saving the client $650,000.