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The course “Splitting Casualty Claim Files” is designed to demonstrate what
considerations should trigger a decision to split a file between liability and
coverage, when the trigger arises, and the mechanics of splitting the file. This
module is presented by Edward J. (Ned) Currie, Jr., Shareholder of Currie Johnson
Griffin Gaines & Myers P.A., and John M. Intondi, CPCU, Executive Vice President
and Senior Claims Officer for the U.S. operations of AXIS Capital.

The
course discusses the insurer’s considerations whether or not to split a file pre-
suit and post-suit whenever coverage issues arise and how to avoid the risk of
coverage by estoppel and bad faith. The course also includes a hands-on
discussion after the decision is made to split a file, including (1) what
contents of the file go to the liability claims professional and what contents go
to the coverage claims handler, (2) what the roles are for each adjuster, (3) how
information received in the investigation and trial phases can be used by both
adjusters, (4) what information can be shared in both files after the split
occurs, and (5) who holds the settlement purse and the roles of the respective
adjusters in settlement of the case and what settlement information can be
exchanged between the two.

After completing the course, the attendee will
be able to determine whether, when, and how a claims file should be split between
liability and coverage when coverage issues arise; recognize and avoid bad faith
potential; enumerate the judicial concerns for conflicts; explore proper
procedures and handling for the liability and coverage adjusters; distinguish
between reservation of rights and non-waiver agreements; define the need for
panel and Cumis counsel; and understand defense counsel’s limitations in sharing
information with the insurer when defending the insured under a reservation of
rights.

The course is designed for practitioners and insurance
professionals working in the area of casualty insurance coverage and litigation.

What CE Credit is available?

Note: To qualify for credit, you must submit completion (including a passed final exam if required) within five days of completing the last quiz. No partial credits will be awarded.

State:
Adjuster General
CE Hours:
Adjuster Ethics
CE Hours:
Attorney General
CLE Hours:
State's Course ID:
NH 2.0 478871
TX (classroom equivalent) 2.0 141165
NC 2.0 203016
FL * ( Provider Number: 364169 ) 2.0 - Optional 1207992
IL 2.0 485560
WY 2.0 37033
OK 2.0 1027189

* This course has been approved by the Florida Department of Financial Services for insurance continuing education credit.

Course Content

Lesson Content

1) Introduction
2) Duty to split the file
3) Process of splitting claims files
4) Requirement to split a file / Cumis counsel
5) Why should a file be split
6) Avoiding risks or conflicts / Coverage by estoppel
7) Recap

Lesson Content

1) When should the consideration to split a file begin?
2) Identifying the conflict
3) Judicial concerns for conflicts
4) Pre-suit considerations
5) Recap

Lesson Content

1) How high does the split go?
2) Reserving rights
3) Reservation of rights letters / Non-waiver agreements
4) Recap

Lesson Content

1) Cumis counsel in California
2) Counsel’s duties in other states / Tripartite relationship

3) Waiving coverage defenses
4) Nuts and bolts on how to split
a) Confidential
information
b) Sources of
information for coverage adjuster
5) Recap

Lesson Content

1) Information sharing between file handlers
2) Who sets reserves?
3) Sending the reservation of rights letter
4) Settlement negotiations
5) Recap

Lesson Content

1) Case discussing crossover / bad faith
2) Audience questions
3) Recap