Friday, September 19, 2014

Tacky Tactics in Insurance Defense Litigation

Michael Sean Quinn, Ph.D, J.D., C.P.C.U., Etc.
2630 Exposition Blvd  #115
Austin, Texas 78703
(o) 512-296-2594
(c) 512-656-9759
(Resumes at  www.michaelseanquinn.com)

Coen v. Aptean, et al (Ga. Dist Ct., 12A42185-6)

         
There were sanctions imposed. There were (legal fees (maybe extras) awarded. Or maybe there were  both.  The quickie description of the problem would be “obviously unjustified war of attrition litigation” tactics
A Georgia District Court make this decision in  a wrongful discharge case.  The background involved a complex business with a parent company, a subsidiary,  where the subsidiary of the parent, the bankruptcy of the parent, the sub being its huge creditor, what to do with—how to treat--the sub’s assets, and various complex transactions.
            The sub had hired a new general counsel. There was a contract specifying a time period of employment, a formula for payment if there was termination, a schedule of payment, and the specification of a substantial bonus. 
            The new General Counsel was terminated. He was not paid. He sued. According to my source, the defendant was a likely loser.  The defense went forward, however.
In the process of defending, defense counsel appears to have sent a letter to plaintiff’s counsel saying the following, or something close to it: “the costs of [Plaintiff] Coen’s suit[—both defense and indemnity--]was being covered by the company’s insurer, a development that ‘remov[ed] the only material litigation risk for the company in pursuing its defense of this case through trial and, if necessary, appeal, which the company fully intends to do.’”
            The defense was aggressive in standard ways of aggression, e.g., it pled 20 affirmative defense when only a fraction of them—probably a small fraction, in my experience—though it reduced them substantially upon the filing of an
objection.  Other than being over done, this is standard.
            In any case, the district judge said he found the letter “revealing,” and wrote that the “’[d]efendants gambled on a bad faith strategy and lost.’” “’This strategy constitutes the very, [i.e., exact] bad faith [that  Georgia law] exists to prevent, and the very bad faith that warrants an award of attorneys’ fees and expenses.” (Of course, this language suggests that there were sanctions and not just fees.)
            Maybe so. . .maybe the conduct of the defense really was outrageous on the whole.  And the letter upon which the judge apparently focused strikes me as in poor taste—what used to be called “ungentlemanly” and now must be called “ungentlepersonly,” or something like it. The question is whether the letter was itself actually revealing, as the judge said, of a defense conduct contrary to laws forbidding such performances.
            The letter by itself, if I have seen all the important part of it on the Law360 news blog is not revealing at all.  One of the lawyers involved says that he has never seen anything like it in his 35 years of practice.  I’m not sure I have either—when coming from a defendant--but I can easily imagine circumstances where such a letter might be thought appropriate and not indicate an invalid and unsound pursuit of a defense.
            What that letter does not do is to say, “We have no defense in this. We know we will lose it, if you pursue it to the end. But keep in mind that, although our client is at the vortex of the financial difficulties surrounding it, there is plenty of money to defend this case, since we have applicable insurance. It has coverage, so we have no real risk in never giving up—something we have no intent of doing.” Part of the message would that the surrounding Chapter 11, “or whatever,” problems are not an impediment to a prolonged struggle.
            One might want to do this if plaintiff’s counsel was saying the same sort of thing: “We will never give up, and we have the money to pursue the matter.” Remember: If you lose, you may well have to pay my attorney fees, and I don’t lose cases. Ask around and find out what my fees usually are.”  That kind of statement is often said in contingency fee cases, for example, by—and only by--prideful, hubristic, “loud and  rambunctious,” ill-educated plaintiff lawyers.
            The word “only” is perhaps the most important in letter from junior (?) defense counsel.  It does not say that the use of our insurance is the only reason we have to pursue the case.  It says that “our only risk, i.e., having to pay a lot of money for a defense as we go along, isn’t really a risk for us. It’s insured. That fact means that we won’t  ourselves have to pay the damages.”
            All of these statements may be absolutely true or thought to be true.  Still, it’s tacky.  How should it have been done?  
First, the insurer should have been informed.  If it had been informed, and had permitted this, the adjuster as well as defense counsel should be replaced. 
Second, all messages like this one, if sent at all—a bad idea-- should happen in conversation not in writing. 
Third, if the plaintiff did not know about the insurance, and had not asked about it in discovery s/he should be told. 
Fourth, if opposing counsel is told, the next event in the law suit will be a Request for the Production of Documents focusing on the policy, the insured’s correspondence with the insurer, reservation of rights letters,  and maybe even a coded or clandestine offer from the plaintiff to restructure the case to make sure that the defendant had plenty of coverage to pay the loss. Conceivably, the defendant trying to put the plaintiff on the kind of notice just mentioned in an effort to make sure that got all the insurance information he “needed.”
            I am not licensed in Georgia, so what I am about to write is general and theoretical only.  There is no indication in Law360 as to the procedure that was employed in the Coen case as to the procedure leading up to what happened.  If there were sanctions involved, and not just fees, it seems to me there would have to be a separate hearing. There would have to be independent testimony regarding the extent to which the defendant deviated from accepted practice and in what ways.  Probably there would have to be expert witness testimony regarding standard litigation practice.  In the absence of this, in many jurisdictions, there could be an application for a writ of mandamus, and not just an appeal when the case in the district court was completely over and done with.
            It is interesting to reflect upon other law suits. We know that Coen has sued at least one of the other participants in the farrago that lead to this suit for defamation. It seems to me that the defendant may wish to sue it s carrier, if was providing a defense and what happened here increases its insurance premiums. The defendant may want to sue its lawyers it increases the damages that have to be paid.
In any case, what happened was still tacky. And my analysis focuses on the letter. All sorts of other things may also be true, and they may affect the correct evaluation of the letter. The district judge may be right; then again, maybe he’s not.


Monday, September 15, 2014

Weighty Insurance Claim Paid in Coins and Pounds



Michael Sean Quinn, Ph.D, J.D., C.P.C.U., Etc.
2630 Exposition Blvd  #115
Austin, Texas 78703
(o) 512-296-2594
(c) 512-656-9759
(Resumes found at
www.michaelseanquinn.com)



One hears about insurance companies paying claims in buckets of coins, from time to time.  Biz Ins. reported another of these events in its August 18, 2014 issue, p 26.  Adriana's Insurance Services, Inc. paid part of a claim that it had settled in "thousands of quarters, nickels, dimes and pennies--in [something on the order of 17] buckets. Else where it was reported that the amount was $21k+/-.The insured was over 70 years old and was recovering from hernia surgery and the time.  There is a photograph next to the article of a pile of money the size of a miniature mountain, but it is not identified as the money involved. Adriana may have weighed its settlement decision carefully. 

It is reported in Southern California, the blog of an NBC TV station in California that the person whose claim was paid suit Adriana's Insurance Services "after he was physically assaulted by one of the company's  employees."

Now, why would an outfit that claims is a leading California insurance broker for many years do such a thing?  Talk about a violation of established business ethics! The company's website is introduced by a large photograph of a woman who appears to be relatively good looking, dynamic, and there is a touch of the sexy. (The latter characteristic can be found more clearly in other photographs of her.) 

To her credit, she does not appear to be a woman would would seek to pay a claim with wooden nickels. And besides the plaintiff's lawyer would have advised him not to take them.  It is a powerful rule of lawyer performance to be sure and bring that up to you client: "Don't take any...."

Here is my guess, and that's all it is.  According to the Net the "Adriana Biz" is not all that respectable an establishment. Its principle product (or service) is the sale of what it called "Super Cheap Insurance" or just "Cheap Insurance." The several evaluations presented on the Internet are uniformly negative, and one of them is critical of it for mistreating customers by making them wait a long time for services in an unattractive lobby, in other words, a "cattle call" process. 

This is a company that works mainly on publicity--any publicity, the more the better. Well, that's what it got here.  It specializes in selling cheap, probably low quality insurance to the less well off. This got its name before the public once again. It either did directly or did impliedly tell a fraction of the masses that it could get insurance there within their difficult budget.  

Many people need to get whatever they can.  They are not always concerned with obtaining a satisfactory amount of coverage or being treated appropriately.  The know they must have it; they want the super-cheap; and they will put up with whatever s--t they have to to get it.

For a company like this one, not even a BBB member though it has several offices around the state, every publicity incident is better than silence. This is especially true if the company was advised that there was probably not a new suit the settling plaintiff could bring.  And, besides, Adriana may have believed that the $21k was worth paying for the publicity the company got. Besides, one can imagine that the payee impliedly agreed not bring a suit like what would be required here. 

In any case, people find the buckets of coins story striking, somewhat to be remembered (even if not memorable), amusing, and indicative of what they may need. Some of the male purchasers may also be intrigued by catching a look at Adriana herself, if they believed that the website figure is she.  Perhaps the unconscious of at least some young men conform to the questionable ad principle in the fashion adv industry, "Fall for the model, fall for the dress." In this case, it would be "Want the chick, want her coverage."

Is it possible, I find myself asking, what sort of insurance company would permit itself to be involved in such an outrage.  I can't think of any.  There probably aren't any, thank God! There is something I am even more sure of, and that's this: Adriana is not cooking up a second version of this incident.  The first one that occurred to me was one involving bitcoins, but that won't work.  On the other hand, I would not be surprised to find out that the PR company for Adriana was not meditating upon another high publicity escapade.  Of course, my not being surprised does not suggest for a moment that the idea has any truth. 

Certainly no more than the idea of my suggesting to Biz. Ins. that when it said that "people prefer cash to coin," it might have wanted to check and see whether or not coins are not a kind of case.  Also, that paper does not appear to understand that Adriana can truthfully and literally say in publicity contexts,without any fear as to whether there is a misrepresentation involved:  "We pay claimants buckets of money."

The extent to which this blog has been proof read correctly, may reflect the degree of respect I have for Adriana's business ethics.



AlanGreenspan, Insurance Importance, & "Stinking" Economics,




Michael Sean Quinn, Ph.D, J.D., C.P.C.U., Etc.
             Law Offices of Quinn & Quinn
             2630 Exposition Blvd #115
             Austin, Texas 78703
            (o) 512-296-2594
            (c) 512-656-0503
              mquinn@msqlaw.corn




          In early September of this year, round about September 9, 2014,
Alan Greenspan, a former Secretary of the Treasury, gave the keynote address at KPMG’s 2014 INSURANCE INDUSTRY CONFERENCE. He listed 9 reasons why the U.S. economy stinks.  One of the reasons he gave was “Nobody Appreciates Insurance Enough."
          His reasoning was that insurance is really nothing more than saving for a rainy day, and in our country, saving-through-insurance is a major source of saving. There have been no new actuarial methods for that since they were  invented in the 18th Century by a couple of Christian ministers in Scotland.
          But it is not given enough weight by economists, and it needs to thrive so that it can invest money in the new technology. So that's one of the reasons for the stinking.  You know the one, don't you? That the one with uniformly record high  stock prices. 
          Premise #1. One might be doubtful about the soundness of this being said by a paid speaker at a convention of people from the insurance industry.  Premise #2.  Greenspan was being paid plenty to speak, and he says something that will please the crowd no end. Conclusion of Syllogism. 
The assertions in Greenspan's speech are subject to more than passing skepticism.
          But there may be something just as important casting doubts.  What he said about insurance was either misleading or false. Sound actuarial methods were begun developed in the 18th Century, and a bit before actually, but there were not extensively used immediately. Moreover, early life insurance worked on gilt system; it was mainly connected to maritime insurance; live insurance policies were originally issued for one year terms where comprehensive actuarial methods are not needed much; reliable and compreshesive mortality tables took quite a while to develop; and even during the early days  many were suspicious of those ideas. It looked too much like gambling. They also did not have at their disposal other kinds of facts that are needed for sound statistical analysis, e.g., causes of death. (This is true even though the astronomer Halley read a key paper to the Royal Society on the death rate in Breslau since it did not have the problems of London and Dublin, at least partly because the record keeping was defective, even shoddy. 
Moreover, actuarial methods have developed in sophistication tremendously in the last—Oh! Say—250, or so, years (1750-2100).

.Moreover, Greenspan appears to address only life insurance. Property and casualty insurance is not particularly a method of long-term savings, and many insurers lose money of the insurance sides of their businesses and make their money elsewhere, granted that they use some of the flow of premium dollars to finance those other services. Of course, heath insurance is a relatively recent offshoot.
Of course, insurance is crucial to the economy. Insurance is big business.  It is important that it's products be sold. And it's important that insurers do their work--render required services--such as the adjustment of claims, in legally, business appropriate, and ethically required ways.  The same, of course, is true for the ways in which insurers treat intermediaries; they are crucial to selling the product, after all. 

                         Resumes: www.michaelseanquinn.com