Disaster Recovery Claims Resolution Services Programs

Transcription

1 Disaster Recovery Claims Resolution Services Programs For Homeowner, Property and Business Claims When natural and other disasters like windstorms, tornados, hurricanes and fire strike, they can result in significant losses for both home and business owners. For many, insurance will cover their losses. However, for some, disputes concerning disaster-related insurance claims may arise with insurance providers. In these cases, the insured, as well as their providers, need skilled negotiators to resolve and settle claim disputes fairly and expeditiously. Efficient and effective settlement of claims enables those hard hit by disasters to quickly move forward with rebuilding their lives. The American Arbitration Association (AAA ), the world s largest provider of full-service conflict management and dispute resolution services, has extensive experience in administering natural disaster-related and insurance industry claims. To meet the needs of disaster-insured and insurers, the Association provides the AAA Disaster Claims Resolution Services a special dispute management program, inclusive of settlement procedures, designed to facilitate resolution of insurance claim disputes between insurance companies and the insured. In addition to administering these unique cases, the AAA provides access to a national panel of neutrals with significant expertise in insurance, construction, commercial and general business matters. The AAA utilizes its Disaster Claims Mediation Procedures to assist insurers, homeowners, property owners and business owners in arriving at resolution and settlement of insurance claims disputes. Under the Disaster Claims Resolution Services programs, the AAA manages cases for disputed homeowner, property, and business claims through telephone and in-person mediations ( upon request). To initiate the dispute settlement process, insurers or their representatives file cases with the AAA on behalf of the insured. Fees for AAA Case Administration as well as fees for the services of the neutral(s) are paid for by the insurance providers; such fees and mediator compensation are at reduced rates. 1 adr.org

2 INSURANCE COMPANY FILES CASE WITH AAA FOR DISPUTED CLAIM AMOUNT Case filed via AAAWebfile, fax, or mail MEDIATION PROCESS COMMENCES AAA provides a single point of contact for parties. Mediation is scheduled. MEDIATION CONFERENCE OCCURS In-person or via telephone. MEDIATION SETTLEMENT Insurer issues payment. Mediator reports to AAA. MEDIATION IMPASSE Mediator delivers reports. Parties proceed to the next step in ageement AAA arbitration or litigation. 2 adr.org

3 AAA Disaster and State Insurance Programs The AAA s programs to assist in the resolution of disaster claims include: Hurricane Katrina and Rita (2005) Following Hurricane Katrina and Rita in 2005, the AAA was named as the program administrator for several mediation programs by the Louisiana Department of Insurance and the Mississippi Federal District Court to help resolve claims arising from the hurricanes. In the Louisiana program, over 15,000 cases were filed for mediation with the AAA, with a settlement rate achieved of 74%. In Mississippi, the AAA mediated over 5,000 cases, with an 82% settlement rate. Hurricane Andrew (1992) To handle claims resulting from Hurricane Andrew, the ADR for Disputed Claims program was created via emergency rule by the Florida Department of Insurance (DOI) in conjunction with the Florida legislature. The AAA administered the program, providing centrally-located mediation sites and bilingual mediators. The mediators handled 2,400 claims and achieved a settlement rate of 92%. All cases were handled without counsel, with representatives from the DOI and the Attorney General s office present for legal and procedural questions. Northridge Earthquake (1995) The AAA administered a volunteer ADR program for the California Department of Insurance to resolve insurance claims arising out from the Northridge Earthquake in The program was designed to resolve claims that the insurance department was unable to resolve. The ADR options included dispute evaluation and assessment, mediation, binding arbitration and non-binding arbitration. The AAA s programs to assist in the management of insurance claims include: New York State Department of Financial Services Conciliation Program (1999 Present) The American Arbitration Association has a long history of developing and implementing customized processes and systems for large, complex claims programs. Notable among these is the New York State Department of Financial Services program. To encourage early settlement and provide a low-cost option to insurance carriers, the AAA, in cooperation with the NYS Department of Financial Services and insurance carriers, developed an early-stage conciliation process, a non-binding alternative to more formal arbitration hearings. In the program s first two years, the AAA completed 400,000 backlogged case filings. More than 60,000 conciliation cases are filed annually. New York No-Fault Arbitration Program (1973 Present) AAA provides specialized rules, extensive case statistics and financial reporting, specific qualifications and training for a roster of permanent arbitrators. 3 adr.org

4 Minnesota No-Fault Program (1975 Present) The program includes specialized procedures, statistical reporting and dedicated case management. New Jersey No-Fault Program ( ) The program included specialized procedures, statistical reporting and dedicated case management. More about the AAA AAA services include the design and development of ADR systems for government agencies, corporations, unions, law firms, and the courts. The AAA administers a wide range of disputes for a spectrum of industries. The global leader in conflict management since 1926, the American Arbitration Association is a not-for-profit, public service organization committed to the resolution of disputes through the use of arbitration, mediation, conciliation, negotiation, democratic elections, and other voluntary procedures. 4 adr.org

5 AAA Disaster and State Insurance Programs - FAQs What is mediation? Mediation is a process in which an impartial person (the mediator) assists the parties (after speaking with them separately and together) in reaching a mutually agreed-upon settlement. The mediator does not have the authority to make a binding decision. What types of insurance-related disputes can be submitted under these procedures? Insurers, homeowners, property owners, and businesses can use the AAA Disaster Claims Mediation Procedures to resolve and settle insurance-claim disputes. AAA Disaster Claims Resolution Services administers cases for disputed homeowner, property and business claims. Who are the mediators? The AAA National Roster of Mediators consists of highly accomplished and respected experts from the legal and business communities who offer diverse experiences across a wide range of fields, including former federal and state judges, attorneys with exceptional subject-matter expertise, and business owners. Many have expertise in and familiarity with insurance and property-damage claims. AAA mediators are trained and experienced neutrals skilled in negotiations and mediation techniques. All adhere to the AAA rules, procedures, and Code of Ethics. Where can I find more information about disaster-claims resolution in particular and mediation in general? Information about mediation is accessible through the AAA s website, Why have these mediation procedures been developed? The AAA Disaster Claims Resolution Services mediation procedures have been developed to provide homeowners, property owners and businesses as well as the insurance companies, with a fast, fair and inexpensive way to resolve disputes that arise from claims filed after natural and other disasters. If I have questions, who do I contact? Please contact customer service at with any questions. 5 adr.org

6 Who pays for this process? The insured incurs the cost of preparing their cases, as well as any expenses associated with providing witnesses. All other expenses of the mediation process, including required travel and other expenses from the AAA mediator, shall be borne by the insurer. AAA s administrative fees and the mediator s compensation are due and payable at the time the submission for Disaster Claims Resolution Services is filed with the AAA. How are mediation hearings conducted? Mediations may be conducted by telephone, communication (if requested) or in-person, when agreed to by the parties or when it is so determined by the mediator. Do I need to be represented by a lawyer at the mediation? There is no requirement that parties be represented by counsel, however, parties may be represented by persons of their choice. 6 adr.org