Why Hire A Lawyer As An Insurance Expert?
When looking for a bad faith claim handling an industry standard of care expert, lawyers oftentimes retain former insurance company claim adjusters. However, does that former claim adjuster have the discipline, patience and broad-based experience to forensically evaluate your insurance claim handling issues?
As a lawyer, Mr. Plitt has established himself as a disciplined, focused, hard-working and tireless lawyer with exceptional analytic skills coupled with the ability to communicate complex subject matter to audiences from varied backgrounds and life experiences. For ten years straight and counting, Mr. Plitt has been identified as one of the Top 50 Lawyers by Southwest Super Lawyers in his home state of Arizona. His insurance law practice is based in Phoenix, the sixth largest city in the United States. The same dedication, tireless work ethic, and razor sharp analytic and forensic analysis skill set that brought him to the pinnacle of the legal community in Arizona he brings to his expert consultant/witness practice. In expert consultations nationwide, Mr. Plitt has brought to his consulting practice the same qualities that made him a successful lawyer. He is always prepared and in command of the relevant facts in the cases where he has been retained as an expert consultant or witness. Cases involving insurance industry standard of care as well as claim handling issues and practices can have a lot of moving parts and it is important to have an expert who has the ability to analyze complex claim situations and forensically reconstruct what took place while the claim was being processed. Mr. Plitt is always prepared to discuss case facts with a depth of understanding that is hard to find with most claim handling consultants and witnesses.
Many former claim adjuster turned expert consultant witnesses have spent their careers adjusting claims with only a few insurance companies and may have limited experience from the type of claims they adjusted while employed by an insurance company. Mr. Plitt brings to his consulting practice extensive broad-based experience regarding claim practices and claim management from more than 100 different insurance companies involving many different types of insurance coverages. During the span of his 34 year career, Mr. Plitt has spoken to hundreds of claim adjusters, supervisors, claim managers, examiners, and other claim management personnel on a regular basis as part of his insurance law practice. These encounters have been in-depth and substantive and were not water-cooler encounters where a claim adjuster may have a shallow meet-and-greet with other adjusters.
Can An Insurance Lawyer Qualify As A Industry Standard of Care and Claim Handling Expert?
Absolutely. Mr. Plitt has qualified in both state and federal courts. He has broad-based practical knowledge and experience in claim management. His experience goes beyond those claims that he has actually adjusted for insurance companies. His practical knowledge of industry claim practices comes from:
As A Lawyer:
- He has adjusted claims under the titular supervision of claim adjusters and claim supervisors. His adjustment of claims has involved all aspects of claim adjustment activities with the exception of setting claim reserves.
- During Mr. Plitt’s practice career, he has reviewed and analyzed thousands of claim files for more than 100 different insurance companies.
- He has extensively consulted with claim adjusters, supervisors, claim managers, examiners, claim legal attorneys and other claim management personnel during his 34 years of legal practice. These substantive encounters have involved all aspects of the claim adjustment process including claim development, investigative scope, liability and damage assessment, coverage analysis and assessment, and claim monitoring to make sure that the adjustment process complies with the insurance policy’s implied covenant of good faith and fair dealing. Because Mr. Plitt managed a large litigation practice where his clients were insurance companies (or insureds in conjunction with insurance companies), he consulted with claim personnel on a regular and oftentimes daily basis over the span of his 34 year career. These frequent and substantive communications inform Mr. Plitt regarding claim adjustment practices, processes and protocols, different claim organizational structures and how they operate, coordination between claim department and underwriting department personnel, underwriting practices and procedures, claim settlement approaches and practices, and all other manner of claim processing activity which are too varied to describe here. For 34 years Mr. Plitt has observed how insurance claim personnel think, what their general level of understanding is regarding specific claim situations, the law and coverage, how the legal community interacts with the claim community and how those interactions are perceived and reacted to.
- Mr. Plitt has participated in many insurance company “roundtable” discussions which are part of the overall claim adjustment and evaluation process. Formal and informal “roundtable” committees are frequently used by insurance company claim personnel as an adjunct to the claim process and are populated by claim representatives, supervisors, and other management personnel. At these “roundtables” the handling of claims are discussed in real time. Mr. Plitt’s role in attending a “roundtable” discussion is to provide guidance and advice on claim valuation, claim handling conduct, issues and problems. At “roundtables” Mr. Plitt has provided independent advice as well as proposed solutions regarding claim impediments that may have arisen in the claim environment on specific claims.
- In his role as coverage counsel for many insurance company clients, he is directly engaged within the claim process, in real time, and therefore is often part of the claim adjustment process.
- During his direct representation of insurance companies, as well his consulting retentions, Mr. Plitt has been able to review the claim manuals, claim bulletins and protocols and general corporate claim documentation for many insurance companies. He has also reviewed the depositions of insurance claim adjusters, claim supervisors, and other claim management personnel (including persons most knowledgeable) regarding the handling of specific claims, the handling of claims generally, and all facets of claim management and operation.
As A Teacher:
- Mr. Plitt is currently teaching insurance law at the University of Arizona’s College of Law. He is a former adjunct professor of law at Arizona State University’s College of Law where he taught the insurance law curriculum. As part of his law school teaching curriculum he discusses insurance policy interpretation, the policy’s implied covenant of good faith and fair dealing, the NAIC Unfair Claims Settlement Practices Act, and extra-contractual liability that arises in the claim context. Through his speaking engagements, Mr. Plitt has taught practicing attorneys the concepts of extra-contractual liability and related subjects.
- Mr. Plitt has been invited to conduct in-house training seminars to insurance companies on claim handling, bad faith and insurance regulations for 22 different insurance companies with adjusting staffs in 13 different states. As part of those training sessions, Mr. Plitt provides advice for specific claims as well as advice for general claim handling practices and protocols. Recently, Mr. Plitt developed an on-line course for claim adjusters regarding Unfair Claims Settlement Practices Act statutes and accompanying state regulations. Adjusters who take the course are eligible for continuing education credits in those states where the Departments of Insurance require continuing education. Currently, Mr. Plitt is on the Executive Counsel for CLM’s Extra-Contractual Claim Management Claim College. As a faculty instructor at the Claim College, Mr. Plitt was responsible for teaching claim handling practices and protocols.
As A National Commentator:
- As a national commentator on insurance law issues, Mr. Plitt has reviewed more than a thousand published and unpublished bad faith cases which have contained within the court opinions recitations of insurance company practices regarding the handling of specific claims as well as general claims handling practices. Mr. Plitt has also extensively studied and analyzed the NAIC Unfair Claims Settlement Practices Act and its various adopted iterations throughout the United States. He has extensively reviewed and analyzed the state-specific regulation which often accompany a state’s adoption of its variation of the Unfair Claims Settlement Practices Act.
- In addition to his extensive teaching as a professor of law, Mr. Plitt is one of the nation’s leading commentators on insurance law issues. He is the current senior author of the widely recognized and authoritative insurance coverage treatise Couch on Insurance 3d. He has written other treatises on insurance law. He has extensively published on the subjects of policy interpretation and analysis and extra-contractual liability. He has a broad base of coverage knowledge throughout the United States that far surpasses the knowledge of the typical insurance consultant.
- As a scholarly commentator, Mr. Plitt has been cited by the Supreme Courts in 32 states, the Intermediate Appellate Courts in 23 states, 10 of the Federal Circuit Courts of Appeal, 50 Federal District Courts, the Federal Court of Claims and the Federal Bankruptcy Court. He has been cited in the code of Federal Regulation. He has been cited extensively in scholarly articles by other commentators.
As An Expert Consultant:
- As a consultant, Mr. Plitt has forensically reconstructed and objectively evaluated the claim handling processes in hundreds of cases. Many of those cases have involved extensive litigation discovery which have produced claim manuals, claim guidelines, internal claim communications, information regarding claim organizational structure, bonus programs, corporate incentives, claim handling protocols and training. Many of those cases have had extensive testimonial records including depositions from claim adjusters, claim supervisors, claim managers, insurance company executives, the claim litigation management team, claim legal attorneys, as well as underwriters, brokers, and sophisticated corporate insureds. General industry standards, customs and practices have been explored in those depositions together with the specific claim handling practices and protocols used by the involved insurance companies. The information Mr. Plitt has learned from his consulting practice further informs Mr. Plitt on industry standards, insurance company claim organization and claim management. Mr. Plitt’s broad-based understanding of insurance company operations and litigation practice allows him to provide significant contextual insight regarding claim handling and claim management decisions.
- Mr. Plitt has reviewed hundreds of expert reports, from other claim handling consultants who have expressed within their reports their understandings and beliefs regarding industry standard, custom and practice. He has reviewed hundreds of depositions from other claim handling consultants where they have testified regarding the claim handling practices of insurance companies that are specific to a particular claim as well as their overall opinions regarding industry standard, custom and practice.
- He has also been given access to claim manuals and guidelines, protocols, Best Practices documents, bonus programs and a wide array of relevant claim department documentation from many insurance companies that have been produced in discovery in his many expert retentions.
- As a consultant, Mr. Plitt has forensically reconstructed and objectively evaluated the claim handling process in hundreds of cases. Many of those cases have involved extensive litigation discovery which have produced claim manuals, claim guidelines, internal claim communications, information regarding claim organizational structure, bonus programs, corporate incentives, claim handling protocols and training. Many of those cases have had extensive testimonial records including depositions from claim adjusters, claim supervisors, claim managers, insurance company executives, the claim litigation management team, claim legal attorneys, as well as underwriters, brokers, and sophisticated corporate insureds. General industry standards, customs and practices have been explored in those depositions together with the specific claim handling practices and protocols used by the involved insurance companies. The information Mr. Plitt has learned from his consulting practice further informs Mr. Plitt on industry standards, insurance company claim organization and claim management. Mr. Plitt’s broad-based understanding of insurance company operations and litigation practice allows him to provide significant contextual insight regarding claim handling and claim management decisions.
As A Coverage Lawyer:
- Some extra-contractual liability cases involve the insurance company’s interpretation of coverage. When that occurs, the central question is whether the insurance company reasonably evaluated the policy language in question in juxtaposition to the existing case law. In this situation, expert witnesses can be helpful without rendering impermissible legal opinions. The issue is not what the law actually is but whether the perception and interpretation of the law relied upon by the insurance company was reasonable. Thus, a discussion of relevant coverage law goes to state of mind and therefore does not constitute a legal opinion. Mr. Plitt has broad-based experience and observation regarding how claim professionals work through coverage investigations and analysis, as well as claim practices regarding coverage.
- When this type of issue is central to the extra-contractual liability question, Mr. Plitt can provide unique insight that most adjusters turned expert witnesses cannot. When it comes to insurance policy interpretation, Mr. Plitt is not just an observer but he is also a do’er. He has been involved with drafting an insurance policy from scratch as well as various policy endorsements. He has worked closely with insurance company product development committees and/or corporate counsel regarding the evaluation of existing policy language and proposed new policy amendments. He has extensively published as reflected in his CV which can be accessed herein.
As A Trial Lawyer:
- Some bad faith cases involved allegations of failure to settle which create excess third-party liability exposure. In that type of bad faith case, it is important to have an expert consultant who is familiar with litigation, and has significant experience with the inter-relationships between an insurance company and the defense lawyer that has been retained to defend the insured’s interests. For a large part of his 34 year practice career, Mr. Plitt managed a large defense practice where he was retained by insurance companies to defend policyholders/insureds. He has tried cases to jury verdict in both state and federal courts. He has extensive experience in the real-time interactions that involve the tripartite relationship that exists with the policyholder/insured, defense counsel and the insurance company.
- As a seasoned litigator and trial lawyer, Mr. Plitt has substantial experience with case evaluation, litigation strategy, and the various twists and turns that can take place in a liability lawsuit.
- As a coverage lawyer, he is frequently called upon to manage cases that have potential excess exposures for both primary and excess insurers. He has extensive experience in situations where the doctrine of equitable subrogation is involved in litigation between primary and excess layers of coverage when an excess exposure has been realized and/or an excess judgment has been entered against the policyholder/insured. Claim adjuster turned expert consultants sit on the sidelines of litigation but have not actually been in the litigation arena. Because of this, Mr. Plitt can offer insights, analysis and evaluation that goes beyond the limited experience of many claim adjusters in cases where bad faith exposures hinge upon nuanced discrete happenings within the discovery process leading up to trial or throughout the trial itself that produced the excess exposure.
As An Insurance Agent/Broker:
- Mr. Plitt has been a licensed producer/insurance broker in the state of Arizona since 1974. He has family roots that are deep in the marketing side of the insurance business. Where nuances of a bad faith case involve the conduct of an insurance agent or broker, Mr. Plitt has the background to analyze and evaluate those issues that a claim adjuster turned expert witness oftentimes does not have.
Because Mr. Plitt has regularly consulted with insurance underwriting and claim personnel regarding insurance policy analysis and interpretation, Mr. Plitt has acquired substantial practical knowledge regarding the understanding of coverage within the industry.
As the foregoing demonstrates, Mr. Plitt’s practical knowledge and experience far exceeds the experiences of most claim adjuster turned expert consultant witnesses when it comes to understanding industry standard of care, custom and practice because Mr. Plitt’s practical knowledge and experience has a much broader base and is multi-faceted.