ADRAnalyzing the 3rd
Litigation Process
Referral Guide
PIP Priorities

COLLISON & COLLISON, P.C.

SUGGESTED FILE REFERRAL GUIDE

 

 

The proper preparation of a claims referral file that has gone into litigation is vital to the efficient administration of the claim. We are cognizant of the fact that, many times, the file must be referred to Legal, on short notice. There are also situations where the lawsuit is the first notice of the loss. The following comments are intended to advise the claims adjuster of the minimum information needed by retained counsel to adequately protect the interests of the insured once the complaint has been filed.

 

If the time period for answering a Complaint is drawing near (generally 21 days if by personal service), every effort to obtain an extension of time to file responsive pleadings from Plaintiff’s counsel should be made. Confirm the extension in writing with the attorney. If an extension cannot be obtained, then retained counsel should be advised immediately so that an appropriate Motion for Extension (MCR 2.108[E]) may be filed.

 

Please see our "New Case Information Sheet" which can be found in our Practice Areas link that we utilize on all new defense file referrals. You may feel free to retain and refer to the form when needed. Ideally, the following information should be included in the initial referral report:

    1. The Court in which suit has been filed.

    2. The Court file number and the name of the Judge to which the matter has been assigned.

    3. The complete case entitlement.

    4. The Plaintiff attorney, name, address, telephone number and Bar Association number, if known. (This is a five-digit number beginning with P-).

    5. The date and manner of service of the Complaint (a copy should be included).

    6. The date of loss.

    7. The addresses of all parties to the litigation.

Note: the above information will allow us to contact Plaintiff’s attorney to request an extension of time and to file and Appearance. It will also allow us to file a Motion for Extension, Motion to Quash Service, Motion for Summary Disposition, etc., if necessary and/or appropriate.

 

We also require your claim number, the identity of the adjuster to whom the claim has/will be assigned, the Claims Office to which we will report and any other information which is required by your Company in order to properly process the claim. As promptly as possible thereafter, we would like a complete copy of the claim file. Ideally, the file will contain:

    1. The Police Report.

    2. Statements from all material witnesses.

    3. Photographs of the accident scene, vehicles and/or persons involved, with appropriate commentary/captions.

    4. Your insured’s home and work telephone numbers.

    5. All medical information which has been obtained.

    6. A complete list of treating physicians, hospitals or other medical providers and dates of treatment, if available.

    7. A short summary of the accident, injuries and medical treatment.

    8. Insurance information such as your policy number, named insureds, additional insureds, policy limits and other pertinent coverage data.

    9. Available information regarding other applicable coverage. (i.e. other liability, excess and PIP carriers).

Naturally, the names, addresses and telephone numbers of all witnesses should be directed to us early on. A copy of the adjuster’s notes and/or file activity notes should also be sent.

 

We would like to know why the claim was denied, i.e. is this a case of no liability, no threshold injury? Are there unusual circumstances involved? Are there extraordinary defenses available?

 

If this is a claim which stands a good likelihood of being settled, please let us know initially so that unneeded time, effort and expense can be avoided. On the other hand, if this is a claim which must be tried, we should be advised of such fact during the initial referral. It is necessary that you apprise us of all settlement negotiations that have occurred.

 

After careful review of the foregoing, we will contact you with our preliminary thoughts regarding recommended course of future file handling designed to protect the insured’s interests in a thorough, prompt and efficient manner.

 

It is hoped that the above suggestions will answer many of your questions regarding pre-suit claims handling and what information is required for referral to retained counsel.

 

COLLISON & COLLISON, P.C.