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Coverage Analysis
Tom
often functions as a legal analyst and counselor,
rather than as an advocate. He provides analysis and advice
concerning unusual, unprecedented, complex, or amorphous coverage problems;
helps his clients take appropriate positions that best serve their legal and
business needs; and, if necessary, provides formal coverage opinions.
Key Benefits
- Know what your insurance covers and does not cover
- Avoid unnecessary coverage litigation
- Help for dealing with difficult or misguided claims personnel
- Make more persuasive arguments for coverage
Example:
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Ellerton v. Five Towns
(1993): Tom
successfully represented a medical group who wanted to settle a medical
malpractice claim. The case presented potential exposure in excess of the
group's primary policy limits, but the primary insurer would offer only a
relatively small amount in settlement and the excess insurer refused to
offer anything. Through a short letter-writing campaign, Tom persuaded the
primary and excess insurers to offer an additional $750,000 to settle the
claim within their policy limits.
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Blackout Business Interruption Claim
(2004): Tom advised a client that had made a business
interruption claim as a result of the Northeastern Blackout of August 14,
2003. The insurer had denied the claim, and the client's risk manager needed
an argument that would raise at least an arguable possibility of
coverage, so he could use it in the course of negotiating the next annual
renewal of his property insurance program. Tom came up with such an argument
(one that the insurer was actually concerned about).
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