Insurance Claims and Negotiations Flashcards
6 cards from real accident attorney practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Insurance Claims and Negotiations flashcards as text
What is 'subrogation waiver' and why would a plaintiff request it in a settlement?
Answer: A release by the insurer of its right to seek reimbursement from the settlement, allowing the plaintiff to keep more of the recovery
Negotiating a subrogation waiver or reduction with health insurers allows plaintiffs to retain a larger portion of settlement proceeds rather than reimbursing the insurer dollar-for-dollar.
What is a 'structured settlement' in a personal injury case?
Answer: Payment of the settlement in periodic installments over time rather than a single lump sum
Structured settlements (often using annuities) provide tax-free periodic payments to plaintiffs, offering financial security and sometimes a larger total payout than the lump sum alternative.
What is 'excess verdict' exposure for an insurer?
Answer: A jury verdict that exceeds the defendant's policy limits, potentially leaving the insurer liable for the full amount if it acted in bad faith
If an insurer unreasonably refuses a policy limits settlement and the jury awards more than the policy limits, courts may hold the insurer liable for the entire excess verdict.
What is 'stacking' of medical bills (billing inflation) and how do accident attorneys address it?
Answer: Providers charging inflated rates knowing litigation is pending; attorneys negotiate reductions at settlement
Medical providers (often on LOPs) may charge above-market rates in litigation cases; attorneys negotiate reductions to increase the plaintiff's net recovery from the settlement.
What triggers an insurer's 'duty to defend' a policyholder in a lawsuit?
Answer: Any complaint alleging facts that, if true, would potentially be covered by the policy
The duty to defend is broader than the duty to indemnify — if any allegation in the complaint could potentially fall within policy coverage, the insurer must provide defense even if coverage is uncertain.
What is a 'release' in a personal injury settlement?
Answer: A legal document signed by the plaintiff giving up all future claims against the defendant in exchange for the settlement payment
A general release is a complete waiver of all claims, known and unknown, related to the accident — once signed, the plaintiff cannot sue again for the same incident.