Coverage and First-Party Defense

The partners of GKASN have evaluated hundreds of property policies and claims under those policies, conducted hundreds of examinations under oath and defended an equal number of first-party suits in New York, New Jersey, Pennsylvania, and Connecticut. This type of investigation and representation is some of the most satisfying work we do.

Representing insurers in a first-party claim is like representing with advantages and disadvantages. After becoming fully familiar with the file of our client and the facts of the loss, we first consider whether any further investigation is needed. We will guide the insurer or its adjuster in demanding the appropriate additional materials and will assist if the insured balks at providing it. Examinations under oath are a valuable and still under-utilized tool for discovering information related to a claim. And even if there is substantial information at hand, committing an insured to testimony under oath has significant value, whether or not the claim is ultimately denied.

We are not shy about advising a client where it appears that there is coverage under a policy, nor are we reticent to urge denial of a claim where the facts, policy terms and the law warrant that decision. But even if there is coverage for a claim, we will, if requested, take a close look at the damages sought by an insured and, if indicated, work with a builder, accountant or others to determine how much should be paid.

We have also developed a relationship with the attorneys recommended by public adjusters in the New York metropolitan area. As a result, we have a good idea how to manuever around their bluster. They also know us, and, therefore, they know we will not stand for their their obstruction, and they know they are in for a battle, whether the claim is ultimately paid or denied.

Since most of the basic concepts of defending an insurer under its policy are known to us, we, accordingly, do not re-invent the wheel at the insurer’s expense. We can efficiently get to the heart of the matter if that is required. If the matter is complex, however, we will delve deeply. We pride ourselves in our invoicing practices and rarely are any of our invoices challenged. That means we take care to charge actual time, follow your billing guidelines, and make every effort to avoid unnecessary expense.

Although less common, retaining experts in coverage litigation is just as important as with other lawsuits. We have worked with forensic insurance professionals, especially when bad faith is alleged. Sometimes, the assistance of an underwriting expert may help to address issues which are complex and need outside expertise. We have identified knowledgeable experts in these areas.

Frequent contact with clients is a  general practice of the firm. We know that those who assign files to us report to others. Our goal is always to provide updates on file progress so that most if not all questions can be answered by the claims handler. Every 30-45 days is the general rule, unless there are reasons to report more or less often.

While every lawsuit matters, when a claim is made directly against an insurer, it seems more personal. We treat your claims that way. When a matter is concluded, we make sure that all details are resolved and the necessary documents are obtained and in the client’s file.

It would be our pleasure to discuss how we handle first-party files and to let you see how we do it.

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