AF recently facilitated its latest filer/responder workshops on May 19 and 21, with 166 member company representatives in attendance. The purpose of these workshops is to drive decision quality by:   

• Sharing information to improve filing and responding effectiveness.   
• Answering questions attendees have regarding filing and responding workflows and procedures.   

The following are key takeaways from the May workshops:  

Shared Evidence – Refute Versus Support

• The recovering company must support their damages through evidence and may request a revisit if the damages are challenged.
• The revisit is used to refute the challenge to damages raised by the responder.
• The evidence attached on the revisit must refute the challenge as well.

Damage Arguments

• Remember: The arbitrator is your audience!
• Provide the arbitrator with sufficient information regarding the type and amount of damages in dispute.
• Without a specific reason or indication of what the proper amount should be, it will be difficult for the arbitrator to consider the argument or agree with your position.
• Use specific arguments, point to the evidence, explain why the reduction is warranted, and show the mathematical breakdown of the reduction.

Post-Hearing Denial of Coverage

• Rule 3-9 allows for post-decision “coverage denial” defenses when the request is received within 60 days of the decision publication and no less than 60 days before the statute of limitations expires.
• A copy of the coverage denial letter to the party seeking coverage must be attached to the PDI submitted for the Rule 3-9 defense.
• The party seeking coverage is the named insured, defined insured, non-permissive driver, excluded driver, etc.
• Do not submit denial letters to other insurers, the other party’s named insured, etc.

Damage Categories: Dos and Don’ts
Do

• Itemize damages under the correct category name.
• Use the itemization categories to help the arbitrator give you the best award.
• Provide the correct dollar amount supported by evidence.
• Present the correct suggested dollar amount when disputing damages.

Don’t

• Don’t provide evidence that does not match requested or disputed damages. Verify your evidence supports your requested amounts or disputed amounts.
• Don’t list your total loss damages under the “Auto Damage” itemization category.  

Quick Tips
Enter a damage dispute only:

• If you have specific challenges about the reasonableness, necessity, or relatedness of the damages claimed.
• When damage evidence has not properly been shared.
• In situations where you have a lack of coverage for a portion of the damages claimed.

Do not enter arguments for the following as a damage dispute:

• If the subject of your dispute is strictly related to liability and not to damages.
• When there is a lack of proof of payment.
• If there are any issues related to jurisdiction.

Concurrent Coverage – Rule 3-9:

• There is no post-decision relief for primacy of coverage arguments.
• An exception is made if the responding company provides a denial of coverage letter for specific damages to its insured or a complete denial of coverage letter.
• See Page 69 of Reference Guide to Arbitration Forums, Inc.’s Agreements and Rules.

Rule 2-8 – Consider the Costs:

• “The responding company will reimburse the recovering company for all legal expenses and court costs resulting from the improper objection to jurisdiction, as well as the additional arbitration filing fee.”
• Make sure your objection to jurisdiction does not end up costing your company.

Our next filer/responder workshops will be held on July 21 and 23 at 2 p.m. ET. Enroll today. We hope to see you there!