INSURANCE LAW

Insurance Fraud Defense. Although fraudulent insurance claims infect the entire nation, they have reached epidemic proportions in Southern California. Insurance fraud rings are highly organized into networks of interlocking cappers, attorneys, doctors and medical clinics.

Our approach matches the magnitude of the problem. In insurance fraud litigation, we have developed a reputation as success-oriented litigators, using highly sophisticated technology with old-fashioned, hard nosed lawyering and concerted teamwork. We pair this aggressive litigation style with an intimate familiarity with civil procedure, and a strong relationship with local law enforcement, producing speedy and favorable results.

Our fraud team has gained a statewide reputation for its high profile successes in auto fraud, medical fraud, first party property claims (including arson and burglary), and uninsured motorist claims. We were the first firm in California to sue a network of doctors, attorneys and medical facilities under California’s new anti-fraud “whistle blower” statute, filing a lawsuit on behalf of Allstate Insurance Company in 1999. That case went to trial, and on March 8, 2001, a Los Angeles Superior Court jury awarded Allstate $8.2 million dollars in a landmark decision that found three doctors liable for insurance fraud.

Many of our lawyers who make up the Whistle Blower Team come directly from the District Attorney’s Insurance Fraud Unit, where they underwent years of extensive training and were responsible for some of the largest investigations and prosecutions of defrauders in Southern California. In the area of insurance fraud defense, we are leaders in the field.

First Party Property. Manning & Marder, Kass, Ellrod, Ramirez LLP is experienced in all aspects of first party property claims, including the factual investigation and evaluation of a loss and the legal evaluation as to whether the insurance policy covers the loss. We evaluate our clients’ matters, direct further investigation, conduct examinations under oath and when appropriate, prepare a letter denying the claim. Because of the firm’s outstanding reputation in the area of SIU, many of the claims we handle involve suspect burglary claims and arson.

Many of our cases also involve the theft of property from vehicles, homes or commercial structures. In these cases, the firm’s strong experience in criminal matters (many of our lawyers are former prosecutors), coupled with a firm understanding of police procedures and reports, aids us in developing state of the art investigation techniques.

Finally, because our firm is also retained as counsel for carriers in bad faith matters, we are well versed in this area of the law. As a consequence of increased property/claims values and the current “deep pocket” mentality, bad faith claims are on the rise. Block policies, all risk policies, floaters, CGL’s are all “fair game.” We often conduct seminars for our carrier clients on avoiding bad faith pitfalls, and employ this knowledge in guiding property claims in order to avoid bad faith litigation.

Coverage/Bad Faith/Risk Allocation. The firm’s insurance coverage department provides sound advice to clients when claims arise and zealous advocacy in coverage or bad faith lawsuits when litigation is unavoidable. The firm also represents businesses in obtaining indemnity or contribution from other businesses under additional insured endorsements or contractual indemnity clauses. The firm’s coverage lawyers confront a wide range of disputes, contexts and policies, including the most novel and challenging issues facing the insurance industry today: environmental damage claims, including those arising out of mold and toxic torts; intellectual property claims; directors’ and officers’ liability policies; complex auto and comprehensive general liability claims; first party claims; and disputes among insurers in continuing loss scenarios. The firm’s lawyers have broad experience at both the trial and highest appellate levels. The department’s lead attorney represented the insurer in two of the most important California Supreme Court cases of the 1990s, Buss v. Superior Court (1997) 16 Cal.4th 35 and PPG v. Transamerica (1999) 20 Cal.4th 310. Both are published opinions that have had a major impact in shaping insurance law in this state.

Automobile Accident Minor Impact Defense. It is no surprise that everyday in L.A., many minor automobile accidents occur. However, it is shocking to see how many of these minor impact cases result in claims and lawsuits. In fact, the problem has escalated to such a level that California’s state legislature was forced to enact comprehensive legislation to try to combat the problem (The Fraud Prevention Act). Unfortunately, this Act was only helpful in dealing with fraud rings that set up accidents. It left a large gap for the minor impact case with medical build-up. We have developed a strategy to fill the gap.

First, we have assembled a team of qualified attorneys, limiting the team to specified individuals to ensure uniform handling. We have emphasized training and communication as essential ingredients in this endeavor, and we also use a limited number of specified experts in both the medical and bio mechanical field on a repetitive basis.

Next, we recommend that all such cases should be limited to a specific settlement authority (for example, $500 per plaintiff) and no more. The object is to educate the adverse side that the limit is real. Any flexibility on this position will have the opposite effect. Refusing to make any offer could unnecessarily force cases into litigation that could otherwise be resolved economically.

Finally, we insist that our trial results be successful. We believe that if the vast majority of these cases result in either a defense verdict or a minimal award, minor impact cases will either significantly diminish or promptly settle for the proposed limit.