Handling Insurance Cases 1 – Screening The Case

Attorneys handling insurance claim denials and their clients, need to understand some basics about what needs to be done when a claim is denied.

Before reaching the court house steps, in most cases, the parties should consider possible resolutions to avoid trial.  The client may not always have the best facts, or the upper hand in negotiations, but counsel should advise the client of the potential risks and rewards of proceeding toward trial.  Ethically, lawyers have a duty to convey all offers made by the insurance company, and clients should be advised on any potential counterclaim risk, if applicable.  Texas Rule of Civil Procedure 167 may severely affect the way a judgement is handled in the event the case goes to trial and the plaintiff obtains less than what was offered.  The client must understand the risk involved.  In the end, he or she should be comfortable with any decision that is made after receiving full counseling and advice.

There is one of two things that have happened when the parties find themselves at the courthouse ready to pick a jury and present their case.  It is because 1) the plaintiff has overvalued the case, or 2) the defendant has undervalued it.  Preparation in the initial stages of the case can be just as valuable as what you do in the courtroom during trial.

Before even considering whether or not to accept a case, the lawyer should get as many documents as possible for review and discuss all relevant facts with the client.  Every client is different and they may not always remember everything, but not getting key facts during the initial client conference may lead to wasted time and effort.  At this early place, the attorney can gauge how his or her client tells their story, including why they believe their claim was wrongfully denied or underpaid, and their general expectations.  These initial conversations with the potential client go a long way towards learning details that will help determine whether the case can be presented to a jury and the facts involved when deciding to draft the initial notice letter and the subsequent Original Petition that may result.