Feature Article in NASP Subrogator by Shannon M. Warren, Esq., “Shall We Share: Balancing the Benefits of Joining Forces and the Risks of Potential Conflicts”

Insurance Subrogation Group is pleased to announce that an article authored by our Director of Subrogation Services, Shannon M. Warren, Esq., was selected as a feature article in National Association of  Subrogation Professional’s 2017 Winter Edition of its Subrogator magazine. Ms. Warren’s article is entitled “Shall We Share: Balancing the Benefits of Joining Forces and the Risks of Potential Conflicts,” and discusses the implications of sharing subrogation counsel, experts, and evidence custodians. The article discusses situations when it may be prudent to consider sharing agreements. It also provides an overview of the considerations that must be taken into account when subrogated insurers contemplate collaborating with other insurers and parties. In the article, Ms. Warren provides numerous examples of how unforeseeable conflicts-of-interest may arise. The article also discusses ways to anticipate such conflicts-of-interest and protect insurers from finding themselves in precarious situations when they elect to share counsel, attorneys, and evidence custodians with others.

Making Obesity Work for You

Obesity is a national epidemic.  It contributes substantially to indemnity and medical costs in workers compensation cases.  Now insurers can find some relief in New Hampshire, Massachusetts, Louisiana and Nevada by filing for recovery from the Second Injury Fund when serious obesity is present.

In May of 2014, IRG successfully argued and established legal precedent in the case Kevin O’Meara v. Retention and Operations Group. In this case, IRG argued that the American Medical Association’s new interpretation of the definition of obesity, that it is indeed a disease and not solely a diet issue, would qualify this condition as a prior, permanent impairment and therefore recoverable from the Second Injury Fund.

If you have any questions involving a claim in which the injured worker suffers from obesity, please refer the matter to IRG for a free consultation to discuss the potential recovery from the Fund.

LexisNexis Published Co-Author Attorney Marie Cheung-Truslow’s Chapter on “Bringing Subrogation Actions”

Attorney Cheung-Truslow co-authored with Attorney Steven Theesfeld of Yost & Baill a chapter in the New Appleman on Insurance Law Library Edition, a LexisNexis publication considered to be the most comprehensive source for insurance law. Chapter 160, entitled “Bringing Subrogation Actions” addresses an insurer’s and self-insured’s rights to recover amounts it has paid for losses on its policies by means of subrogation. Subrogation is distinguished from restitution, reimbursement, liens and assignments against third parties and its own insureds. This chapter deals with who has the right to pursue a subrogation action, when such actions are allowed, and against whom such actions may be brought. The Chapter not only provides an analysis of recent case law, with citations, but also helpful hints from Attorneys Cheung-Truslow and Theesfeld. A copy of New Appleman on Insurance Law Library Edition is available by searching the publication at New Appleman on Insurance Law Library Edition

Policyholder’s Failure to Cooperate Requires Disgorgement of Monies Paid by Insurer

In Merchants Mutual Insurance Company v. Olaniyan et. al., Massachusetts Superior Court judge on August 7, 2013, ruled that monies paid out by the insurer for additional living expenses must be disgorged by the policyholder where he failed to appear for examination under oath and produce salient records.  Attorney Marie Cheung-Truslow and Scott Dildine represent Merchants Mutual Insurance Company. See Merchants Mutual Ins. v. Olaniyan

Insurance Recovery Group forms new division, Insurance Subrogation Group

Insurance Recovery Group, Inc. (IRG), a firm that has successfully recovered more than $2.0 billion dollars for insurers and self-insureds, launches a new division, Insurance Subrogation Group (ISG). ISG provides comprehensive subrogation services to insurers, self-insured companies, third party administrators and captives throughout the United States. Our expertise in multi-line subrogation solutions for Property & Casualty, Automobile & Trucking, Fidelity & Surety, Workers’ Compensation and other specialty lines ranges from smaller losses to the most complex and catastrophic casualties.

According to David A. Jollin, President and CEO of IRG, “The new division will expand on Insurance Recovery Group’s core competency, which is identifying, investigating, and recovering claims dollars through legal and regulatory processes.” He adds that, although IRG has offered workers’ compensation subrogation services to select clients in the past, the new division expands the scope of the operation and creates a dedicated unit with deep expertise.

IRG Wins Claim for Client Reimbursement in Amount of $778,732, Plus Interest

In a decision dated October 1, 2008, an Administrative Judge at the Massachusetts Department of Industrial Accidents ordered the Workers’ Compensation Trust Fund to reimburse an IRG client a total of $778,732.77, which represents the full exposure of the Trust Fund under the Massachusetts statute. The Trust Fund was also ordered to pay ongoing medical reimbursement at the statutory 75%, plus interest at 10%, which is estimated to be $212,000.

The Trust Fund made an offer for settlement that IRG deemed inadequate and out of sync with the Fund’s exposure in the case. IRG instead recommended a trial of the case.

IRG, through its law firm IRLA, brought the employee back from California to testify at hearing. Although the evidence was strongly in favor of our client, the Fund still failed to make a reasonable offer of settlement. In the end, the Judge issued a well-crafted decision, finding all the elements of the statute satisfied. The appeal period for the Fund will run out on November 1, 2008.

This claim exemplifies IRG’s willingness to prosecute claims on behalf of our clients and maximize our client’s rights to reimbursement when Trust Funds are unwilling to offer fair value for their exposure.

Uehlein, Nevils Published Overview of Second Injury Fund Changes in The Journal of Workers Compensation

The Journal of Workers Compensation recently published Second Injury Funds in Flux; Opportunities, Changes, and Questions by W. Frederick Uehlein and Mark Nevils.

Summary: In recent years, New York, South Carolina, and Georgia have enacted legislation to phase out their respective Second Injury Funds (SIFs). Over 20 SIFs have closed or “sunset,” leaving about 20 states with SIFs open to claims with new dates of injury. Of these, about 10 have enabling language that creates significant opportunities for employer savings.

While many SIFs have closed to future claims, employers should not forget that there is still, by the authors’ estimates, upwards of $40 billion dollars to recover from those funds. Employers and insurers need to be certain that processes are in place to recover those dollars effectively and efficiently. Furthermore, the clock is ticking on several funds, making it imperative that insurers and employers with exposure in those states act now to recoup any outstanding recoveries.

This article briefly reviews the history and intent of SIFs and provides an update of major changes with respect to SIFs that have recently closed or been changed by key laws. It also seeks to put the role of today’s SIFs in a more modern context. For employers, that context is an era of significant interstate and world competition.

IRG Victory in MA Court Ruling: Door is Still Open for Recoveries Previously Thought Closed

For insurers with potential MA Second Injury Fund claims with dates of injury between 12/10/85 through 12/23/91, the door is still open for successful recoveries. This past spring, the Massachusetts State Supreme Judicial Court in both the Oakes v. Travelers and Alves v. GM claims established that there is no statute of limitations for claims by insurers pursuant to M.G.L. ch. 152 s.37, the second injury fund law, for claims with dates of injury between December 10, 1985, and December 23, 1991 (“Mid-Act”).

Insurance Recovery Legal Associates fought this battle to preserve the right to file these claims for our clients. We diligentlay pursue claims through the appellate system when necessary in order to protect our clients’ rights. This decision was extremely close with the SJC split 4 to 3 on one case and 3 to 3 on the other. It is favorable news for the many clients and business partners that currently have IRG working on their Massachusetts files.

If you are not currently working with Insurance Recovery Group (IRG) on your MA files, be aware that the further we get from the 1985 – 1991 DOI claims, the more difficult it will be to obtain the documents and evidence needed for successful SIF recovery. Timing is of the essence and urgency is in order to ensure that all such cases are identified and are being aggressively pursued before the passage of time creates an insurmountable obstacle to obtaining aged documents. Otherwise, your opportunities may be lost forever.

Contact us today if you would like to learn more about how we can help you with your second injury fund recoveries.