Tag Archives: lawyers

The Right Counsel for the Right Coverage

As a scientist, I value clarity—in every sense of the word. From the work I do to the conclusions I draw to the products (or policies) I buy, I act based on the clarity of the terms and conditions of the documents I sign; or choose not to sign, if the language is unclear, the provisos too ambiguous, the provisions too abstract. 

Were I to act otherwise, unaware of the consequences and unable to bear the costs of my own ignorance, I would betray my commitment to clarity. I would also jeopardize or squander my family’s financial safety.

When in doubt, in other words, have an expert review the words. Have a lawyer explain the words, so the insurance you have is the insurance you need. Simply stated, assurance comes from ensuring you have the right insurance.

According to Reed Aljian of Daily | Aljian, a boutique litigation firm in Orange County, CA:

“Insurance can save a business millions of dollars and can change the landscape of litigation. But if you did not get the right insurance or you did not carefully review the policy to determine whether you have all necessary coverage, your premium payments could be worthless. This is precisely why hiring competent counsel early is important: Get the right insurance, and you could save yourself millions. Get the wrong insurance, or no insurance, and watch your business die.”

I agree with Reed Aljian for reasons both moral and monetary, because I think it is irresponsible to not know—to refuse to know—what insurance you need; while I know how ruinous it can be to dismiss the advice of counsel by trying to defy the odds and anger the oddsmakers, the actuaries who calculate the risks of every policy an insurer issues. I know the outcome from having seen employees lose their jobs and employers close their businesses.

We need sound counsel to help us choose just policies over unsound business practices.

We need to be unafraid to ask for help, too, because many of us are reluctant to admit or embarrassed to say we need help in the first place. But we need only remember a truth as old as the scriptures and as clear as a prelate’s personal constitution: Be not afraid.

See also: COVID-19’s Once-in-a-Lifetime Opportunity  

In asking for help, we may receive the help we deserve. 

When help comes in the form of a lawyer’s advice, when a lawyer clarifies what each form says, when the forms provide the right insurance to protect a business, the rewards belong to the many.

Insurers and lawyers thrive in such a scenario, as do business owners, because clarity is triumphant. So triumphant, in fact, that all parties may pursue their respective interests and champion their individual causes.

Let us work to achieve these goals, knowing that insurers and lawyers have much to offer. 

Let us, therefore, resolve to be clear in our intentions, unequivocal in our needs and unwavering in our support of lawyers who can help us.

The Future of Work: Collaborative Robots

Recent developments in robotics and artificial intelligence have changed the playing field for automated technologies. (Here is an earlier blog on the topic.) Historically, automation was beyond the reach of small and medium-sized companies. Robotics were costly, required highly sophisticated programming expertise, took months to integrate and could only perform single, discrete tasks.

In 2012, the advent of artificial intelligence (AI) was a game changer. AI brought collaborative robots to the market — robots that see and feel like humans, learn (including integrating new data sets and information) and perform multiple tasks. These collaborative robots are also more cost-effective and easier to integrate, making them available and attractive to small and medium-sized businesses.

AI and robotics are now transforming many traditional labor-intensive industries, such as farming, construction, factories and fast food. While Amazon continues to be a global leader in leveraging AI and smart robots, there are plenty of examples of smaller businesses across the country embracing these new automated technologies.

Agricultural farms are using automated tractors and drones to help with growing their crops. Construction firms are purchasing automated brick-laying machines (to lay 3,500 bricks per day). Restaurant owners are investing in new automated machines that can store, prep and cook fast food in a highly controlled environment without any human intervention.

If the adoption of these new automated machines continues, there will be fewer jobs and payrolls in these industries. Over time, the job and payroll loss will affect insurance carriers that specialize in writing workers compensation insurance for these industries.

Historically, technology’s disruption was limited to blue-collar workers; however, AI technology now has its sights set on white-collar workers, including insurance underwriters, claims executives and legal professionals. The insurance industry, which has not been easy to disrupt, is primed for transformations due to developments in AI and automation.

Two years ago, Cambridge University predicted that insurance underwriters were vulnerable to automation. Since that time, we have seen a greater demand among U.S. carriers to invest in new AI technologies that allow them to automate the underwriting and settlement of claims for small commercial insureds. Given the shortage of new talent available to fill expected insurance and claims executives retirements, coupled with new AI technologies, we expect this trend to accelerate.

See also: Measuring Success in Workers’ Comp  

Developments in AI and automation are already changing the U.S. legal profession, one of the most regulated and specialized professions in the U.S. — McKinsey estimates that 22% of lawyers’ and 35% of paralegal tasks can be automated today. A recent HBO documentary, “The Future of Work,” supports this prediction. It highlighted how LawGeex, a new AI-driven computer software, performed against skilled corporate lawyers on a common task — analyzing complex legal documents. LawGeex proved its ability to review and interpret the documents, identify potential legal issues and provide substantive advice to a client in half the time — and with much greater accuracy — than the corporate lawyer.

While LawGeex and other AI technologies will not displace lawyers in the short term, it will exert pressure on lawyers to shift their time to more highly skilled work – such as negotiating and deal structuring – and away from research, writing and reviewing documents. The result could significantly change law firm practices and economics.

Have you considered how robots, AI and automation will change the workplaces of your insureds – and your own company? Stay tuned for my next blog, “Navigating the Fourth Industrial Revolution,” for ideas on how to navigate AI and developing technologies.

A Way to Attack Healthcare Fraud

If insurers want to mitigate risk, rather than risk their time and money with litigation, if they want to guard against fraudulent claims, if they want to protect good doctors against wrongful claims, then they should invest in sound legal counsel.

Insurers should highlight the value of retaining healthcare lawyers with the intelligence to know—and the strength to do—what is necessary to defeat false allegations of fraud or abuse. A doctor’s career can hang in the balance when defending against a professional liability claim.

Without sound counsel, our best doctors may not be able to practice medicine. Unless we work to stop fraudulent claims, or make it more difficult for fraudsters to enlist the government to pursue these claims, our healthcare system will continue to suffer. Stopping this injustice starts with healthcare lawyers in search of justice—namely, healthcare lawyers whose expertise doctors need.

See also: Proof of Value for Medical Management  

According to Fenton Law Group, which specializes in defending healthcare providers against allegations of fraud and abuse, the charges themselves have their own nuances and degrees of sensitivity.

Take the firm’s representation of Dr. Alwin Lewis (Lewis v. Medical Board) before the Supreme Court of California, regarding a purported violation of a patient’s privacy rights. Because HIPAA prevents people from delving into personal medical records, an insurer cannot muster much of a defense without access to and knowledge of the very things that would exonerate a doctor from a wrongful claim.

Bear in mind, too, that insurance companies often hire panel counsel to defend against claims of fraud. Which is not to say that all insurance companies put savings ahead of saving doctors from fraudulent claims.

Given these circumstances, doctors need effective counsel. Insurers should, in turn, at least listen to what healthcare lawyers have to say about what constitutes a smart legal strategy.

Perhaps elevating the role of defense counsel will benefit insurers, reducing the number of fraudulent claims by increasing the difficulty of bringing claims against doctors who have done nothing wrong. Perhaps hiring the right healthcare lawyers is the right thing do.

Perhaps, indeed; but until then—until the honest unite against the dishonest—we need defense lawyers who can expose fraudulent claims and dismantle claims of fraud against innocent doctors.

We cannot afford to do otherwise. Not if we want to preserve our healthcare system and protect our preferred providers of healthcare.

We cannot afford to have insurers settle all fraudulent claims, either, because we will pay the price for these payouts in higher premiums and deductibles.

See also: 4 Reasons to Join Agency Networks  

The price will come at the expense of choice, leaving us with one of two choices: less affordable care or no care at all.

We must avoid that false choice.

We must have lawyers who champion our rights. We must have lawyers who defend the rights of doctors and healthcare providers. We must have lawyers who expand our rights.

To have lawyers at the forefront of this cause is a good thing, an altogether just and necessary thing.

How to Repair Car Insurance Policies

Car insurance is, to borrow the title of a book by Ralph Nader, unsafe at any speed. It is a gruesome fact, indeed, as the annual number of automotive fatalities is too large to be an abstraction and too sizable to be a purely academic matter.

Maybe the reform the insurance industry needs—and the safety every driver deserves—comes from without rather than within; maybe those who advocate safety, and agitate (peacefully) for change, are the very advocates who do this for a living; lawyers who specialize in representing car accident victims.

Where there is no room for doubt—where there is no roadway for leeway and no acceptance of maybe as an answer—concerns the status quo. The current system is economically unsustainable and morally unforgivable, a pileup of a disaster that requires cleanup from insurers and better clarity from most lawyers. That is, if we want to lower costs and lessen risk, we must inform drivers of their rights and, pardon the series of automotive metaphors, dissuade insurers from making yet another wrong turn.

According to John K. Zaid, a Houston-based lawyer, companies should invite attorneys to speak to their respective workers about car and road safety. Insurers should join this conversation, too, because it is in their interest to make personal safety a professional priority.

See also: The Sharing Economy and Auto Insurance  

Far from being an adversarial process, these seminars can unite lawyers and insurers. The two share most of, if not all, the same goals—including an emphasis on education, so drivers can be more aware of the dangers they face and automobile manufacturers can produce less dangerous cars, so everyone can profit from fewer risks and more benefits.

Lawyers can give voice to these issues—they already do, when entering a courtroom or issuing opening and closing remarks to a jury. They can be, and are, a voice of reason.

They nonetheless need insurers to convert these voices into a chorus of rhythm and harmony; in which safety is a universal mission; in which life is too precious a commodity for talk about compromise; in which product liability compromises the health of many and the lives—and livelihoods—of millions; in which the way some corporations do business is an increasingly surefire way for companies to go out of business.

Let this chorus be as diverse as possible, resonating in every city, county and state.

Let it echo in the corridors of power and reverberate among the powerful.

Let it be a call to action by lawyers and insurers alike, because we cannot afford to read more statistics without seeing the faces behind the numbers: young and old, rich and poor, parents and grandparents, friends and neighbors.

See also: Beginning of the End for Car Insurance?  

We cannot afford a policy of indifference, whose premiums we can neither permit nor attempt to pay.

We can, however, save lives through a partnership of protection.

We can do so—we must do so—before car accidents become too commonplace to be cause for concern.

The consequences are too important to look or feel inconsequential.