Chicagoland Chapters of CPCU

And

HeplerBroom, LLC

Presents the First Annual

Insurance Law and Coverage Seminar

Casualty/Third-Party Track

Medical Fraud - Determining the Starting Point in Medical Insurance Investigation Claims

  • This presentation will cover the methodology being used by insureds in an attempt to manipulate the claims system while attempting to gain a financial advantage from insurance companies
  • The case studies provided will demonstrate where and how fraud is occurring, show the clusters of claim locations and highlight the importance of data gathering during the investigation process
  • A review of redacted medical records and deposition excerpts will help to illustrate what medical fraud looks like in real world practice
  • A discussion of current trends in the medical fraud arena, such as coding issues, the use of/referral for certain diagnostic tests, procedures, and durable medical equipment

Professional and Medical Liability Law

  • Social Media and the Internet: The Impact on Professional Liability Claims
  • Legal Malpractice Actions: Understanding the Complexities of the Claim and recent Developments and Trends
  • Evolving Trends and HIPAA Basic Training in Medical Liability Law
  • The Impact of Electronic Records in Medical Negligence Litigation
  • Emerging bad-faith issues and trends arising out of third-party claim litigation

Construction Coverage & Risk Transfer
  • Significant Construction Contract provisions, and the interplay with liability, coverage, and risk transfer
  • Common construction insurance dilemmas, with an understanding of the important differences in the laws in Illinois and other states, along with current strategic considerations
  • Interplay between Additional Insured coverages and contractual liability coverage – in construction and other non-construction GL matters, along with developing trends
  • Interplay between additional insured coverage and scope and Anti-Indemnity Acts, in Illinois and other jurisdictions
  • Builder’s Risk coverage overview including whom it protects, who generally purchase, and related subrogation waivers
Employment Practices Liability Coverage: Addressing Employment-Based Claims
  • What is EPLI Coverage, who is an “Insured” and what is a “Claim”under an EPLI Policy?
  • General Differences between EPLI Coverage and Coverage Under D&O and CGL Policies that Provide Coverage by Endorsement for Employment-Related Claims
  • Employee Letters and Demands, and EEOC Charges and the impact on coverage
  • Arguments for coverage for employment practices claims under CGL policies
  • Discussion of claims handling and defense of employment practices cases with liability coverage issues, and avoidance of bad faith and extra-contractual liability
Chicagoland Chapters of CPCU
And
HeplerBroom, LLC
Presents the First Annual
Insurance Law and Coverage Seminar
Property/First-Party Track
What the Hail! - Issues Surrounding Assignment of Claim Benefits, Appraisals and Public Adjusters
  • Participants will be given real-life examples of assignments of benefits agreements and discuss how these documents impact the insurer’s rights and obligations.
  • Discussion regarding the rights and obligations of insurers, insureds and public adjusters during the course of a property insurance claim investigation.
  • Identification of physical loss or damage from hail versus wear and tear or other causes, establishing necessary scope of repair, determining date of loss, fixing cost of repair, and other issues commonly arising in these claims.
  • Discussion on how to properly manage the appraisal process.
How Claims, Underwriting and Agency Work Together to Create a Bad Faith and Liability Exposure
  • This class will focus on how the producer’s conduct and the underwriting file impact a claims investigation and ultimate coverage decision
  • Discover best practices for documenting the claims and underwriting file to protect the insurer from a bad faith exposure.
  • Issues that cause a producer to be exposed to litigation
  • Understanding the issues surrounding reservation of rights letters, non-waiver agreements, and proper response to Department of Insurance complaints.
Arson and Fraud Investigations – Avoiding the Pitfalls
  • Focus on emerging fraud scams, including the constraints of NFPA 921’s standards relating to negative corpus
  • Managing issues of non-cooperation during a suspect claims investigation, while also adhering to the insurer’s duty of good faith and fair dealing is a critical component of reducing risk of bad faith exposure to insurers.
  • Discover best practices for documenting the claims file to protect the insurer from a bad faith exposure.
  • Understanding the issues surrounding reservation of rights letters, non-waiver agreements, and proper response to Department of Insurance complaints.
  • Recognize how the insurer's duty to investigate in good faith can become the basis for bad faith exposure Good Faith versus a Bad Faith Claims Investigation
  • Legal and contractual issues surrounding the examination under oath (EUO) process
Panel Discussion - Cyber Liability and Data Breach
  • The program will examine the emerging intersection of insurance law and cyber issues. Specifically, this program will inspect traditional policy provisions in various types of insurance policies analyze typical policy provisions when applied to occurrences arising from data breaches, hacking, and other cyber issues.
  • The panel will provide an overview of insurance coverage issues facing businesses as they struggle to protect themselves against the emerging, and quickly exploding, danger of cyber risk. This includes liability to the insured’s customers, clients and employees for breaches of their private information which can be a major component of liability in the case of a data breach.
  • The panel will explore trends in class action litigation, emerging cyber and privacy risks, including emerging threats such as cyber espionage and cyber terrorism, under "legacy" insurance policies and the newest cutting-edge "cyber" insurance products Facebook profiles and Twitter feeds at trial.
  • How cyber risk coverage is being cut back with newly developed exclusions and cyber risk coverage under specialty policies theft or destruction of the insured’s data and theft of the insured’s funds.