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Recreation Club

Claim triage specialist gets defense cost paid by carrier

Business issue

A recreation club was facing a $100,000 lawsuit after one of its directors hired an employee from a neighboring club. The previous employer sued the club claiming a non-compete contract was violated when they hired the employee. Our client’s legal counsel filed a response to protect the suit from default. After some delay, the client contacted their McGriff agent and the claim and subsequent lawsuit was filed with the insurance carrier under the Director’s & Officer’s policy. Nevertheless, the insurance adjuster said they planned to decline coverage due to the policy conditions and delayed reporting.

Action plan

The McGriff Risk Solutions Group has a claim triage team to review all reported claims. When this claim appeared on the daily report, a claims triage specialist recognized the need for special handling and contacted the insurance carrier’s adjuster. The client wasn’t aware they were covered for this type of loss, the specialist explained, nor had their attorney properly advised them. The carrier adjuster ultimately agreed to accept the claim under a reservation of rights with the agreement the client would be counseled on the conditions of the policy and claim reporting requirements.

Result

The lawsuit went through the adjudication process with a settlement of $50,000. In addition to covering the defense costs, the insurance carrier paid $25,000, leaving the client only their deductible of $25,000, saving them more than $75,000. The McGriff client was grateful for their broker and the claim advocacy provided. They also learned a valuable lesson and will consult with their broker when unique situations arise to determine if insurance coverage is available.

Disclaimer: Individual results will vary.

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