So sue me! Or not.

When claim disputes arise between insurers, the disagreements can become heated, jeopardizing critical working relationships as the lawyers gear up for battle. For those seeking a more measured (and less expensive) approach, Tampa-based Arbitration Forums, Inc., (AF) offers an alternative. Founded in 1943, the organization helps its member insurers and self-insureds settle claim disputes in meeting rooms, not courtrooms.

President and CEO W. Russ Smith, CPCU, reports that the membership-driven, not-for-profit organization is the largest firm of its kind in the nation, with 4,300 insurers and self-insured members and 5,900 arbitrators. In 2009, it resolved by arbitration over 520,000 inter-insurance company disputes involving $2 billion of contested funds. Disputes leading to arbitration typically arise when insurance or self-insured companies believe their insureds are not at fault or are in disagreement over the percentage of liability or the amount of damages.

Smith began his insurance career in 1976 as a claims adjuster with Amica Mutual Insurance Co. He joined AF in 2008 after a long tenure at USAA, where he rose to vice president-claims. Smith has served on numerous insurance industry committees, including the American Insurance Association Casualty Claims and Property Claims subcommittees, the Florida Joint Underwriters Association, the Florida Residential Property and Casualty Joint Underwriting Association, Citizens Property Insurance Corp. committees on claims and quota share, and the Florida Claims Manager Association. He spoke with Florida Underwriter about this industry niche and the success of the organization he leads.

Q. Tell us about your business model. AF is member-driven, yet it does not cost to join. You have reduced your client fees, yet AF is successfully spreading across the country.

A. As a not-for-profit, membership-driven organization, AF is committed to serving our members' recovery and resolution needs, and therefore serving the needs of the entire insurance industry. From the beginning, our business model has been focused on resolving high-volume disputes. Amounts in most of the cases we handle average between a few thousand dollars and the mid-teens.

With improvements to our fee structure (which went into effect Feb. 1, 2010), in conjunction with previous changes to the notification service and simplified program participation, we expect to be able to give back $4 million to the industry during this year. Some fee reductions have come in the areas of uninsured motorist and special filings, deferments and reschedules, and in award pays, challenges to deferments, and coverage denials.

Along with the fee reductions, we continue to explore the advancement of the services we offer. Our services also help preserve relationships among companies when disputes could grow bitter or head to the courts.

Q. Your web site offers assistance with subrogation claims involving homeowners, commercial property, inland marine coverage, and damage to vessels on navigable waters within the geographic limits of one state. With Florida's immense number of property transactions, is this among the most utilized forums you offer?

A. The property forum is one of the many forums we offer. However, auto damage issues comprise one of the largest areas of disputes we help to resolve. Arbitrated auto property and physical damage, multiple-vehicle and bodily injury claims help not just insureds, but also opposing companies who need to work together in the future.

Q. What are the advantages of the special arbitration forum that deals with defective construction disputes?

A. AF responded to recent changes within the insurance industry by implementing the construction defect enhancement to our special forum. Its key benefits include reduced litigation and claim expenses, reduced cycle times, and improved productivity. Coverage and liability disputes between general contractors and subcontractors and their respective insurers often get resolved with AF's help.

Q. You clearly have a strong dedication to using technology throughout your operation. What are some of the innovations in use now?

A. We have invested a great deal of resources into enhancing our use of technology in ways that improve how our members do business both with AF and with one another. Those initiatives include our online filing system, which provides a paperless alternative to filing or responding to arbitration. More than 92 percent of the filings in 2009 were made electronically. AF continues to work hard to create a paperless arbitration environment that reduces expenses for members, lowers cycle times, and supports our green philosophy.

Q. Talk about your other big paper-saver, the no-fee E-Subro Hub system that eliminates paper and allows participants to track the progress of subrogation demands and provide performance data.

A. E-Subro Hub is a free, web-based electronic communication, document, and claim management tool that provides our membership and the industry with a more efficient method to process their subrogation demands and responses. Right now we are focusing on auto, but other forums will be added. The E-Subro Hub system tracks all activities, so every task's performance can be measured and reported on to improve business productivity. Our previous work was in arbitration, but now with so much of the procedure electronic, the average time from filing to closing is 16.2 days, proving E-Subro Hub significantly reduces cycle time compared to using the traditional mail and fax methods. After extensive pilot testing last year in the mid-Atlantic states and Massachusetts, in April the system was expanded into California and Pennsylvania, two of the largest states in the subrogation market. Expansion continues throughout the rest of this year. E-Subro Hub will be in use in Florida in October and rolled out in 26 of the largest states by the end of 2010, with upwards of 60 percent of the market participating. PIP and Med Pay are in our plans for the future for E-Subro Hub.

Q. You claim to save the industry huge amounts of money and time. How does that play out in individual offices or companies?

A. Each company's business model will dictate the individual financial outcomes from using our products and services. The free services available on our web site such as E-Subro Hub, webinars, and on-site training, plus substantial litigation cost-avoidance make our offerings integral to any claims organization.

Q. Your web site www.arbfile.org offers online tutorials and webinars to provide the basics for filing or responding to cases in arbitration. Who should be visiting your site to consider your subrogation/arbitration services?

A. Anyone involved in claims adjusting should be very familiar with our products, services, and forums. Our forums allow for recovery and dispute resolution in physical damage, workers' compensation, bodily injury contribution, property/building, PIP and Med Pay, concurrent coverage, and uninsured motorists claims. We resolved 22,000 disputes in Florida in 2009.

Special Reports /

Resolving Insurance Claim Issues Outside of Court

Related Stories

Recommended For You