CAMICO's Claims Handling Process
The Claims Department's strategy toward claims handling includes a proactive approach and a strong emphasis on risk management. Our team of well-trained claims specialists, most of whom hold law degrees, possesses many years of experience in the handling of accountants professional liability claims. To date, the specialists have used their expertise in managing more than 15,000 incidents that could have led to claims. On an average, our hotlines receive more than 750 calls from policyholders each month, one-third of which concern problems that have the potential to become claims.
To quantify CAMICO's claims experience, nearly 100 characteristics of each claim are collected and analyzed in our sophisticated policy management computer system. This data provides CAMICO with better underwriting procedures, timely actuarial information and effective claims management. Additionally, information concerning the causes of claims can be determined and addressed by developing appropriate risk management techniques.
There are three basic steps that are followed when handling claims:
1. General Philosophy and Approach
Consistent with the company's mission, the claims function at CAMICO solves professional liability problems for the insured in a way that balances the interests of each insured and the company. CAMICO's goal is to treat all insureds and claimants fairly and equally so that claim problems are resolved efficiently and expeditiously.
Every claim is an opportunity to demonstrate to the insured CAMICO's superior services, expertise and personal approach.
2. Early Intervention, Evaluation and Resolution
Problems are best solved if they can be identified and addressed as early as possible, often even before they are at the claims stage. This requires motivating insureds to notify CAMICO early on, so that we can provide timely and meaningful services and assistance. Insureds will not be penalized for early notification.
As a CAMICO policyholder there simply is no reason for not calling our hotlines to report circumstances likely to give rise to a claim. Such early reporting protects your rights under the policy and may qualify you for a reduction in your deductible. CAMICO does not surcharge for claims or potential claims, so early reporting will not increase your premium. Most importantly, we may be able to help you avoid or minimize a claim.
Often before early intervention occurs, an evaluation of the problem and potential solution needs to be completed. This evaluation may lead, if appropriate, to attempts at early resolution of the matter through a variety of means, including settlement with a claimant, repair work on behalf of a claimant or other appropriate means. Claims are handled by a team including the insured, the CAMICO representative, and external attorneys and consultants.
The CAMICO representative is responsible for coordinating the efforts of the team members and making strategic decisions after seeking the advice of the other team members. The CAMICO representative will consult with the team and insured before making any offers or negotiating settlements. When the insured has not committed an error and there is no exposure, the costs of providing a defense are not used to justify a loss payment. Early action minimizes the impact of professional liability problems on the insured and leads to better claims results.
3. A Focused and Active Defense
The defense of claims is done in a focused manner. Upfront analysis results in the development and implementation of a plan to resolve the matter. Periodically, the plan is reviewed and modified, as necessary. While there are occasional exceptions, defense efforts are proactive rather than passive and reactionary. This is especially true for litigated matters.
CAMICO Claims Specialists
Mark Aubrey is a claims specialist with CAMICO and has been with the company since 1994. He brings 25 years of claims handling experience and over 20 years of litigation management experience to CAMICO's policyholders, including expertise in employment practices matters. Mark has handled claims and managed litigation in virtually all 48 contiguous states and Hawaii and has been involved in some of the largest and most complex exposure cases managed by the CAMICO claims department.
Hunter Colby is a claims specialist with CAMICO and has been with the company since 1990. He has over 20 years of experience in claims, with expertise in claims avoidance and mitigation procedures. He earned his bachelor's degree from State University of New York at Stony Brook and his Juris Doctor from Peninsula University in Mountain View, California. Hunter is a member of the State Bar of California.
Michael Davenport, J.D. has been a professional liability claims specialist with CAMICO since 1988. He has managed claims since 1983 and has handled accounting malpractice claims, developing expertise in avoidance and mitigation procedures related to potential malpractice claims, since 1988. He earned his bachelor's degree from the University of Hawaii-Manoa and his Juris Doctor from Southwestern University School of Law.
Samantha Feanny, J.D. is a claims specialist with CAMICO and has over 10 years of legal and case management experience. She joined CAMICO in 2006 after having worked in the litigation unit for a major home improvement retailer. She earned her bachelor's degree from Georgia State University, and her Juris Doctor from Georgia State University School of Law.
Gerard Mack joined CAMICO as professional liability claims specialist in 2008. Prior to that he had 10 years experience in the legal field and 5 years of managing liability litigation. Gerard attended John Jay College of Criminal Justice in New York and received his Bachelor of Science in Forensic Psychology.
Andrew Rustad, J.D. joined CAMICO as a professional liability claims specialist in 2009. He received his bachelor's degree from the University of Illinois - Chicago and his Juris Doctor from Golden Gate University School of Law in San Francisco. While attending law school, Andrew served as an intern at the California Department of Insurance, Enforcement Division.
Steve Saunders is a senior claims specialist and former manager of CAMICO's Atlanta office who joined the company in 2002. He has 30 years of claims experience with over 20 years in professional liability claims handling and management. Steve also has experience in loss prevention education. A University of Georgia graduate with a degree in business management, he holds the professional designation of Casualty Claims Law Associate and is a member of the Atlanta Claims Association and the Society of Claims Law Associates with the American Educational Institute.
Irene Shpolyansky joined CAMICO as a professional liability claims specialist in 2010. She has over 15 years of experience working in various aspects of the insurance industry and over 6 years of experience in handling professional liability claims. Irene received her Bachelor of Arts degree in English from the University of California at Davis.
Tag Wilson has been a claims specialist with CAMICO since 2001. He has more than 30 years of claims handling, loss prevention and risk management experience, mostly in accountants and construction/design litigation. He earned his bachelor's degree from Bethany College in West Virginia in 1976.
Phone: 1.800.652.1772
Fax: 1.800.227.2090
Email: claims@camico.com
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