Originally Posted By: Joseph A. Ferry
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Chris -
That there is no evidence that arbitration clauses reduce insurance losses - an averment, the truth of which you do not document - may be due to a variety of reasons having nothing to do with the issue: the sample may be too small to warrant tracking, for example.
Empirical evidence suggests that it does, to judge from the growing popularity of such clauses in other contractual contexts. See, for example, your uninsured motorists coverage, your underinsured motorists coverage, your credit card agreement and a myriad other agreements. That insurance companies insist on arbitration clauses is pretty good anecdotal evidence that they reduce costs. Reduced costs = lower premiums.
Your contention that the vast majority of a program's losses come from defense costs would make sense ONLY if the vast majority of claims resulted in NO payment to the claimant. Defense costs are a subset of Loss Adjustment Expenses [which include all claims service costs]. LAE generally represent about 20% of total claims costs, actual payments to claimants making up the other 80%.
A client once told me that "if you go to court, you both lost". That is an accurate statement of fact. No one 'wins' in court. To understand the benefit of arbitration, one needs to understand the process of going to court.
Anyone with $250.00 and a piece of paper can file suit against you. It is easy to do. After a complaint has been filed, the defendant has to respond to it paragraph by paragraph. A defendant can represent himself, of course. UNLESS the defendant is a corporation. A corporation has to be represented by an attorney. The defendant files an Answer and Defenses and sometimes a Counterclaim to the Complaint and then the plaintiff files a Reply to the Answer. There then ensues an extended period of discovery: depositions, document exchanges, expert reports. Finally, you are ready for trial. You go on a list. You eventually get a trial date. There are then pre-trial motions, witness lists, document lists. Then you try the case before, usually, six to eight folks who were the LEAST OBJECTIONABLE of an array of mostly objectionable citizens. You've spent a fortune before the first witness is sworn.
Then you try the case for a day or two, hope that you got all of your evidence in, that it was understood, that it supported your theory of the case and that your attorney was able to explain how it all worked out to your benefit in his closing argument. Then the jury retires to consider all of this evidence. Then they render their verdict and GUESS WHAT?
It's not OVER. Not by a long shot. You've got post-trial motions, appeals and on and on. It's never over - until one party gets tired of paying legal bills and settles.
It's not fun and rarely delivers justice. Notwithstanding all of that, it's better than dueling.
That's why most commercial enterprises have embraced arbitration because it is AT LEAST as fair as the judicial system and because it is OVER in a reasonable period of time. CLOSURE is a vastly overused new-agey word but it has a lot of merit in dispute resolution. There is a lot to be said for putting things behind us.
If a claimant contractually agrees to arbitration, she is BARRED from filing suit. If she does, one need only plead the arbitration agreement to have the case dismissed. One would also be entitled to one's costs in filing that dismissal.
Moreover, there is no 'public policy' against arbitration clauses. On the contrary, they have been upheld in every jurisdiction.
Your concern about rogue decisions, while understandable, is misplaced. Under the Federal Arbitration Act, 9 U.S.C. Sect 10, an arbitration award may be vacated if procured by corruption, fraud, or undue means; or if an arbitrator exhibits "evident partiality", when misconduct by the arbitrator prejudices the rights of a party or if the arbitrator exceeded his power.
NACHI Arbitrators will be subjected to exacting standards of competence, experience and character and their decisions will be reviewed and subject to reversal by a rotating review panel using familiar appeal standards.
Joe Ferry
NACHI General Counsel