MAISL ANNUAL MEETING THURSDAY, JULY 24, 2014 FRANKENMUTH, MICHIGAN Disputed Matters: Following...
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Transcript of MAISL ANNUAL MEETING THURSDAY, JULY 24, 2014 FRANKENMUTH, MICHIGAN Disputed Matters: Following...
MAISL ANNUAL MEETINGTHURSDAY, JULY 24, 2014
FRANKENMUTH, MICHIGAN
Disputed Matters:Following Proper Claims Procedure
and Avoiding Pitfalls
Presenter:Kevin T. SuttonLusk & Albertson PLC
Want to download this presentation? Do it now:
www.luskalbertson.com/maisl2014
Overview
Recent confusion regarding what is a “claim” that should be reported
Failure to report a “claim” in a timely manner could result in the denial of coverage
Central question: When Do I Have a “Claim” That Needs Reporting?
Primary questions to be answered… What things should you be looking out for? What do these various things mean? What should you do when you are confronted with
these things?
What to Watch Out For …
Lawsuits Filed with the circuit court or federal court Typically served via process server or certified mail
Charges of Discrimination Filed with the EEOC or Michigan Department of Civil
Rights Typically arrive in the mail, with little fanfare
Demands for Pre-Suit Resolution Often sent to Superintendent or HR directly
Q: HOW ARE THESE DIFFERENT? THE SAME?
Lawsuits
Most obvious need for help – you’ve been sued!Send copy of lawsuit to Gallagher Bassett upon
receiptMake notation of when you received and how it
was deliveredBegin gathering documentation/materialsPlace a hold on destruction of documents, emails Wait for assignment of counselCooperate with counsel to defend
Complaint identifies …
• The court filed in• The case number• The name of the party bringing suit• The name(s) of the Defendants• The name and contact information of the attorney filing the suit• The specific allegations lodged• The amount of “damages” sought (don’t get too excited)
Charge of Discrimination
Typically also called a “complaint”Packet of information to employerA complaint to the EEOC or the MDCR is an
allegation by an employee that their employer violated one of the statutes administered by the agency
It is the first step in the process that leads to an investigation into the allegation by the administrative agency
A complaint to the EEOC or MDCR is not a lawsuit, but it may be the precursor to one
Do I Report an EEOC/MDCR Charge?
YES!Not a lawsuit, but a possibility that Charge
will become a lawsuitNeed to alert carrier about claim when you
know about it, receive packet of informationCoverage frequently provided for
EEOC/MDCR charges under SBLL policyFailure to report Charge could result in
denial of coverage later if lawsuit is filed
Complaint Resolution - Good
Once the investigation is complete, a finding is made
If the agency does not find “reasonable cause” to believe a statute has been violated, it will issue a “right to sue letter”
“Right to sue” doesn’t mean district did anything wrong; just advises employee that they can file a lawsuit
Realistic chance of success?
Pre-Suit Demands
Not a lawsuitNot a ChargeNot filed with anyoneTypically, a letter from an attorney
Threatening a lawsuit Claiming mistreatment, discrimination, etc. May enclose a “draft” EEOC/MDCR Charge or
Complaint Expressing desire to “work something out”
Do I Report a Pre-Suit Demand Letter?
YES!Want to make carrier aware of potential
disputeCoverage may be available
Want to protect coverage if there is a lawsuit Coverage esp. helpful if decide to mediate - carrier may
be able to contribute to resolutionIf litigation is inevitable, gives time to get
organized, review situation, make coverage determinations early
Time is on your side
Other Events to Watch For
Student injuries Think big, esp. head Think about injuries in a global fashion; not just
sprained ankles and broken bones Sexual assault
Employee issues Harassment/bullying Hostile work environment
Remember
Is this issue something that it likely to turn into a claim?
Likely?Possible?Better to err on the side of caution
Report and have nothing happen Better than being aware of claim, not reporting, and
potentially missing out on coverage
A Difficult Reality
Cannot avoid … Charges of Discrimination (EEOC/MDCR) Lawsuits Demands for pre-suit resolution
Can … Follow proper procedure to ensure
coverage Prepare your District to be in the best
possible position to respond to claims when they arise
Rely on MAISL and partners to navigate treacherous waters
Questions?
Kevin T. Sutton40950 Woodward, Suite 350
Bloomfield Hills, MI 48304-5129
Direct: (248) 988-5695Cell: (734) 377-7400
Email: [email protected]