Over 550 member arbitrators attended our February arbitrator workshops. The purpose of these 30-minute workshops is to drive decision quality by:

• Sharing information with arbitrators on recent decision quality trends and drivers.
• Answering questions arbitrators may have on hearing cases.

February’s topics and key takeaways included the following:

Shared Evidence – Revisits

• Evidence must be attached to the damages section in support of the feature damages.
• Evidence can be submitted during the revisit as part of the recovering company’s rebuttal to refute the damage dispute. 
• The arbitrator will determine if the evidence attached to the initial filing adequately supports the feature damages. 
• It is at the arbitrator’s discretion to determine if the revisit evidence has been submitted to refute the damage dispute.  

Shared Evidence – Proof of Payment

• A jurisdictional exclusion (JE) can be raised for no proof of payment. A responding company would need to have a valid reason as to why proof of payment is necessary.    
• Self-insureds are not required to submit proof of payment for damages incurred to their vehicle. 
• Since evidence is shared in the Auto forum, an arbitrator may award damages when the only supporting documentation for the feature damages is proof of payment, as long as damages are not in dispute.

Operating Expenses
Under Article First: Compulsory Provisions in the Reference Guide, insurers and self-insureds cannot recover:

• Insurer and self-insured operating expenses (associated with investigating and adjusting losses).
• Insured out-of-pocket expenses.
• Insurer or self-insured administrative fees as “costs” for pursuing a loss.

Insurer and self-insured operating expenses include:

• Costs that could apply to both insurers and self-insureds
• Costs related to adjusting the claim (investigation fees, adjuster fees, accident reconstruction, appraisals, etc.)
• Self-insured administrative fees that are costs associated with pursuing the loss
• Costs that are not insurer or self-insured operating costs include:
  • Tow company charges (gate fees, cleanup, dolly fees, administrative fees, etc.)
  • Body shop fees (administrative fees, storage, vehicle wrapping, etc.)
  • Other third-party charges

How to Respond to a Post-Decision Inquiry (PDI)

• You can use the links provided in the PDI email received. 
• You can access the PDI from the “My Support Inquiry” tab. 
• The PDI can be reviewed using the “View in Workflow” feature. 

When responding to the PDI:

• Please respond in a timely manner. The members are awaiting a response for a possible error.
• You cannot make changes to the decision. Any changes will be made by AF on your behalf.
• Using the link to respond uploads your response into the PDI. 
• Only AF can see what the member has written in the PDI. 
• Please ensure you address what was specifically asked in the PDI email. 

Quick Tips

• Cashed Payment Status 
  • Copy of a cashed check proved the payment has been honored. 
  • EFTs are treated as cashed payments. 
• When to Proceed
  • A responding company admits 100% liability in a two-party case. 
  • In a multi-party case, you will need to review the liability arguments presented even when one of the companies has admitted 100% liability.
• Concurrent Coverage Denials
  • Rule 2-4 clarifies that a coverage denial based on concurrent coverage/primacy of policies does not remove a party/case from the arbitrator’s jurisdiction.
  • A liability or damage argument can be made stating the damages were due to normal wear and tear and this type of damage is excluded from the policy. This is the issue in dispute and would proceed for the arbitrator to decide the issue.

Our next arbitrator workshops will be held on June 23 and 25 at 2 p.m. ET. Visit the Training Enrollment page to view the schedule and enroll. We hope to see you there!