The claim was decades old; indemnity was supposedly fully paid. The carrier hadn’t paid a medical bill in years. The applicant had dismissed her attorney, but continued to pursue the claim.
The carrier wanted the claim off the books, so they called me. Without prompting, the adjuster disclosed his authority limit to me in an email.
The applicant, the carrier’s hearing rep, and I met for mediation.
While there was no question the applicant was disabled, the dispute was whether the disability was industrial. Thankfully, the applicant had a very good alternate form of medical insurance which had been providing and continued to provide full coverage.
I spent time with the parties separately, allowing each of them to vent about how they had been taken advantage of by the other. Issues were raised, demands and offers exchanged. While remaining neutral, I empathized with both parties, discussing pros and cons. Finally, the hearing rep made what he said was an offer of his full authority. I showed him my print-out of the email which showed authority for an additional $15,000.
He stared at me. “I have to make a call.”
“Let’s make it together,” I said.
We got on the phone to the adjuster who said the hearing rep was correct. “Mike” (not the real name), I said, “Are you able to take a look at your email to me of [the email date]?”
“Yes, I see it.”
“That says your authority is $15,000 more.”
“Oh, I didn’t have that authority. I never had that authority.”
I did NOT say, “Then why did you tell me that’s what you had?”
Instead, I went to the room where the applicant was waiting and put the hearing rep’s offer on the table.
“I have to call my spouse.” I left the room to give her some privacy.
After a little while, the applicant told me her spouse said the offer was an absolute non-starter.
The hearing rep stated he had to leave for another commitment, and the mediation adjourned without resolution.
A few days later, the applicant called me to ask if the offer was still open. I said I would check.
The case settled by Compromise & Release for the amount of the hearing rep’s offer.
Parties sometimes need time to process everything that happened at mediation. They may have learned about new issues or gained new insights about the basis for the opponent’s position. People often have a negative kneejerk reaction to a demand or offer. After some time to cool down, they may be able to understand a different point of view, even if they don’t agree with it.
Think about why this case settled. What did the applicant gain by being able to talk about the claim with the mediator? What do you think happened between her and her spouse once she got home? What can you conclude about pre-mediation communication between the adjuster and the hearing rep, between the adjuster and the applicant?
How important is it to have everyone who will participate in making the settlement decision attend the mediation?