Ala. Admin. Code r. 482-1-135-.07

Current through Register Vol. 43, No. 02, November 27, 2024

Section 482-1-135-.07 - Mediation Conference

(1) The insurer will produce at the conference a copy of the policy and will bring the entire claims file. The insurer is not required to allow the insured to review or copy the claims file. The representative of the insurer attending the conference must be familiar with and know the facts and circumstances of the claim and have authority to settle the claim on behalf of the insured. The insurer will be deemed to have failed to appear if the insurer's representative lacks authority to settle the claim and the ability to disburse the settlement amount at the conclusion of the conference. Insurer's representative satisfies the requirements of this Paragraph if he or she has immediate access to a person who has authority to settle the claim.

(2) A party may move to disqualify a mediator for good cause at any time. The request shall be directed to the Department if the grounds are known prior to the mediation conference. Good cause consists of conflict of interest between a party and the mediator, that the mediator is unable to handle the conference competently, or other reasons that would reasonably be expected to impair the conference. Upon a showing of good cause, the Department will appoint a new mediator pursuant to the procedure set out in Chapter 482-1-135-.06.

(3) On or before the date set for the conference, the insurer shall pay $350 to the Alabama Department of Insurance to defer the Department's costs which includes the mediator's fee. If the mediation is cancelled for any reason within 48 hours of the scheduled mediation time and date, the party canceling the mediation will pay the mediator $175 and the other party will not owe the mediator's fee. If either party fails to appear at the conference, without good cause as determined by the Department, that party shall pay the other party's actual expenses incurred in attending the conference, shall pay the mediator's $350 fee, and the conference shall be rescheduled at a mutually convenient time upon the non-showing party's payment of an additional mediator's fee of $350. If the insurer fails to appear at the conference, without good cause as determined by the Department, the insurer shall pay the insured's actual expenses incurred in attending the conference and in any event shall pay the mediator's fee. Failure of a party to arrive at the mediation conference within 30 minutes of the conference's starting time shall be considered a failure to appear. Good cause shall consist of severe illness, injury, or other emergency which could not be controlled by the insured or the insurer and, with respect to an insurer, may include the inability to attend due to handling other hurricane-related or tropical storm-related claims and whose non-attendance could not reasonably be remedied prior to the conference by providing a replacement representative or otherwise.

(4) Upon request of the insured or the mediator, a representative or attorney of the Department will be available to help insureds prepare for the mediation conferences. A representative or attorney of the Department will be present at the conference if requested by a party or the mediator to offer guidance and assistance to the parties. Representatives attending the conference shall not assume an advocacy role but shall be available to provide legal and technical insurance information. Any request for assistance shall be submitted in writing to the Department at least 14 days prior to the scheduled mediation conference.

(5) The mediator will be in charge of the conference and will establish and describe the procedures to be followed. Mediators shall conduct the conference in accordance with the standards of professional conduct for mediation. Each will be given an opportunity to present their side of the controversy. In so doing, parties may utilize any relevant documents and may bring any individuals with knowledge of the issues, such as adjustors, appraisers or contractors, to address the mediator, with each party bearing their own expenses in providing said documents and individuals. Attorneys are not permitted to attend or participate in a mediation conference held pursuant to this chapter, except for the attorney or representative of the Department. The mediator may meet with the parties separately, encourage meaningful communications and negotiations and otherwise assist the parties to arrive at a settlement. Both parties must negotiate in good faith. A party will be determined to have not negotiated in good faith if they, or a person participating on their behalf, continuously disrupts or otherwise inhibits the negotiations as determined by the mediator. For purposes of this claims settlement process, mediators shall be deemed agents of the Department and shall have immunity from suit. All statements made and documents produced at a settlement conference shall be deemed settlement negotiations in anticipation of litigation, shall not be public records, and shall not be subject to discovery or admissible in a civil action.

Author: Commissioner of Insurance

Ala. Admin. Code r. 482-1-135-.07

New Rule: December 21, 2005; effective December 31, 2005. Filed with LRS December 21, 2005. Rule is not subject to the Alabama Administrative Procedure Act.

Statutory Authority:Code of Ala. 1975, § 27-2-17.