Claims Handling
When claims occur, you can rely on United Educators (UE) for effective claims resolution.
Thoughtful Claims Handling
Our Cool Head, Warm Heart® approach addresses both the claimant’s personal and emotional concerns and your institution’s financial needs.
Our staff of resolutions professionals, together with select outside defense counsel, provide the individual attention each claim deserves. Through early case evaluation and litigation management, we help our members reduce the expense, time, emotional toll, and unpredictability of litigation.
We’ll work to protect your interests in reaching a fair and equitable resolution of claims. And a senior resolutions officer is available 24/7 should a catastrophic event occur.
ProResponse®*, our supplemental crisis response program, provides members with expert guidance to recover from situations such as allegations of sexual misconduct or financial scandal, or death of a member of the educational community.
Members benefit from our pre-claim advice credit*, which reduces their self-insured retention when they seek early advice from UE-selected counsel for an incident that later becomes a claim.
*Subject to terms and conditions.
Video
Ellie Kennedy, Vice President of Resolutions Management and General Counsel, shares how UE's Cool Head, Warm Heart® philosophy brings a thoughtful, compassionate response to claims.
Resolutions Team
UE offers unsurpassed claims service to our members. UE’s Resolutions analysts and counsel receive about 2,000 claims per year and handle over 3,000 ongoing claims at any given time. Our Resolutions department is organized to optimize resources, meet our members’ claims handling needs, and prepare for future innovation and growth.
Collaboration among member representatives, outside counsel, and UE’s mission-driven Resolutions team ensures effective claims resolution. UE’s resolutions counsel and analysts, along with our outside expert counsel, realize every claim is unique and give individual attention to each one.
The Comprehensive Resolutions Group handles our high-frequency, low-severity claims. It is a high-volume operation staffed by talented professional analysts. Matters with higher risk exposure or complexity are managed by our experienced counsel within our Specialty Resolutions Group.
With our experience in solely handling education claims, UE knows how to balance the costs and benefits of a settlement with mounting a rigorous defense on an issue of principle. Recognizing that prolonged disputes demand resources from all parties, we craft strategies to develop good legal outcomes. UE has represented our members all the way to the Supreme Court, winning the legal challenges and establishing important precedents. While cases of this complexity are not the norm, UE is prepared to go to extensive lengths to protect each member, thereby protecting all members.
After Reporting a Claim
After reporting a new matter you will receive an automatic email response acknowledging receipt of your claim. A Resolutions department representative assigned to handle your institution’s claim will usually contact you to discuss the claim soon after it is reported.
Once a claim has been made, don’t discuss the matter externally — especially with the media — without consulting your UE claims representative. Don’t sign or accept any releases from any parties without obtaining approval from us. Accept all correspondence, memoranda, suit papers, and the like without comment or argument. Don’t admit liability and don’t attempt to place blame.
Handling Claims
As the claim proceeds, UE will investigate and evaluate potential exposure. Over the life of the claim, we will work with you to evaluate various strategic options and courses of action.
When needed, UE will appoint vetted local defense counsel to represent your institution’s interests. Prior to appointment, our defense counsel must agree to conduct the defense in accordance with UE’s defense counsel guidelines. This includes providing written status updates and defense budgets when requested. The guidelines provide for the communication and accountability necessary for UE to help in the timely resolution of the claim and to approve costs reimbursed under your policy.
UE collaborates with our members to ensure that we reach the right outcome for each claim. Therefore, we will make recommendations, in consultation with your institution’s representative and any outside counsel, about whether the case should be defended or settled.
Medicare Reporting
As of Jan. 1, 2010, Section 111 of the Medicare, Medicaid, and SCHIP Extension Act (MMSEA) set forth mandatory notice and reporting requirements under the Medicare Secondary Payer (MSP) Statute relating to liability and no-fault cases. This placed an affirmative obligation on UE to determine if a plaintiff/claimant is a Medicare beneficiary and notify Medicare of settlements, judgments, awards, or other payments to or on behalf of Medicare beneficiaries. The penalty for failing to report any settlement, award, or payment to a Medicare beneficiary is severe. Therefore, UE must have the requested information in order to verify a claimant’s Medicare status and comply with the reporting obligations provided by Section 111 before issuing any payment.
For each primary general liability (GL) and educators legal liability (ELL) claim, in order to meet our MMSEA reporting requirements, we request that claimants provide:
- Full legal name
- Date of birth
- Gender
- Social Security number
- Medicare Beneficiary Identifier (MBI)
For additional information on Section 111, please refer to the FAQs below and visit the CMS website.
Other Insurance
Coverage for a claim also may be provided by another insurance policy, such as:
- General liability
- Educators legal liability
- Trustees and officers liability
- Professional liability
- Police professional
- Media liability policy
To protect your interests, submit notice of a claim to any potentially responsible carrier. Discuss any questions with your Broker or UE Resolutions representative. Other risk-shifting or indemnification mechanisms also may be in place, and your UE Resolutions representative may follow up with questions about indemnification arrangements or tendering a claim to other parties.
Expect the Unexpected
As society evolves, claims trends and defense strategies evolve as well. UE extensively studies claims data to identify patterns and enable members to proactively mitigate risks. Tenure denial challenges, sexual misconduct allegations, athletics injuries, and school bus accidents have an established history. But as trends emerge on issues such as traumatic brain injury, active shooters, and Title IX compliance, we inform our members and provide resources and forums for sharing information.
We will continue to use our growing knowledge to help our members prevent and reduce risks. And when incidents occur, UE will be there every step of the way.