| EXECUTIVE
SUMMARY |
IN BUDGET-CONSCIOUS TIMES
MANY COMPANIES MISS the
opportunity to recover hundreds and
thousands of dollars each year through
the subrogation processfiling
claims against third parties responsible
for causing damage or injury to companies
and their assets when these losses are
uninsured or fall below the policy
deductible. In these instances the
company has to take the steps the insurer
would if it was involved. THERE ARE SEVERAL STEPS CPAs
CAN TAKE TO HELP minimize the
financial impact of property losses. The
first is to immediately activate an
investigation team to preserve evidence
and inform the authorities and any
potentially adverse parties of the
companys loss.
THE SECOND STEP AFTER A LOSS
IS TO DEVELOP the claim. Primary
responsibility for this lies with the
companys insurance or legal
department, but CPAs will need to
calculate the dollar amount of damages in
terms of lost production days, delays and
lost business opportunities. The
accounting department also likely has
copies of contracts, service agreements
and guarantees related to the work that
caused the damage.
THE THIRD STEP INVOLVES
EVALUATING DAMAGES the company
suffered to its building and interior
contents, and business interruption due
to lost or delayed business. The company
may want to hire an adjuster to help with
this process.
CPAs SHOULD HELP COMPANIES
CREATE AN ACTION plan they can
implement when a loss takes place. The
plan should identify the employees within
the organizations engineering, risk
management, accounting and legal
departments who will respond to a new
loss. Managers should be trained in how
to identify, preserve and protect
potentially valuable evidence of a loss.
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| JOSEPH A. GERBER, JD, is cochair
of the crisis management department and
ELLIOTT R. FELDMAN, JD, is chair of the
subrogation and recovery department at
the international law firm of Cozen OConnor
in Philadelphia. Mr. Gerbers e-mail
address is jgerber@cozen.com. Mr. Feldmans e-mail
address is efeldman@cozen.com. |
n
these days of corporate belt-tightening,
companies are understandably concerned with
dollars that drop to the bottom line. Yet, there
is one largely unnoticed area of operations that
could deliver hundreds of thousands of dollars
each year: subrogation and recovery. Subrogation
is a legal process that permits an insurance
companyafter paying a policyholders
claimto sue one or more third parties
responsible for causing the damage or injury to
the policyholder. The goal is to recoup the
insurance payments, plus the policyholders
deductible. Even when an insurance company
isnt involved in the loss, CFOs and CPA
financial managers at many types of companies can
use the same practices and procedures to recover
lost profits.
With the significant increase
in property and casualty insurance premiums,
companies have been raising their policy
deductibles or the amount they
self-insurethe loss the company will absorb
thats not covered by insurance. Typically
the larger the deductible or self-insurance
amount, the lower the premium.
When a property or casualty
loss is less than the deductible amount or is not
covered by insurance, CPAs can help companies
recoup some of these losses by putting a team and
a process in place to immediately investigate the
loss and pursue recovery in court against the
responsible parties. This article describes how
to assemble such a team and what it should do to
get maximum recovery.
Subrogation
A legal term, the
literal meaning is standing in the
shoes of. In an insurance context,
subrogation involves the substitution of
one party (the insurer) for another (the
insured) to pursue any legal rights the
latter may have against a third party
liable for an insurance-reimbursed loss
the insured suffered.
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A CASE IN POINT
Consider a
situation that happens time and again. An outside
contractor, perhaps a plumber or an electrician,
comes onto a commercial property to repair a
minor leak or replace an electrical fixture.
While the technician is working, or shortly
thereafter, a problem causes significant water or
fire damage to the companys property.
Typically, despite the damage
to the building and its contents and the
potential interruption of business, the total
loss doesnt exceed the deductible on the
companys property insurance policy (which
may be as high as $500,000 or more). So the
company promptly repairs the damages at its own
expense and resumes operations.
Most companies dont think
about filing a claim or lawsuit against the party
responsible for the loss to regain the
companys repair and downtime costs. If the
damages had exceeded the deductible, the
insurance company would have pursued recovery
against the wrongdoer; why shouldnt the
companys financial management team do the
same thing on the companys behalf?
How much can a business expect
to recover? Companies with aggressive subrogation
programs can expect to recover upwards of 5% to
20% of the losses they sustain. In virtually all
companies, a certain percentage of losses
ultimately will be attributable to the actions of
the companys own employees without any
third-party responsibility.
THREE
STEPS TO RECOVERY
To assist
companies with their recovery efforts and thus
help minimize property and casualty losses, CPAs
should understand three steps insurance companies
typically take in cases of property damage.
Step
1: Begin
an immediate investigation. Since
the first step in any successful recovery is
proving responsibility for the loss, CPAs should
immediately activate an investigation team to
preserve evidence. In addition to the
companys corporate accounting department or
CPA firm, players assembled or waiting in the
wings should include in-house counsel or the
companys outside law firm, forensic
consultants, insurance adjusters (even for
self-insured losses which must be
adjusted for accounting and tax
purposes) and experienced recovery counsel who
can lead the teams overall efforts. The
adjusting process involves determining the cause
and amount of a loss, the indemnity recoverable
by the insured and the amount to be paid under
the terms of the policy.
The team should inform
authorities and the potentially adverse parties
(the individual or business suspected of causing
the damages) of the circumstances of the
companys loss. Depending on the facts and
circumstances and whether any personal injuries
or exposure to toxic materials occurred,
interested local, state or federal authorities
might include the Occupational Safety and Health
Administration (OSHA), the state department of
labor and industry or the appropriate
environmental protection agencies. Potential
adverse parties might include the general
contractor on the job at the time of the loss;
subcontractors such as plumbers, electricians or
HVAC providers; and the manufacturer, seller or
installer of any defective product that caused or
compounded the loss. To help begin its
investigation, the company should ask these
parties to provide all relevant information about
their product or service.
Without a rapid response, crucial physical
evidence may be lost or destroyed in the cleanup
process. This will hamper and possibly negate the
companys recovery efforts. Working with
experienced forensic consultants and attorneys
skilled in recognizing and preserving physical
evidence, the company should
Photograph evidence in
place.
Carefully tag or otherwise identify
it.
Remove the evidence and secure it to
prevent intentional or negligent destruction.
Step
2: Developing
the claim. Although primary
responsibility for putting together the claim
rests with either the companys insurance or
legal department, CFOs and CPAs will play a
significant role in helping to analyze and
finalize the damages. Although initially such
damages may be categorized as lost production
days, delays in production or even lost business
opportunities, CFOs and CPAs will be responsible
for converting the losses into dollars and cents
and for providing that information to either the
insurance or legal department.
Depending on how a company is
organized, the accounting department may have
documents critical to the underlying theories of
liability, including service agreements and
contracts, guarantees and warranties or other
documents that relate to work performed (or not
performed) by a potential adverse party. The
companys risk management and legal
departments will need to see these contracts and
related materials as they will significantly
facilitate any claims.
Step
3: Establishing
damages. Even when losses fall
within the companys deductible or
self-insurance amount, CPAs still should
calculate the loss amount for accounting and tax
purposes. Companies frequently overlook this step
or dismiss it as insignificant. Either the
in-house risk management team or an outside
adjuster should assess the damages as accurately
and thoroughly as possible and gather all
supporting documentation required to prove the
claim. (For losses that trigger coverage above
the deductible or self-insured limit, the
property insurer typically will assign a staff or
independent adjuster.) The investigation and
recovery team should work with the adjuster to
ensure a quick and fair resolution to the damage
claim.
To establish damages CPAs
should help the adjuster evaluate losses such as
Building damages. Includes
damage to a structure and its component parts
including walls, floors, ceilings and roof, as
well as electrical, plumbing and HVAC.
Interior contents. Ranges
from furnishings and fixtures to equipment and
machinery.
Business interruption. Covers
financial losses the company sustained from the
partial or total disruption of its operations.
Other. Includes
other damages that reasonably arise from the
property loss, such as lost business
opportunities or market share or other economic
impairments.
What an
Investigative Team Should Look Like
The investigative and recovery
team should include The
companys own CFO or CPA
to calculate the loss in terms of
dollars, lost production time or other
measurements potentially relevant to the
company in connection with its quarterly
or annual performance and any tax losses
attributable to casualty claims. The CFO
or CPA investigative team leaders must
coordinate their investigative efforts
with company executives and public-sector
authorities, including local, state and
federal representatives (as in police
departments, fire marshals and OSHA) and
give notice to potentially adverse
parties (manufacturer, seller or
installer of a faulty product) that may
be responsible for the cause or origin of
the loss.
Forensic
consultants to assist in
conducting the loss site examination,
including interviewing witnesses,
examining and collecting physical
evidence, obtaining applicable plans and
blueprints for the structure and ideally
reaching a professional opinion as to the
mechanism(s) responsible for the cause or
origin of the loss.
Experienced
outside recovery legal counsel
to help coordinate all activities
(especially inviting potentially
responsible parties to retain adjusters
to assess the property damage during
their own investigations).
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PLANNING FOR THE FUTURE
In addition to
understanding the process of putting together a
claim against responsible parties, its
important for CFOs and CPAs to work with other
company executives in advance to create an action
plan the company can implement when a property
loss takes place. The plan should identify the
employees in the companys engineering, risk
management, accounting and legal departments who
will respond to a new loss and assign specific
duties and responsibilities for investigating the
loss, recovering from it and assembling and
presenting any claims the company makes to its
insurance company or the third parties
potentially responsible for causing the loss.
There are financial benefits to
having such a plan in place. For example, one
large national retailer maintains a proactive
loss recovery program, relying heavily on members
of its risk management, accounting and finance
and legal departments. Additionally, outside
counsel provides critical support following
property losses.
Typically, these losses involve
damages to company buildings by delivery trucks,
leaking or ruptured sprinkler lines resulting in
water damage, fires of all sizes in both
warehouse and public retail space and occasional
collapses of ceilings or displays. Given the
companys significant property insurance
deductible of $500,000, many of these losses are
less than that amount. Accordingly, the
retailers property insurer frequently is
not involved in any loss investigation,
adjustment, payment of claim or pursuit of
third-party liability.
As the result of careful
preplanning, the department stores parent
company, working with its outside counsel,
Developed a list of
available forensic investigators and experts.
While companies dont typically keep these
experts on retainer, its a good idea to put
together a preferred list in advance of a loss.
Educated its managers on
the need to carefully investigate and document
losses and to involve both outside counsel and
outside forensic investigators. Special training
programs using case studies will help an
organization prepare its personnel for a loss.
Interactive training of loss team members will
enable the company to take a more coordinated
approach following a real incident.
Trained its managers on how
to identify, preserve and protect potentially
valuable evidence.
Instructed its accounting
department to carefully calculate any and all
losses sustained including building damage,
contents or merchandise damage, business
interruption, lost sales, loss of business
opportunity or any other damages attributable to
the casualty.
As a result of this careful
preparation, the department store chain is able
to maintain evidence of a loss, evaluate and
calculate damages and quickly notify and present
a detailed claim to potential adverse parties.
Because of its proactive approach, the retailer
has improved its bottom line, collecting
literally hundreds of thousands of dollars from
third parties in connection with otherwise
uninsured losses in recent years.
WHATS NEXT?
Subrogation and
recovery departments have become important
revenue centers for both insurance companies and
for their insured policyholders. As accountants,
CFOs or risk managers for their employer or
client, CPAs will be evaluated, at least in part,
on the basis of the quality of the recovery
programs they establish. By leading such efforts,
CPAs can take advantage of the same opportunities
that directly improve every insurance
companys profit and loss statement. To do
otherwise is to leave dollars in the pockets of
the very entities responsible for causing losses
rather than recovering them on behalf of the
organizations that suffered the damages.
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