This page contains a Flash digital edition of a book.
quired to send “to the insured a copy of the [carrier’s] response.” Md. Ins. Art. §27-1001(d)(4)(ii). The insur- er’s answer to the claim, due “within 30 days after the date the filing is forwarded to the insurer,” must in- clude a “written response together with a copy of each document from the insurer’s claim file that enables reconstruction of the insurer’s activities relative to the insured’s claim, including documentation of each pertinent communication, transaction, note, work paper, claim form, bill, and explanation of ben- efits form relative to the claim.” Md. Ins. Art. §27-1001(d)(4). Typically, Commissioner Tyler relates, the car- riers send the claims file, coupled with a narrative from counsel explaining the insurer’s position. And when it comes to opinions the carrier received from attorneys, he


believes these are not shielded from production, if the carrier asserts advice of that counsel as proof of good faith.


4. MIA Decision by a Retired Judge. Within “90 days after the date the filing was received by the Admin- istration, the Administration shall issue a decision . . .” Md. Ins. Art. §27-1001(e)(i). A “failure by the Administration within” this time period “shall be considered a de- termination that the insurer did not breach any obligation to the insured.” Id. at §27-1001(e)(ii). A party in receipt of an “adverse rul- ing” has two options:


A. Administrative Appeal: Within 30 days of the “adverse decision,” a party can seek de novo review of the MIA’s ruling before a judge from the Office of Administrative Ap- peals. Md. Ins. Art. §27-1001(f). A


further appeal of the Administrative law judge’s decision can be taken to the Circuit Court, where the matter is “heard de novo.” Md. Ins. Art. §27-1001(g).


B. Civil Suit for Bad Faith: Once a “final decision” is entered in the MIA claim, the aggrieved insured can sue the carrier for first party bad faith. Md. Cts. & Jud. Proc. Art. 3-1701(c)(1). Note that claims within the “small


claims jurisdiction of the District Court,” or for benefits under “a com- mercial insurance policy on a claim with respect to that which the applicable limit of liability excess $1 million” can be filed in the Circuit Court, without first submitting them to the MIA. Also, the parties can agree to “waive” the MIA exhaustion requirement. Md. Cts. & Jud. Proc. Art. §3-1701(c)(2). Also worthy of note, is that the Cir-


cuit Court, whether by a jury or judge trial, can award damages that include, litigation expense and attorney’s fees, if the carrier that acted “failed to act in good faith.” Md. Cts. & Jud. Proc. Art. §3-1701(e).


Conclusion So, it is Commissioner Tyler, who is


the best witness to testify about “noth- ing” − that the horrors forecasted by the insurance industry never materialized. Claims come in, responses are submit- ted, and retired judges adjudicate the claims, and life as we know it has not ceased to exist. Back when the bill was being debated,


one had to wonder why the insurance industry, who told legislators adjusters that they always acted in good faith, had a good “reason” to believe that the new law would swamp the system with claims by their customers. With the new law in place, one can equally muse over why, now that the insurance industry is aware it can be sued for bad faith, its policyholders are not showering the MIA with bad faith claims. H.L. Menken said, “Conscience is the inner voice that warns us somebody may be looking.” Could it be that, thanks to the adoption


28 Trial Reporter Summer 2008


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76