Mediating Insurance Claims in Texas Lawsuits: A Ft. Worth Mediator's View
As a Texas mediator and attorney with experience handling complex insurance lawsuits, I have often observed that the most successful mediations are driven by a deep understanding of what insurance adjusters need to see to authorize a settlement. An adjuster’s primary goal is to evaluate risk, verify damages, and justify the claim payment to their internal committees, which often requires more than just a emotional appeal. Best practices dictate that the claimant or plaintiff must provide clear, objective documentation—such as medical records, repair estimates, and, where applicable, expert reports—well in advance of the session. Providing this information early allows the adjuster to evaluate the claim's merits, which is critical in Texas, where claims-handling duties and potential extra-contractual, or "bad faith," claims are heavily scrutinized.
Effective preparation for a Texas mediation means treating the session as a mini-trial rather than just a check-the-box negotiation. I advise parties to prepare a concise, persuasive mediation statement that outlines the facts, relevant law, and a realistic evaluation of damages, supported by evidence. For insurance companies, seeing a well-prepared plaintiff who has already demonstrated their ability to present evidence at trial increases the likelihood of a favorable settlement. The goal is to show the adjuster that the risk of a lawsuit going forward—including legal costs and potential jury exposure—outweighs the cost of settling now.
Understanding the adjuster’s perspective in Texas also involves recognizing that they often have specific authority and must work through a structured, often slow, decision-making process. A common mistake is getting frustrated by a low initial offer or slow progress; however, the adjuster is likely waiting for the mediator to shuttle back and forth to justify increasing their authority. It is essential to have the appropriate, high-level decision-makers present, or at least available, to avoid the frustration of a stalled mediation. A patient, methodical approach that allows the adjuster to see the evidence and build their own internal case for settlement is usually the most productive strategy.
Another key aspect of successful mediation in Texas, particularly when dealing with insurance, is managing the emotional and non-monetary aspects of the claim. While the monetary, or "special damages," are the focus, the adjuster also assesses the credibility of the parties involved. Personal attendance of the claimant can help build this credibility, allowing the adjuster to "size up" the witness and understand the impact of the loss, which can be harder to convey through paperwork alone. The mediator's role is to bridge this gap, ensuring that both sides, particularly the insurer, feel they have a complete, honest picture of the dispute before signing a binding settlement agreement.
Finally, preparing for the worst-case scenario—no settlement—is an essential part of the process. If mediation does not resolve the case, having a clear plan for the next steps is crucial, such as engaging in further, targeted discovery or using a mediator’s proposal to bridge the gap. A good mediator will often continue to follow up with the parties after a session, as many complex insurance cases settle in the days or weeks following the official mediation day. The best practice is to view mediation as a crucial, well-prepared step toward resolution, where understanding the adjuster's needs and the legal landscape of Texas, provides the best path to success.