One of the most common questions posed by our clients is, “What does a well documented claim file consist of?” Below is our response.
Throughout the life of the claim or litigated case, the file activity notes should contain chronological documentation of activities, and the cause and effect of these activities as they relate to exposure. Received and generated correspondence should be uniformly stored and identified for ease of access.
A properly documented claim file or litigated case, as applicable, should contain activity notes that contain at a minimum:
• A clear, detailed description of the claim being made.
• Known facts and unknown information needed.
• An initial plan of action.
• A prompt and detailed initial investigation with documented results.
• An assessment of that investigation as it relates to liability and damages.
• A detailed documented rationale supporting the loss reserve and as needed, expense reserves.
• An updated assessment of liability, damages and reserve changes as needed, and a revised
detailed plan of action based on the results of any new or developing information.
• Files in litigation should contain an initial case evaluation report from defense counsel that
details initial case analysis, a litigation budget, and a proposed litigation plan.
• Defense counsel should provide a meaningful updated status every three to six months
depending on the stage in the life of the file.
• The file notes should contain a summary and analysis of all documents received. The notes
should reflect that the document has been read and its effect on the exposure.
• A summary of any roundtable discussions or supervisory direction as applicable.