Gilbert, Kelly, Crowley & Jennett LLP

Unfair Claims/Coverage

Workers' Compensation

Recognized as the leader in the deterrence and aggressive defense of fraudulent claims, GKC&J has gained the respect and admiration of law firms around the country for its unparalleled expertise and success in handling landmark cases.

One of the best examples of this remarkable department is when GKC&J served as lead counsel in one of the largest civil RICO suits brought by the insurance industry against doctors, attorneys and others for violations of white-collar criminal statues and fraud.

The strength of this department lies in a first rate team of attorneys, each one of whom specializes in the defense of fraudulent and suspect claims and who acts as support to the Workers' Compensation Department, which also aggressively defends suspect claims.

The key to their phenomenal success lies in GKC&J's sophisticated information tracking systems that are designed not only to facilitate the defense of these types of matters, but to do so cost effectively. These systems track key information, thus enabling the firm to develop statistics and conduct pattern analyses of high-volume suspicious or fraudulent claims operations.

The highly-trained teams in the Fraudulent Claims, SIU Support and Workers' Compensation Departments have been instrumental in establishing SIU (Special Investigation Unit) operations for other companies, as well. They have led sold-out seminars on fraud awareness and prevention techniques to associates of insurance carriers, risk managers, and self-insured companies.

These seminars focus on everything from high-exposure cases and claims-handling practices for special investigations to settlement tactics in negotiating suspicious claims and litigation techniques used in connection with the dismantling of fraudulent and suspect claims.

To underscore the outstanding achievements that GKC&J has made in this arena, one of its own senior partners has long been lauded as a contributing author to the John Cooke Fraud Report, a national publication widely circulated to the insurance and self-insured industry.

GKC&J continues to make a significant difference in these following areas:

Pre-litigation identification, investigation, and detection of fraudulent claim activity and analysis;

Aggressive litigation of fraudulent claims in all judicial and arbitration forums;

Prosecution of civil actions against perpetrators of insurance fraud, including actions against attorneys and health care providers; and

Implementation and organization of Special Investigation Units, pursuant to California Code of Regulations, Section 2698.40 et seq.

For information, contact the following:

John J. Russo

jjr@gilbertkelly.com