如何选择独立法律顾问并其在索赔中的影响

目录

• 序言
• 第一段
• 第二段
• 第三段
• 第四段
• 第五段
• 第六段
• 第七段
• 第八段
• 第九段
• 结束语

序言

本文将介绍保险法专辑播客的相关信息。我们将讨论触发保险公司提供独立法律顾问的情况以及如何选择和支付法律顾问费用。同时，我们将详细解释独立法律顾问的职责和一些相关的案例。请继续阅读了解更多有关保险法专辑播客的内容。

第一段

保险法专辑播客是由最好的保险律师推荐所推出的最佳保险法专辑。该专辑涵盖了影响保险行业的及时和重要法律问题。本期节目的嘉宾是国家律师事务所Ropers Majeski的合伙人Tim Agarjanian先生。Tim Agarjanian先生在商业诉讼、重大伤害、房地产和侵权等方面为全国各地的公司和保险公司提供法律代表。他还经常担任作者和演讲人，并就法规和判例法的更新进行演讲。非常感谢Tim Agarjanian先生今天的参与。

第二段

本期节目的讨论内容是关于独立法律顾问以及它如何影响保险索赔。我们首先来看一下触发保险公司提供独立法律顾问的情况。根据2860子部分b，如果保险公司在给定的诉讼问题上保留了自己的权利，并且该问题的结果可以由保险公司为辩护而聘请的律师控制，那么就不会存在利益冲突。然而，如果保险公司对给定的诉讼问题保留了自己的权利，并且该问题的结果可能受到由保险公司聘请的律师控制，那么就可能存在利益冲突。对于有关惩罚性赔偿的指控，并不认为存在利益冲突，或仅仅因为保险公司被起诉的金额超过了保险单的金额而认为存在利益冲突。因此，保险公司提供独立法律顾问的情况是由1984年加利福尼亚圣地亚哥海军联邦信用社诉Kumas保险协会案件决定的。该案件在1984年由加利福尼亚第四区上诉法院裁决，为保险公司辩护提供了选择自己的法律顾问并由保险公司支付费用的机会。由于一些滥用和有趣的背景问题，加利福尼亚立法机构确实颁布了一项称为Kumas法令的法规，即加利福尼亚民法第2860节。下面是触发保险公司提供独立法律顾问的情况。

第三段

首先，如果保险公司对某个问题保留了自己的权利，并且该问题的结果可以由被保险人雇佣的律师控制，那么就会触发独立法律顾问的权利。这是触发独立法律顾问的情况中的98%，是Kumas法令的使能法律。第二种情况是保险公司同时承保原告和被告，显然存在利益冲突。第三种情况是保险公司对被保险人提起诉讼，无论这起诉讼与保险公司的辩护是否相关，保险公司都有义务进行辩护。这显然违反了加利福尼亚职业道德准则，我们将在本次演示中稍后讨论。第四种情况是保险公司在未经保险同意的情况下追求超出保险单限额的和解，并使被保险人面临第三方的索赔。

第四段

加利福尼亚民法第2860节的第五款是指任何其他情况，其中代理律师同时代表保险公司和被保险人，发现他或她代表其中一个方的利益受到代表另一方方面的影响。这个案例的例子可以记为James III Corporation诉Truck Insurance Exchange，这是2001年Cal App裁决的案例。我提供了一些触发Kumas法令的基本情况，其他一些州也有类似的法令或普通法规定，会触发提供独立法律顾问的义务，最常见的触发独立法律顾问的义务的情况是保险公司在提供保险金的同时保留异议。

第五段

Kumas案还意外开创了一个广泛而几乎无限的机会，使保险的个人代理律师有权要求并寻求由保险公司支付为被保险人提供辩护律师的费用，并由此引发了对独立法律顾问法规的需要。以下是一些触发独立法律顾问的实例，根据新的法典第2860节。其中之一是故意行为与过失指控之间的区别，以及保险公司对保留权益的行动。当然，根据保险定义，律师可能更倾向于表明火灾是有意引起的（例如，房屋被放火）的情况。当然，还有许多其他的例子，如果保险公司仅仅拒绝支付某些未覆盖的索赔，那就仅仅是一个保险权益问题，这并不会触发独立法律顾问的权利。

第六段

Kumas案例中的五个限制问题是，至少五年的民事诉讼实践经验，其中包括在相关诉讼中具有丰富的辩护经验。在整个商业和个人事故赔偿的范畴内，及承保了错误和疏漏。保险公司支付给被保险人选择的独立法律顾问的费用，仅限于保险公司在普通业务中向委托的律师支付的费用率。该委托的律师是指在类似案件的辩护中实际上由保险公司支付的收费。

第七段

律师的小时费用是如何确定的？根据上述规则，如果对Kumas派遣律师的费用存在争议，通常将通过具有约束力的仲裁来解决。仲裁员将有权决定小时费用是多少。同时，要注意的是，Kumas派遣律师的费用往往比普通业务中的律师收费更高。如果对小时费率有争议，仲裁员将考虑多种因素，例如案件的复杂性、地区、潜在风险以及律师是否具有类似案件的经验。因此，仲裁员将根据实际情况进行裁决。

第八段

如何解决对Kumas派遣律师费率的争议？根据上述规定，对于对费率存在争议的情况，仲裁员将进行有约束力的仲裁，并有唯一的权力决定小时费用是多少。对于保险公司来说，如果发生需要提供Kumas派遣律师的情况，重要的是先同意在费率上有分歧的情况下继续支付费用。保险公司应当认为费率是合理的，并且与当地类似案件的律师费用是一致的。如果保险公司不同意支付费用或者达到一致，可能会放弃在仲裁中挑战律师要求的费率的所有权益。

第九段

总结一下，本期节目对于了解保险法专辑播客是非常有帮助和信息量很大的。我们详细讨论了何时触发保险公司提供独立法律顾问的义务，并介绍了独立法律顾问的选择和付费。同时，我们也解释了独立法律顾问的职责和一些相关的案例。希望这一期的节目能对你有所帮助。

结束语

感谢大家收听保险法专辑播客，如需订阅本音频节目，请访问我们的网页www.ams.com。如果您对保险法案例或问题有任何建议，请发邮件至lawpodcast@ambest.com。谢谢大家的参与！

Questions & Answers

Q: What is the purpose of the Kumas council?

A: The purpose of the Kumas council is to provide independent legal representation for the insured when a conflict of interest arises between the insured and the insurance company. It ensures that the insured's legal rights and interests are protected throughout the claims process.

Q: How are Kumas attorneys selected?

A: Kumas attorneys are selected by the insured. They must have at least five years of civil litigation experience, including substantial defense experience in the subject matter of the litigation. The insured has the right to choose an attorney who meets these qualifications.

Q: What factors determine the hourly fees of Kumas attorneys?

A: The hourly fees of Kumas attorneys are determined through binding arbitration. The arbitrator takes into consideration factors such as the complexity of the case, the location, the potential exposure, and the expertise of the attorney. The rates paid to attorneys retained by the insurer in similar actions in the community where the claim arose or is being defended also play a role in determining the fees.

Q: Can the insured challenge the hourly rate of the Kumas attorney?

A: Yes, the insured can challenge the hourly rate of the Kumas attorney through the arbitration process. If there is a dispute over the rate, the arbitrator has the sole discretion to determine what the hourly fees should be. The insured and the insurer can agree to negotiate or arbitrate the differential at a later date.

Q: What are some examples of conflicts that would trigger the appointment of a Kumas attorney?

A: Some examples of conflicts that would trigger the appointment of a Kumas attorney include situations where the insurer reserves its rights on an issue that can be controlled by the insured's retained counsel, cases where the insurer insures both the plaintiff and the defendant, cases where the insurer has filed suit against the insured, cases where the insurer pursues settlement in excess of the policy limits without the insured's consent, and any other situation where the attorney's representation of one party is rendered less effective due to their representation of the other party.

Q: Are there any exceptions to when the obligation to provide a Kumas attorney is triggered?

A: Yes, there are exceptions. For example, if the claim is not covered by insurance and it is purely a coverage issue, it would not trigger the right to a Kumas attorney. Similarly, in construction defect cases where the workmanship was not good but did not result in damages, the obligation to provide a Kumas attorney may not be triggered. Each case is unique and should be evaluated based on its specific circumstances.

Q: How are disputes over Kumas attorney rates resolved?

A: Disputes over Kumas attorney rates are resolved through binding arbitration. The arbitrator has the sole discretion to determine the hourly fees, taking into account various factors such as the complexity of the case, the location, and the rates paid to attorneys retained by the insurer in similar actions in the community. The arbitrator's ruling is binding.

Q: What is the ethical duty that forms the basis for the Kumas rule?

A: The ethical duty that forms the basis for the Kumas rule is the duty of an attorney to avoid representing conflicting interests. The Kumas rule is not based on insurance law but on this ethical duty. It ensures that attorneys do not have a conflict of interest when representing both the insurer and the insured.

Q: How can insurance companies ensure they retain their rights to challenge the hourly rate of a Kumas attorney?

A: Insurance companies can ensure that they retain their rights to challenge the hourly rate of a Kumas attorney by agreeing to disagree on the rate and continuing to pay the fees at the rates they deem fair or standard in the community. It is important for insurance companies to make it clear that they reserve their rights to challenge the rate through binding arbitration or negotiation in the future.