Case Studies

Recovery of Value of Insurance Fund following Sale of Business

Accumyn reviewed and critiqued a dispute involving sale of a business – and it’s existing self-funded employee benefits plan – to an unrelated third party. The entity was sold in the middle of a multiyear funding approach for the self-funded plan, in which the seller had established significant deposit reserves, as required by the insurance carrier. Some months later, as the self-funded plan came to an end, the calculations by the insurance carrier generated a significant refund of premium to the buyer of the business, and the buyer refused to compensate the former owners of the business for the experience of the self-funded plan during their ownership tenure. Accumyn re-calculated losses for pre-sale and post-sale, adjusted for changes in employer and employee contributions and calculated the amount due seller from the refunded premium and deposits, and provided an expert witness report which was used to settle the matter to our clients satisfaction.

Business Interruption Claim Following a Fire Loss for a Funeral Home

Accumyn prepared detailed analyses and provided expert services for a commercial insurance client in a business interruption and extra expense dispute with its insurance carrier following a fire at a funeral home. The client operated more than one funeral home facility, and was able to shift work to alternate facilities to process and prepare deceased for final disposition. The insurance carrier involved sought to minimize the loss of income and extra expense experienced to keep the client operational during reconstruction.

Accumyn’s work included a review of insurance coverages provided and computation of actual losses sustained, reviewing records of previous customers who experienced a subsequent death of a family member during the period of reconstruction, and found that many previous customers used competitor funeral homes during that period.   Separately, the cost to prepare deceased for final disposition grew significantly as transportation costs to other owned facilities and hiring of additional staff at those facilities grew substantially. The loss of income and extra expense was minimized by the insurance carrier, and the client was offered approximately $100,000 for its loss.

Final settlement, following Accumyn’s analysis of claim value computation by the insurance carrier and preparation of an expert report to the insurance carrier showing errors in its original settlement approach to the claim, resulted in payment to Accumyn’s client of approximately $350,000 – the value calculated in Accumyn’s report.

Business dispute between Insurance MGA and Insurance Carrier

In a lawsuit involving termination of a Managing General Agency agreement by an insurance carrier, Accumyn provided a review of the operating documents and transactions involved in a multi-state insurance program, and the impact of an insurance carriers untimely termination of the program had on commission income earnings by the MGA, insurance agency relationships that the MGA brought to the relationship, and profit contingency to be received by the MGA. In this ongoing case, Accumyn has made extensive calculations and projections of insurance account submission activity during a period following the termination of the agreement, which was done in violation of the written agreement and insurance codes of the states involved. Expert witness reports and rebuttal reports, along with testimony have been provided in this proceeding to date. The damages sustained by the MGA were for loss of commission income and profit sharing resulting from untimely termination of the agreement, and interference in business relationships the MGA had developed over many years.