The best defence is good offence
At the Cayman Captive Forum 2025, the panel discussion titled “The Best Defence is a Good Offence” offered an illuminating exploration of evolving strategies in healthcare liability and claims management. Featuring Rob Blasio, managing director at Gallagher Bassett Specialty; Keri Marmorek, healthcare claims team leader at Beazley; and Larry Smith, vice president of risk management services at MedStar Health, the discussion emphasised a shift from reactive defence to proactive, offensive strategies.
Marmorek opened the conversation by highlighting the limitations of traditional defensive approaches, drawing on sports analogies to illustrate the need for a strategic rethink. She noted that in complex healthcare cases, early identification of high-risk claims is often impossible, making a proactive, well-prepared plan essential. “We no longer know right away which cases will be severe,” she said, emphasising the need for a structured approach to managing claims before they escalate.
Blasio reinforced this perspective, observing that the landscape has shifted dramatically since he began practising law in the 1980s. Seven-figure demands, once headline news, are now commonplace, necessitating creative strategies and a structured “playbook” for litigation. According to Blasio, each organisation must define its philosophy—whether to aggressively contest every claim or focus on minimising public exposure—and ensure that all team members, including defence counsel, align with this strategy.
Smith contextualised the discussion historically, noting that the defence community has often lagged behind plaintiffs’ counsel, who have innovated through legislative changes, life care planning, and capital market engagement. He argued that a paradigm shift is required: defence teams must adopt offensive tactics, leveraging expertise and structured collaboration to counter increasingly sophisticated plaintiff strategies.
A central theme across the discussion was the importance of a team-oriented approach. Blasio described a “five-council” model, in which different legal experts—including trial, appellate, damages, and settlement counsel—collaborate to maximise efficiency and strategic impact. Smith added that this approach is particularly vital in high-exposure cases, where bifurcating responsibilities and integrating specialised expertise can materially influence outcomes.
Both Marmorek and Blasio stressed the value of early and accurate information, including loss runs, jurisdictional intelligence, and plaintiff profiles. Marmorek noted the significance of mock trials and focus groups not merely to determine settlement, but to refine case presentation and anticipate jury reactions. Blasio highlighted the importance of “intellectual honesty” in assessing potential damages and setting realistic strategies, warning that delayed recognition of liability or reliance on outdated counsel practices can be costly.
Innovative practices, such as MedStar’s “virtual law firm” model, were showcased as examples of integrated defence strategy, enabling firms to share insights and resources effectively. Smith also emphasised the strategic use of internal communications within healthcare systems to acknowledge responsibility early, address patient needs, and potentially mitigate exposure.
The panel concluded with a consensus that the industry must adapt to the new realities of claims management. Traditional defence approaches are no longer sufficient; success depends on collaboration, strategic foresight, and a willingness to challenge established practices.
By combining proactive planning, integrated legal teams, and data-informed strategies, healthcare organisations can transform liability management from a defensive posture into a calculated, offensive strategy, ultimately protecting both patients and the institution’s bottom line.
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