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Big I Buzz - September 9, 2020

Posted By IIAW Staff, Wednesday, September 9, 2020

Happy Wednesday, we hope that everyone enjoyed their Labor Day weekend. In this week's Big I Buzz, we discuss a new study finding that agents can do more to service their clients' needs, Amazon getting FAA approval to deliver packages via drones and an insurance company who claims to be the first with a work from home discount.

Insurance Company Claims to be the First With a Work From Home Discount

Elephant Insurance, based in Virginia, has announced to offer its policyholders and their spouses discounts for driving less during the pandemic. According to Insurance Business, "In a move that the direct-to-consumer insurance company claims is a national first, the Admiral Group company doesn't require any telematics devices, just a statement explaining the number of days that their customers now work without commuting to the office." The new discount scheme will start in Indiana and Tennessee from October 14, Illinois, Maryland, Ohio, Texas and Virginia for policy renewals after October 19th, according to Insurance Business. Learn more here.

Amazon Gets FAA Approval to Deliver Packages By Drone

The Federal Aviation Administration officially designated Amazon an "air carrier" on Monday, paving the way for Amazon to start testing its plans to drop off packages within 30 minutes, according to the New York Post. Amazon will begin testing customer deliveries for packages under 5 pounds with drones. According to the New York Post, "For Amazon to effectively rely on drones for regular deliveries, it must be able to pre-program the drone's routes and let them fly without human pilots watching their every move, but US regulations don't currently allow for completely autonomous flights, Bloomberg reported. The FAA would also have to develop a new air-traffic system to track low-altitude drone flights, as well as come up with rules to minimize the risk of drones striking other aircraft and disturbing human activity below." Read more about Amazon's move to deliver via drones here

Agents Could Do More to Service Clients' Needs, Study Finds

A study from Nationwide's largest Agent Authority research surveyed 2,600 U.S. independent insurance agents, small-business owners, mid-market business owners, mid-market business owners with fleet vehicles and general consumers between June 9 and June 25 to understand what business owners and consumers value in their insurance relationships. The survey revealed there's a perception gap in the value agents believe they are bringing to their customers, according to Property Casualty 360. According to the article, "In one example, 95 percent of insurance agents said they are always there when their clients need them, but only 79% of customers felt the same. Similarly, 94% of agents reported they are regularly checking in with their customers; however, only 69% of customers said they receive sufficient check-ins from their agent."The survey also found that there's a need for expertise in the following lines of business, in addition to property and casualty support: 

"•26% of consumers want guidance on retirement planning

• 39% of small-business owners want help with business interruption or disaster planning

• 35% of small-business owners are interested in safety and loss control resources

• 18% of small-business consumers want information on cybersecurity and retirement," according to Property Casualty 360. Read more about the study and its findings here

For more news, check out the Action News section of our weekly e-newsletter Big I Buzz.  If you aren't subscribed, click here  to add your email to our emailing list. We hope that everyone has a great rest of their week! 

Tags:  Big I Buzz  insuring Wisconsin  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

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Big I Buzz - September 2, 2020

Posted By Kaylyn Zielinski, Wednesday, September 2, 2020
Updated: Wednesday, September 2, 2020

big i buzz

In this week's Big I Buzz, we are discussing how an exotic dancer received a $8.6 million insurance payout, new PPP rules from SBA aimed at clarifying loan forgiveness and increase in reports of cyberattacks since the start of the pandemic. 

Exotic Dancer Gets $8.6 Million Insurance Payout

This news strikes close to home as a Middleton, WI-based insurance company has paid a former exotic dancer, Kailee HIggins more than $8 million over a contentious liability claim. In 2010, the exotic dancer was served as many as 15 shots by the Centerfolds Club staff (located in Worcester, MA, she was escorted to her car and drove off resulting in a collision with an off-duty police officer. The dancer later sued the club alleging that they were liable for serving her alcohol and letting her drive under the influence of alcohol. Higgins was awarded $5.4 million initially but it was increased to $8.6 million in consideration of attorney's fees and interest calculations. 

New PPP Rules From SBA Aimed At Clarifying Loan Forgiveness

The U.S. Small Business Administration released an interim final rule this week. What has changed in the PPP rules? "The new guidelines state that an owner-employee or a C- or S- corporation who has less than a 5% ownership stake will not be subject to the owner-employee compensation rule, which caps the amount of loan forgiveness on owner-employee compensation," according to Forbes. Previously, the owner-employee compensation rule stated, "anyone with stake in a company - no matter how small - that took out a PPP loan was eligible for forgiveness of the lesser of $20,833 or 20.833% of their 2019 compensation or $15,385 or 15.385% if the borrower elected to use an eight-week covered period." Read more about the new rule here.

FBI Sees A 400% Increase In Reports Of Cyberattacks Since The Start Of The Pandemic

Since the start of the pandemic, as more people work from home there has been a rapid increase in cybersecurity incidents among small- to mid-sized business. According to cybersecurity firm DIGIGUARD, here's three steps that small to mid-sized businesses can take to protect their systems from cyber intrusion,

"• Secure and update network perimeter defenses along endpoints taht access the network, such as computers and mobile phones

• Back up and secure business data for recovery in the event of a cyberattack or system failure

• Train employees to recognize and avoid cyber threats like phishing attacks and malware"

Because there has been a 400% increase in reports of cyberattacks, ransomware attacks are increasingly targeting small- to medium-sized businesses. Read more here

For more news, check out the Action News section of our weekly e-newsletter Big I Buzz. If you aren't subscribed, click  here to add your email to our emailing list. We hope that everyone has a great rest of their week! 

Tags:  Big I Buzz  insuring Wisconsin  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

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E&O Exposures: Increased When Working from Home?

Posted By IIAW Staff, Thursday, August 27, 2020

glasses, notebook and pen on table

By Chris Boggs | CPCU, ARM, ALCM, LPCS, AAI, APA, CWCA, CRIS, AINS, is IIABA's Executive Director Risk Management and Education

Focus is key! From an errors and omissions (E&O) perspective, agents cannot lose focus during this disrupted work setup. Working from home does not change the fact that all procedures and processes that apply in the home office also apply at the "home" office.

From now until we are released from our lockdown and able to return to normalcy, we must remember that every action or inaction has consequences - good or bad. There are a few simple rules or guidelines agencies and agents should follow during this unprecedented moment in time to avoid or lessen the effects of an errors and omissions claim. 

Rule #1: Document! Document! Document!

Franklin D. Roosevelt may be the most famous cheerleader of all time (other than Toni Basil). It’s true. As a student at Harvard he was a cheerleader for home football games. Some years later, he led the country through World War II, using his fireside chats to calm America’s tensions and fears. He was still a cheerleader. Given the tensions and even insecurity some feel as we live through our current pandemic panic, we need a cheerleader and simply a leader to keep us calm and to keep us focused. Roosevelt was a forward thinker; he actually wrote a cheer to help agents remember Rule #1 for working from home. Are you Ready? OK! Document day; Document night; Document left; Document right; Document, document, document! Yea, document! OK, so maybe this isn’t a Roosevelt original, in fact it’s a pure fabrication – but the point is no less relevant. Even when working in a non-traditional space, remember to document every conversation, text, email, yell, whatever. When it involves a client, document it.

Rule #2: Keep the Schedule You Had at the Office

No, this isn’t limited to “open” and “close” times; this refers to regularly scheduled staff and team meetings. Not being in the same room is no excuse for ending activities necessary for the successful operation of the agency. Basically, if it was important for the agency and the teams leading up to the disbursement, it still is.

“We have our normal commercial lines staff meeting on Mondays at 10. We go over new and renewal business, lost accounts, cancellations, claims, accounts with issues, industry news and current events and any issues that popped up that need to be addressed,” reports one agent. “We also have individual team meetings for personal lines and employee benefits.”

Another agent tells us, “Zoom is our new contact method for client meetings and for meetings with staff. We have ‘Town Hall’ meetings every Friday afternoon with all employees; producer meetings every Monday morning; the commercial lines, personal lines and employee benefits teams have staff meetings once per week; and the Leadership team has probably had Zoom meetings 10 times over the past three weeks.” E&O Exposures: Increased When Working from Home? PROFESSIONAL LIABILITY. Keeping everyone connected and informed is paramount when everyone is in the office. But when there is no office “atmosphere,” keeping everyone connected and informed is even more important.

A cornerstone of these meetings should be policies and procedures. Pick one errors and omissions topic and remind every person on the call of the office procedure relevant to that topic. This conversation does not have to take more than three or four minutes. One topic, one reminder - this keeps the staff on course. 

Rule #3: Keep "Them" Close and Informed

Your clients and your carriers are living in this same altered reality in which you are living. Any sense of normalcy is welcomed.

Stay in contact with your clients and keep them informed. As their agent, your insureds will likely turn to you more now than in the past. News reports, press releases and the problem of “someone told me” will certainly spread a lot of misinformation among your customer base.

To manage and hopefully end the spread of misinformation, you need to know the correct information. Know policy language, know the carrier’s processes and plans, know the insurance regulations, and know when to say “No.” From an E&O perspective:

  • Never answer a coverage question without the insured's policy in front of you. Even the most "common" policy has "uncommon" endorsement you may forget were attached.
  • Not every carrier is the same; in fact, no carrier is like any other carrier. Know the underwriting guidelines and what can and can't be done for the client. Don't promise something until after you know it can be delivered. 
  • Don't practice outside your licensure. As a licensed agent, your job is to procure and manage the insurance program with and for the client. You are not licensed or qualified to offer an opinion on contract wording or other legal matters. 

Remember also, you are not licensed to help complete federal forms unrelated to insurance. Direct the insured to the proper professional; don’t create an E&O problem by being too helpful.

Your underwriters need to hear from you as well. In fact, they may want to hear more from you now than in the past because they may be lonely. Kind of a weird thought, but many underwriters are used to working in an office with other humans; being alone is hard on them. Even field underwriters who normally work at home are accustomed to meeting with and talking with agents face to face on a regular basis.

Keep the underwriters informed when something new is learned about a client. Talk with them about unusual situations or unusual requests made by the insured. You and your underwriter may be able to find creative solutions that best serve your client and the carrier. You also want to know what the carriers are thinking and planning in regard to renewals. Are there new endorsements coming that may limit coverage? Find out during these “keeping in touch” calls, it may help avoid an E&O situation.

Many insureds are concerned about money as a result of state-mandated lockdowns. Commercial lines clients may essentially be out of business, personal lines clients may be out of a job; the result is the same for both clients - fear. The fear of having to choose among feeding their family, paying the bills or paying insurance premiums. When this question arises, this is a conversation that involves both your insured and your insurance carrier. Everyone must be informed.

When the specter of policy cancellation appears, address it directly and appropriately. 

  • Know if your state has enacted any temporary measures regarding cancellation for non-payment. Current information is available here.
  • If a regulation is in place, advise your client of the regulation and give them a copy of the wording. 
  • Advise your insured to never cancel any policy and document the conversation. 
  • If the insured insists on cancelling any policy, make use of a cancellation notification letter. 

Rule #4: Recognize Potential Weaknesses

“One of my E&O concerns is our new producers and what they are telling prospects and customers. Are they writing the correct coverages on new and renewal accounts? We do have mentors for each of the new producers and we hope nothing is falling through the cracks,” reports one agent.

This agent’s concern is probably the same as many other agents, what are the new, less experienced employees doing? Are coverages being written correctly? Are questions being answered correctly? Do they know and understand the agency procedures well enough to properly protect the client and us?

These are valid concerns. One drawback of working from home is the loss of “quick confirmation.” Generally, employees have the ability to quickly check their understanding of the policy language, an underwriting guideline or anything else with someone in the office; all they have to do is walk to someone’s desk and ask for help.

Well, unless there is an open-line Bat Phone there is no one to ask and get an answer from quickly. Emails, instant messages and/or phone calls have to be made to get the answer. Some agents feel like the insured is unwilling to wait for an answer and will just “wing it” and hope they are correct, or that if they are wrong, nothing will happen to highlight the error.

Make sure every employee understands this is NOT OK. It is never acceptable to “wing it,” and the current situation does NOT change that fact.

Train every employee, not just the new employees, that it is acceptable for them to explain to the client that they don’t know the answer or that they want to confirm the answer. Rarely is the insured unwilling to wait for a correct answer. “Mr. Insured, that is a great question. Let me confirm the answer and call you right back. I would rather give you the correct answer the first time.”

Then, do what you promised. Get the answer as quickly as possible and call the insured back as soon as possible. The insured will be satisfied and you will be able to sleep well. (Oh yeah, don’t forget to document the conversation and follow up in writing with the insured.)

Last Rule: Don't Forget Your Upbringing

As my kids got old enough to go out with friends and on their own, I would always say, “Remember who you are; whose you are; and who you represent.” My goal was to impress upon them that their actions affected more than just them.

Every employee’s actions affect the agency – positively or negatively. It is necessary to remind your employees, often, that what they do matters; not only does it matter to them, it matters to everyone in the office.

Train them, retrain them, and train them some more on E&O avoidance. Make it part of the fabric of the agency. Make it important. When it is important to the leadership, it is important to everyone.

Now that they are “out on their own,” in some respects, training will show. That statement should bring you comfort, not scare you. If it scares you, let’s talk. 

Learn more about Big "I" agency risk management here

Tags:  E&O Risk Management  insuring Wisconsin  remote work  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog  work from home 

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Big I Buzz - August 26, 2020

Posted By IIAW Staff, Wednesday, August 26, 2020

big i buzz

Happy Wednesday! This week we are discussing our upcoming webinar series, traffic tickets raising car insurance rates and Progressive's pet insurance benefit for employers through PetsBest. 

Agency Leadership Webinar Series

Tune into our Agency Leadership Webinar Series starting October 1st. Our webinar series is a free member benefit. 

Thursday, October 1 at 10 a.m. - Impact of COVID-19 on the Insurance Industry

Thursday, October 22 at 10 a.m. - State and Federal Election Preview

Tuesday, November 10 at 10 a.m. - State of the Current Economy & the Next 5 Years

Friday, December 4 at 10 a.m. - E&O Claim Trends

Tuesday, January 19 at 10 a.m. - Agency Technology

See the schedule, register for the webinars and learn more about the featured speakers here

Common Traffic Tickets That Raise Car Insurance Rates the Most

Certain traffic tickets may not cost much, but the impact on insurance premiums can be significant. According to The Zebra (a leading insurance comparison site and independent source for industry resource and consumer education), "Drivers who get ticketed for forgetting to turn on their lights pay an average of $68 more per year for car insurance than drivers without any violations on their record. Drivers who get a ticket for speeding in a school zone will see an average insurance increase of $342 per year." 

Here are some of the riskiest tickets that can more than double an existing auto premium: 

Reckless Driving - Average rate increase of 67 percent

Driving with a Suspended License - Average rate increase of 67.4 percent

Refusing a Breathalyzer - Average rate increase of 69.8 percent

DUI - Average rate increase of 71 percent

Racing - Average rate increase of 73.1 percent

Hit and run - Average rate increase of 78.3 percent

Read more here

Progressive Teams with PetsBest for New Pet Insurance Benefit

"Progressive has offered consumer pet insurance plans to dogs and cats owners through PetsBest through 2009. Now, Progressive is using that offering as a springboard as they enter the voluntary benefits market for the first time. new employer clients will be able to offer a pet insurance benefit through Progressive." according to Employee Benefit Adviser. Learn more about the pet insurance benefit through Progressive and its partnership with PetsBest here

For more news, check out the Action News section of our weekly e-newsletter Big I Buzz. If you aren't subscribed, click here to add your email to our emailing list. We hope that everyone has a great rest of their week! 

Tags:  Big I Buzz  insuring Wisconsin  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

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Illinois DOI 'Requests' Insurers Not Apply Policy Provisions

Posted By IIAW Staff, Monday, August 24, 2020
Updated: Tuesday, August 18, 2020

Open Sign on Business

By: Chris Boggs | Big "I" Virtual University Executive Director

Company Bulletin 2020-15 issued June 8, 2020, by the Illinois Department of Insurance (IDOI) threw key provisions of the business income policy out the proverbial window. In its  bulletin, the IDOI addressed the recent riots and how thedepartment expects insurance carriers to respond.


In a press release accompanying the bulletin, the IDOI and Governor’s office stated: “Damage to businesses followsdramatic declines in revenue for businesses across the state as a result of COVID-19 pandemic. As the state works with businesses to recover, the governor’s office and IDOI have made expectations clear to insurance companies.”


To clarify the IDOI’s expectations, the bulletin states, in part:


The Department hereby requests that all insurers licensed or authorized to transact insurance business in this Stateimmediately implement the following protective measures:


• To the extent business interruption provisions are included and operative under a policy, insurers should base payouts on business activity levels that eliminate the impact of COVID-19.


Note the highlighted phrase. The IDOI is directing theinsurance carriers to pay losses they do not owe. Why do the carriers NOT owe the loss when coverage is written using Insurance Services Office (ISO) or similar language? Because both business income policies, CP 00 30 10 12 - Business Income Coverage Form-With Extra Expense and CP 00 32 10 12 - Business Income Coverage Form-Without Extra  Expense, apply the same methodology for determining

business income loss payments, specifically both policies state:


3. Loss Determination


a. The amount of Business Income loss will be determined based on:


(1) The Net Income of the business before the direct physical loss or damage occurred;


(2) The likely Net Income of the business if no physical loss or damage had occurred, but not including any Net Income that would likely have been earned as a result of an increase in the volume of business due to favorable business  conditions caused by the impact of the Covered Cause of Loss on customers or on other businesses;


(3) The operating expenses, including payroll expenses,necessary to resume “operations” with the same quality of  service that existed just before the direct physical loss ordamage; and


(4) Other relevant sources of information, including:


(a) Your financial records and accounting procedures;


(b) Bills, invoices and other vouchers; and


(c) Deeds, liens or contracts.


Paragraph 3.a.(2) in both ISO’s business income policies state that the loss is partly determined based on the LIKELY Net  Income. If the business was considered “non-essential” and was thus closed in an attempt to control the spread of COVID-19, the likely Net Income is zero. No dollars were being earned.


IDOI is strongly suggesting (maybe requiring) insurancecarriers to ignore this and similar policy language. Carriers appear to be expected to pay business income claimsresulting from riots and looting as if the business was fully operational.


The Independent Insurance Agents and Brokers of America (Big I) addressed the issue of covered losses occurring during the period of shut down as a result of COVID-19 in late March. As was specified in this article, the only business income loss any carrier should owe is the amount of income lost AFTER the business COULD have opened but was not able to because of the property damage.


Any carrier paying claims not supported by policy language is doing so in violation of the principle of indemnification, the cornerstone of property insurance. Paying losses unsupported by policy language puts the insured in a better position than they would have been had these losses not occurred. This is a slippery slope carriers need to stay off.

 

Tags:  business income  COVID-19  DOI  insuring Wisconsin  virtual university  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

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Negligent Referrals And You

Posted By IIAW Staff, Friday, August 21, 2020
Updated: Tuesday, August 18, 2020

Handing a Business Card to Someone

By: Richard F. Lund, JD | President, Americas Property and Casualty, SwissRE

 

Felix has decided to sell his house and contacts Mary, an independent insurance agent, who he knows has been in the community for many years. Felix asks Mary if she knows of a good real estate agent who can help him. Mary tells him she knows the perfect person, Rusty Nail at Nail Real Estate. Mary doesn’t hear from Felix until about 3 months later when Felix calls her and relates the following story.

 

Rusty advised Felix that an open house would be a good way to show the house to prospective buyers and that it would best for Felix to be out of the house during that weekend. When Felix returned, the interior of the house had been destroyed. Felix learned that Rusty had a party that left Felix’s house in shambles with damages in excess of $10,000. When Felix approached Rusty to pay for the damages, Rusty responded that he in fact was not a real estate agent, that his license had been suspended for 3 years and he had no insurance to cover the damages.

 

Felix blamed Mary’s recommendation of Rusty for the damages and threatened to file suit against her. Mary then reported the claim to her errors & omissions carrier. Is this covered? The Swiss Re Insurance Agents Errors and Omissions policy provides coverage for claims arising out of “professional services” rendered to others.

 

“Professional Services” is defined to include activities as a managing general insurance agent, general insurance agent,insurance agent or insurance broker. As a general rule, referring a customer to a third person or entity unrelated to the insurance products provided by the agency is not considered “professional services” under the policy. In this case, the claim for negligent referral against Mary would not be covered under her insurance agent’s errors & omissions policy.

 

What can you do to protect yourself in this type of situation? There are several options.

 

1. Risk avoidance - decide you are not going to continue providing referrals

 

2. Risk mitigation - continue providing referrals, but offer several names and be sure to include a statement or statements that specifies the scope and limits of what you are providing; for example, that the person getting your referral should look into the qualifications of anyone they choose to use to be sure their needs and requirements are met. You should consult with an attorney licensed in your state as to the use of and the specific language of a disclaimer and the legal effect of such language.

 

Unfortunately, sometimes it just doesn’t pay to be nice, and in fact it can cost you.

 

Tags:  errors and omissions  insuring Wisconsin  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

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Big I Buzz - August 20

Posted By IIAW Staff, Thursday, August 20, 2020

big i buzz

In this week's Big I Buzz, we are discussing new changes coming to IIAW Committees, how agents can adapt to the "new normal" and how major US insurers see lower coronavirus costs than expected. 

New, Exciting Changes to IIAW's Committees

Thought Leaders Wanted for Online Community

The IIAW Committees are more important than ever! With the launch of our Online Community on November 1st, we will be moving our current committees online, and committees will now be called "Groups".

Group participation in our Online Community with be recognized and awarded! Earn gift certificates to your hometown restaurants, donations for your favorite local charity, IIAW swag and prizes.

If you're new to the Association or have thought about joining a committee in the past, now is the time to join as a Thought Leader on our new Online Community. A "Thought Leader" is an industry leader for topics within a Group. If you want to join a Group without being a Thought Leader, you can! Three is no limit to the number of Groups you can be a member of. The invitation to join a Group as a member and not a Thought Leader will be sent at a later date. Learn more about the Online Community, its Groups and Thought Leaders here

Digital, Accelerated: How Agents Can Adapt to the New Normal

With easy, instant, online buying experiences now the norm, consumers have come to expect the same from every company they do business with. COVID-19's impact on our everyday normal has accelerated the shift towards digital. Foundational tools for a digital shift internally include agencies setting up a virtual private network (VPN), investing in a cloud-based agency management system (AMS) and also, setting up a Voice over Internet Protocol (VoIP) phone system to let your staff make and receive calls from your office number even if they are working from home. Read more from Independent Agent here

Major US insurers see lower coronavirus costs than expected

A new Q2 2020 report of five insurers that have large US operations shows what they call a 'relatively modest $2.5 million blow'", according to analysts cited by Reuters. "The $2.5 billion loss is lower than was initially feared and the loss has been absorbed by the industry without insurers resorting to more bad tidings in the form of major claims just around the corner, considering that the coronavirus continues to spread," according to Insurance Business Magazine.

For more news, check out the Action News section of our weekly e-newsletter, Big I Buzz. If you aren't subscribed, click here to add your email to our mailing list. We hope that everyone has a great rest of their week!

Tags:  Big I Buzz  insuring Wisconsin  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

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Government Affairs: Workers' Compensation and Liability for COVID-19

Posted By IIAW Staff, Tuesday, August 18, 2020

coronavirus

By: Misha Lee | IIAW Lobbyist

 

While IIAW member agencies continue to try and answer questions and provide as much helpful information to their customers on various issuesrelated to the Coronavirus pandemic, a recent publication from the Wisconsin Legislative Council comes to mind as a resource. The Legislative Council is a nonpartisan service agency that provides legal advice and guidance to members of the Wisconsin Legislature so that legislators can make better, more informed decisions.

 

The Legislative Council published a June 2020 issue brief discussing Workers’ Compensation and  employer liability for employees diagnosed with COVID-19 following returning to work. The issue brief explains that the state Workers’ Compensation Act provides that employee injuries sustained from an illness or infection are generally covered by Workers’ Compensation, but employees must demonstrate that they became ill through the course of their employment. Employees seeking Workers’ Compensation coverage for a COVID-19 diagnosis must show their illness was caused by exposure at work. Injuries, including COVID-19, are covered whether or not the employer was negligent.

 

Wisconsin Workers’ Compensation law provides an “exclusive remedy” for employees who are injured in the course of their employment, meaning that employees cannot bring separate legal actions outside of the Workers’ Compensation system against their employer for an employment-related injury. However, as the issue brief outlines, employees can still bring actions against third parties other than their employer, if the third party is at least partially responsible for their injury. Employees must prove that the third party’s negligence led to their injury, which also could include COVID-19 exposure.

 

Read the Legislative Council issue brief athttps://bit.ly/AugGovAffairs.

 

The widespread COVID-19 pandemic leaves employers and third parties, even those following federal and state government recommended best practices and guidelines, open to lawsuits ifemployees or customers contract the virus. Various polling data suggests that employer liability is real with many employees indicating they would sue their employer over contracting COVID-19. This uncertainty and increased exposure to liability and costly lawsuits is of great concern to many employers throughout the state. Wisconsin needs a “safe harbor” for businesses that comply with government recommendations and practice appropriate protocols. These measures will help ensure business owners and their employees are comfortable reopening and protect employers from civil claims filed outside of the Workers’ Compensation system. Wisconsin lawmakers need to take action otherwise it will be “open season” on employers and a wave of COVID-19 related lawsuits from trial lawyers will seriously undermine efforts to restart and rebuild our state’s economy.

 

The IIAW supports efforts by the Wisconsin Civil Justice Council (WCJC), Wisconsin Insurance Alliance (WIA) and other business partners who are advocating for COVID-19 liability protections to protect our commercial customers.

Tags:  government affairs  insurance happenings  insuring Wisconsin  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

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Does Requiring Customers to Wear Masks Have Any Effect on Legal Liability?

Posted By IIAW Staff, Friday, August 14, 2020
Updated: Monday, August 10, 2020

face masks

States are in various stages of reopening following months of COVID-19 lock downs. As the states progress through the phases, businesses are making key decisions regarding masks, should masks be required or optional? Some legislatures have taken the    responsibility for this decision away from business owners and are requiring masks be worn; but other states leave the decision to the business owners.

In states where the decision rests with the business, some operations have made the corporate decision to require masks be worn by all who enter the premises. From a legal liability perspective, is this necessary?


Legal Liability


Legal liability is liability imposed by the court or regulators on the person or entity legally responsible for injury or damage suffered by another party. Such legal obligations (or liability) can arise from intentional acts, unintentional acts, contracts (express or implied) or regulations. Legal liability generally focuses on civil wrongs but can include criminal wrongs. “Legal liability” exists when:


• The wrongdoer is found guilty of “Negligent Conduct” (breached the duty owed);

• The injured party suffers actual damages; and

• The wrongdoer’s “negligent conduct” is the proximate cause of the injury or damage.


A key requirement towards proving “negligent conduct” and ultimately legal liability is proving that the supposed tortfeasor (the wrongdoer) has or owed the injured party a specific duty of care and breached or failed to satisfy that duty. The degree of care owed to an injured party is based on the relationship between the wrongdoer and the injured party.


The greater the degree of care required or expected, the lower the threshold for breaching a duty owed (it is easier to breach a duty when greater care is required). Courts generally recognize four degrees of care or “levels” based on relationships are:


• Slight Negligence: A high degree of care is required;

• Ordinary Negligence: Requires “reasonable” care such  as would be provided by a reasonable and prudent  person;

• Gross Negligence: Very little care beyond slight care (not to be  confused with slight negligence) is required. This is represented by a deliberate or reckless disregard of a duty to exercise care which is  likely to cause foreseeable and significant harm; and

• Negligence per se: A breach of duty because the law says it is.  Negligence per se requires: 1) the at-fault party to violate the  law, 2) the law to pertain to public safety, 3) the violation of the  law be the cause of the injury, and 4) the injured person be a  part of the class of persons the law was designed to protect.


In a business/customer relationship, the business generally owes the customer a duty of reasonable care. While there are certain business relationships that increase the duty owed (such as that owed by an operation transporting passengers in a vehicle), reasonable care is the most common duty owed. For sake of this review, assume the business owes a duty of reasonable care.


Examples of duties owed by business establishments under the concept of reasonable care include repairing/correcting known hazards; warning against intrinsic/unrepairable hazards; and taking steps to avoid preventable hazards.


Consider the example of a restaurant that has several sets of steps in the path to the dining area, where a member of the wait staff has spilled some water and where the plate comes out of the oven very hot. Reasonable care in such a restaurant might include actions such as the person showing the customer to a table warns of the steps (“watch your step”), the wait person puts up a little yellow sign warning of the wet floor, and the person delivering the food says, “Be careful, the plate is hot.” These are examples of reasonable care.


Let’s return to the question of masks and legal liability associated with requiring or not requiring them. For this discussion, the injured party moves from a restaurant (it’s hard to eat while wearing a mask) to a retail location.


From the perspective of reasonable care, are masks necessary to avoid legal liability?  


(Note, this discussion does not and will not address the availability or applicability of liability insurance coverage. Only the concept of legal liability regarding customers in a typical retail setting is addressed in this article.)


Effectiveness of Masks


Before exploring the relative differences in legal liability between requiring masks and allowing customers the option, the purpose and effectiveness of masks must be considered. Discussions focused on the effectiveness of masks may be more complicated than the  concept of legal liability because of the emotions and the lack of clear

information surrounding the wearing of masks.


Purpose: The Centers for Disease Control (CDC) and the World Health Organization (WHO) both state there are essentially two “grades” or levels of masks: 1) those that filter out the virus designed to protect the wearer from contracting the virus and prevent the wearer from spreading the virus; and 2) those intended to prevent the wearer from spreading the virus, but that do not necessarily prevent the wearer from contracting the virus. The masks most often worn by the public are the second type – masks intended only to prevent the spread and not the contracting of the virus.


Effectiveness: Unfortunately, the question of effectiveness seems to be unanswerable. Some claim the masks are very effective (giving percentages of protection without credible source substantiation) and some say they are little more than a “feel good” measure using drywall dust and even smoke to prove the point. Even the CDC and WHO are inconsistent in their messages. In regard to legal liability, effectiveness is largely irrelevant.


Masks Optional


Business operations choosing to allow the customers to make the mask-wearing decision may subject themselves to accusations by a customer that he or she contracted the virus from an unmasked  person or persons in the store. The injured person may assert that close contact with an unmasked person or persons led to their  sickness.


Such charges may be impossible to prove. A virus is a humankind exposure and is not limited to a location where people are not wearing masks. If the claimant visited the grocery store, bank,  pharmacy, office and/or other places during any particular day, proving the only place where they were exposed to the virus was the grocery store would be of utmost difficulty. Add to this the reality that other members of the family may have been several places, contracted the virus, and brought it home to everyone else in the house. Lastly, the masks worn in public are not designed to keep the virus from getting in, they are designed to limit the expulsion of the virus from the nose and mouth.


Frankly, lacking a law to the contrary, the business owner does not owe the customer a duty beyond reasonable care. Reasonable care is limited to the premises and what the business can actually control; viruses exist in more places than just the business premises and a business cannot be expected to protect a customer from exposure in all aspects of a customer’s life. Narrowing the person’s exposure down to one business on one particular day is truly picking gnats out of pepper.


Additionally, the legal concept of assumption of risk may be an affirmative defense to the mask-optional discussion. Assumption of risk is a legal doctrine under which an individual is barred from   recovering damages for an injury sustained when he or she voluntarily exposed him or herself to a known danger. Put another way,   assumption of risk prohibits the injured party from seeking damages on the basis that the plaintiff (injured person) knew of a hazardous or potentially hazardous condition and willingly exposed him or herself to it.


Assumption of risk defenses require the defendant to show:

• The injured party had actual knowledge of the risk involved  (conspicuously post signs warning “Enter at your own risk, masks are  optional”); and

• The plaintiff voluntarily accepted the risk (they entered the store).


When a customer visits a business where masks are optional, they make a conscious decision to enter the premises or not. If the injured party assumed the risk by entering the premises, the law generally  recognizes the defendant no longer owes a duty to protect the plaintiff against that risk.


Given the relatively unclear requirements of reasonable care, the difficulty in proving the virus was contracted at a particular place on a particular day, the doctrine of assumption of risk, and the limited purposes of the masks, business owners are unlikely to be held legally liable solely because masks were not required of all customers.


Requiring masks may exceed the requirement of reasonable care. In fact, certain disabilities and ADA laws may make it impossible for all customers to wear a mask. If courts made mask wearing the  minimum standard of reasonable care, removing the freedom of personal choice generally granted to the business owner and the customer/citizen, in a sense, the court would “legislate” masks by making mask wearing the minimum standard of care while ignoring the protection of assumption of risk. Some states have already undertaken legislative efforts to protect business owners.      


Masks Required


Previous paragraphs addressed the types and relative effectiveness of masks. Does requiring all customers to wear a mask decrease the business owner’s potential for being held legally liable?


Health officials recommend (where not a requirement) masks be worn that prevent the spread of droplets and mists from the nose and mouth that may contain the virus. Again, these masks aren’t  necessarily designed to prevent the wearer from contracting the virus, but when every customer wears masks, the theory is everyone has a reduced (though not completely eliminated) chance of contracting the virus.


On the surface, requiring everyone to wear a mask appears to lower the chances that the business will be accused of contributing to or causing a person to contract the virus. Requiring a mask seems to be a physical manifestation of an exculpatory statement such as, “Not Responsible for Broken Windshields” or “Enter at Your Own Risk, Not Responsible for Injury.” The statement doesn’t make it so.


Individuals may be less likely to sue but requiring masks may not lower or heighten an operation’s legal liability for injury to a  customer – if it can be proven the virus was contracted at the location. What other steps were taken to protect the customer?


Legal liability is a function of duty and facts. Requiring masks of all customers may be above and beyond the duty of reasonable care owed to customers.


To Mask or Not Mask


Requiring masks or allowing customers to make a personal choice apparently has no effect on the business owners’ ultimate legal liability. What is the duty owed (reasonable care)? Did the owner meet the duty owed? If both questions are answered “yes,” the business is not legally liable for any injury suffered.


Can the infected person prove the virus was contracted at the business? Given the facts of a virus and particularly this virus (with its long incubation period), proving it was contracted in any one place on any given day is nearly impossible.


Holding a business legally liable without other clear and convincing evidence simply because customers were not required to wear masks forces the court to set a standard of care almost impossible to  maintain in the future. Every flu season or the event of another community sickness will subject business owners to a higher degree of care than ever required in history or should be considered   reasonable.


A virus is a natural organism that man can avoid only so long. Holding a business owner legally liable is unreasonable given the facts of care and the reality of a virus.


Requiring masks may dissuade some from naming the business in the suit; but not requiring masks likely does not increase the overall chances of being held legally liable.

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Errors & Omissions: From the Email Bag - If You're A Babysitter, Let's Hope You Don't Get Paid Like One

Posted By Kaylyn Zielinski, Thursday, August 13, 2020
Updated: Monday, August 10, 2020

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I recently received a question from a Swiss Re Corporate Solutions/Westport Insurance Corporation policy holder: “Are there any real-world claim examples of agents being held liable when they establish a habit of contacting clients when a Notice of Cancellation (NOC) is issued on a direct bill policy; but then they forget and the policy gets cancelled, and the client has a claim, aka babysitting.


Such claims have been happening for at least the 27 years I have been with the firm although we have advised agencies not do so. I can safely say that this subject comes up at virtually every E&O risk management course I have ever taught or attended, and I regularly saw this type of claim when I was in the claims department. Just to be current, I contacted our claims department team leaders and within 5 minutes Jim Redeker found two recent examples where we paid substantial losses. Both were carrier direct bill policies.


Jim’s initial response was this:


“Every time a policy cancels for nonpayment of premium and there is a loss, the argument is made that the agent should have done something. In most cases we simply state that the customer received the same notices that our insured received, and our insured has no duty to notify its customer of an impending policy cancellation. We have trouble when the agent failed to notify the customer that the policy was about to be cancelled for nonpayment of premium after the agent has made a practice of providing such notifications in the past. At that point the agency customer has an argument that they relied on our insured to notify them when their premium was due.”


In most cases the agent never had a legal duty to contact the customer, but because they had created an 

expectation that they would do so, the duty was now in place. And because of that, if they failed to do so they had breached their duty to the customer. If a loss occurred the agent could be held liable.


Example 1: “The customer alleged that on May 25 the agency mailed notice of policy expiration to the wrong address and unbeknownst to the customer the policy was cancelled. The customer alleged that no one at the agency contacted them to advise the policy would be cancelled.


The Agency would mail cancellation notices to customer who would then pay. They would wait for the notice from the agency disregarding the notice mailed to them by the carrier. In this case, the agency mailed the cancellation notice to the wrong address, so the customer never paid the bill. There was then a claim made by the customer on the cancelled policy that was denied by the carrier. $101,242 loss paid by Swiss Re Corporate Solutions/Westport on behalf of the insured.”


Example 2: “Mr. (Customer) is claiming that the agency developed a practice and procedure of personally

collecting premium payments from Mr. (Customer) but failed to do so in this instance. The agency had a change in staff and was not aware of the previous practice, so the payment was not collected from the customer. The policy cancelled and there was a loss. The carrier denied coverage as the policy had rightfully been cancelled due to non-payment of premium. We paid a total of $204,837 on a death claim for a cancelled auto policy.”


These are just two of many examples where an agency developed a duty that they would not otherwise have 

resulting in substantial claim against the agency. The lesson for you as young agents (and not so young gents as well,) is simple: on direct bill policies where a Notice of Cancellation has been sent to the customer, DO NOT babysit your customers to make sure they pay the bill on time. HOWEVER, you should contact them immediately after the date of cancellation to see if they want you to try to obtain a new policy.


As a member of the IIABA, you have access to the “Virtual University” and if you are also a Swiss Re

Corporate Solutions policy holder, you also have access to the “E&O Happens” website. 

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