Please ensure Javascript is enabled for purposes of website accessibility
The IIAW Blog
Blog Home All Blogs

Risky Business | Spokesperson or Employee: Which One Are You?

Posted By IIAW Staff, Thursday, May 12, 2022
Updated: Tuesday, May 24, 2022

By: Mallory Cornell, IIAW Vice President

This article was originally published in the May 2022 Wisconsin Independent Agent

Many of you have been participants in my E&O Risk Management courses and have heard me discuss the importance of a Social Media Policy. Perhaps you’ve even requested a sample template from me. Whether it’s a reminder or an introduction, giving employees guidance for how you want them to represent the agency when they’re online is crucial.

 

What is the purpose of a Social Media Policy?

 

The primary functions of a Social Media Policy are to: guarantee a constructive relationship between the organization and its employees, manage risk and preserve the agency’s reputation, discourage the use of company time for personal social media activities, and promote awareness among employees of how their personal information can be accessed and interpreted online.

 

Why do we need one?

 

It is important to provide guidance on several aspects of utilizing social media. From everything to defining what “social media” includes to how the individual should represent (or not represent) the agency and the agency brand. As an example, the agency would identify topics such as: do not impersonate the agency or its employees, make statements on behalf of the agency without authorization, or make statements that can be construed as establishing the agency’s official position or policy on any particular issue.

 

How do I get one?

 

Just ask! Your friends at the IIAW can provide a sample Social Media Policy for you to tailor to your agency needs and implement within your organization. The sample document outlines the basic needs of the agency. It also includes a place for an employee to acknowledge they’ve received and reviewed the Social Media Policy. This document should be a part of every employee’s personnel file and reviewed on an annual basis.

 

Reach out today for your complimentary copy of an agency Social Media Policy or any other template you may need to create or update.

Tags:  E&O Risk Management  insuring Wisconsin  risk mitigation  risky business  social media  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

PermalinkComments (0)
 

Risky Business - Workflow Mapping: A Bird's-Eye View for the Agency

Posted By IIAW Staff, Monday, November 8, 2021
Updated: Wednesday, December 1, 2021

By: Mallory Cornell, IIAW Vice President

How an agency operates, should never feel like a guessing game for anyone. Too often we see owners assuming workflows exist, staff finding workarounds for cumbersome tasks or inconsistent methods of completing operational processes. Whatever the obstacle, there is a fun and helpful navigation tool to create smooth and efficient workflows.

 

Workflow Mapping is an exercise that provides a visual representation that can be used to drive consistency, identify areas to add technology, pinpoint inefficiencies and even improve customer service. By providing a top-down view of the agency, decision making is easier than ever due to the clarity provided an ease of creating a targeted approach to operational change.

 

The exercise of workflow mapping can be as high level or in-depth as you choose. It can be done internally or with an outside consultant. There are a few important points to be mindful of when it comes to successfully mapping your agency workflows:

1. This is NOT a process to create a procedure manual

2. The workflow must have a defined scope (rabbit holes are everywhere!)

3. The end goal should be defined prior to starting the exercise

4. Everyone must be given an opportunity to provide feedback

5. Have fun!

 

Workflow mapping may seem challenging or time-consuming, but it is a great way to build collaboration, invoke positive change and redefine the work of the agency. An agency’s operations have likely been challenged and will continue to be. For this reason, it is essential to check and adjust and make sure everyone involved in the operations has a voice in the adjustments.

 

If you would like more information on Workflow Mapping, please feel free to reach out with questions,

mallory@iiaw.com!

Tags:  E&O Risk Management  insuring Wisconsin  risk mitigation  Risky Business  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

PermalinkComments (0)
 

Risky Business | Does the Right Hand Know What the Left Hand is Doing?

Posted By Mallory Cornell, Friday, October 8, 2021
Updated: Wednesday, December 1, 2021

As technology allows the ability to service large groups of clients more efficiently, many agencies are increasingly expanding their reach beyond the confines of one metropolitan area. In order to better service their customer base, agencies may open additional locations or may acquire existing entities to expand their business. The management of multiple locations creates new challenges and those challenges if not handled correctly may lead to increased opportunities for error.

 

Controlled growth whether organic or through acquisition can increase efficiencies and reduce cost. However, it is important to manage that growth. Be sure that the “right hand knows what the left hand is doing”. Consistent culture, compliance and communication throughout the agency at all locations, is essential to prevent confusion and potential claims which may otherwise arise from acquisitions and dispersed locations.

 

Make sure all staff understands your agency culture. Owners, producers, agents, CSR’s and all staff must understand the focus of the business. If the agency’s stated focus is on personal lines, then the agency should not deviate into complex specialized lines. If the agency focus is on certain niches of business, the agency should train their agents and supporting staff on how to service those markets. Often claims begin when the agency attempts to sell insurance products with which it is unfamiliar. Understand your focus. If you are acquiring agencies, acquire those that fit your vision. Then share your vision with all staff at every agency location on a regular basis. Help your team see what the agency is trying to accomplish and how each person can contribute by staying focused on the goals of the entire organization.

 

When the workload is heavy and clients demand your attention at your primary agency location, it can be difficult to give your attention to the other office locations. But in order to keep those other locations in line with your vision, you must provide them with the attention they need. You should try to visit your other agency locations frequently, at least once a month. Visit each site for a long enough time that the each site does not put on a front for you but actually reveals to you its true method of operation. By allowing each office to become comfortable with your visits, you can build trust and familiarity. The agents and staff at each location must feel close enough to the primary agency to be able to ask questions, share problems and seek feedback.

 

Establish uniform office procedures and a standard system of compliance. Each province has regulations to protect their own citizens. If you locate a branch office or even a teleworker, in another state, you must research licensing and other business regulations impacting your insurance operation. Failure to comply with regulatory requirements could lead to regulatory investigation, disciplinary action, or even the possible revocation of your license.If adjustments are needed to be made as a result of the regulations do not begin operating your business until you comply with the law.

 

For example, an agency had a CSR move to another state and began working remotely as a clerical assistant to their Personal Lines Manager. This employee’s job description did not entail discussing or recommending coverage with clients, and the agency believed that her job description was in line with the requirements of the state department of insurance. However the department viewed it differently and fined the agency $7,000 for the employee not having the proper license and viewed the tasks performed by this employee as “effectuating the sale of coverage”. As soon as the agency was notified of the infraction, they made changes to her job description and directed her to acquire the proper license. They then established a Director of Compliance and Compliance Committee to monitor the activities on an ongoing basis.

 

Standard operating procedures will enhance the efficiency and management of multiple agency locations. Staff can transfer among agencies, without extensive readjustment. The essential procedures should not vary. Each agency should have similar procedures regarding date-identification of communication with clients and carriers. Additionally, documentation of coverage offered and rejected, and maintenance of expiration lists should be standardized.

 

This excerpt from a letter we received from the attorney retained to defend an insured, reveals the difficulties in offering a defense when procedures are not followed. The litigation arose from damage sustained by a commercial enterprise where the carrier argued that the agency had not provided the necessary information for the carrier to quote coverage, despite several requests. Counsel stated the agency “has no documentation that it sent the proper information and the agent who worked on the account left the agency several years ago on unfavorable terms. The agent’s CSR says the agent was not detail oriented, was not good about providing information, and often made mistakes.” Defense counsel opined that it was highly likely the judge will rule that the agency failed to provide the necessary information. The agency itself had a strong culture of compliance but suffered from one agent who had not followed the standard office procedures established and who, thus, created a significant problem for the agency.

 

In addition to implementing uniform procedures around the process of file documentation, the agency should also implement uniform procedures for diary and suspense systems. There should be a centralized agency management system and computers in each location should be compatible with one another. In fact, it is likely that computer systems will become a backbone for your organization as offices are spread out geographically. Additionally, it is essential that you ensure adequate security of personal information acquired from your insureds, and that you provide proper privacy training to all employees. The use of encryption and other measures to protect personal data when transmitted is important. If employees use smart phones, verify the phones are password protected.

 

As part of the establishment of standardized procedures, make sure the staff in each location knows the method to report an errors and omissions situation. Establish and discuss the procedure with all agents and employees. Do so regularly to prevent hesitation in reporting at the time of occurrence. Don’t let problems linger. Delays could create coverage issues with your professional liability carrier.

 

Communication is a key to successfully running multiple locations. Free and open communication with all staff is very important when you have multiple locations. Neither the culture nor the compliance can happen if you neglect to focus on communication.

Have weekly staff meetings by phone or webinar. Have your office personnel get together at least once or twice a year to enhance communication between people on all levels.

 

Communicate your vision to all managers in all locations and they in turn must commit to clearly communicating your vision to others in the off-site agencies. Regular audits and evaluations of the manager and the office are critical to making sure your vision is being carried out according to your expectations.

 

While striving for positive energy in your organization, do not avoid discussing problem situations. Consider learning opportunities which may present themselves from potential claims situations. Educate your employees about the situations which have created problems in one office so other office sites can avoid the same mistake.

 

Growth is positive when controlled but be sure that the “right hand knows what the left hand is doing”. Consistent culture, compliance and communication throughout the agency at all locations, can be essential to preventing confusion and potential claims which may otherwise arise from acquisitions and dispersed locations.

 

Annette Hollingsworth has spent over 30 years in the insurance industry. While with ERC /GE Insurance Solutions/Swiss Re, Annette Hollingsworth has served in a variety of capacities ranging from claims to underwriting, legal to regulatory services and global compliance. Annette now serves in the Products unit where she supports the Insurance Agents Professional Liability underwriters in both the US and Canada. She attended Washburn University undergraduate and KU Law School. She has her JD., CPCU, CLU, and ARC designations.

 

This article is intended to be used for general informational purposes only and is not to be relied upon or used for any particular purpose. Swiss Re shall not be held responsible in any way for, and specifically disclaims any liability arising out of or in any way connected to, reliance on or use of any of the information contained or referenced in this article. The information contained or referenced in this article is not intended to constitute and should not be considered legal, accounting or professional advice, nor shall it serve as a substitute for the recipient obtaining such advice. The views expressed in this article do not necessarily represent the views of the Swiss Re Group (“Swiss Re”) and/or its subsidiaries and/or management and/or shareholders.

Tags:  E&O Risk Management  risk mitigation  Risky Business  wisconsin insurance agency help  wisconsin insurance blog 

PermalinkComments (0)
 

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 

PermalinkComments (0)
 

Errors & Omissions - And You Call Yourself an Expert!

Posted By IIAW Staff, Wednesday, July 8, 2020
Updated: Tuesday, June 23, 2020

expert sitting at desk

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

 

This article was originally featured in our July Wisconsin Independent Agent Magazine. Read the full issue here

 

An insurtech firm I prefer not to name, other than to say they think they are geniuses when it comes to policies, was founded by two people who believed purchasing insurance was too frustrating. In fact, their website specifically states, “Navigating the world of insurance is confusing, stressful and a step backward in time....”

 

Because the founders were “consultants to the top insurance companies,” they knew there had to be a better way for consumers to purchase insurance. Their stated mission is help consumers get the insurance they need and feel good about what they got. Sort of sounds like something an agent does, but that’s not the point of this article. 

 

Towards this goal, the firm publishes consumer-facing articles. I recently read through several of the articles and felt they were relatively well written for consumer consumption and largely correct. What disappointed me was the “level” of credit they gave the writers; each writer was listed as, “Insurance Expert. 

 

The title “insurance expert” caught my eye - in a big way. It stands to reason that obviously these writers have many years of insurance experience since they are “experts” Uh, they didn’t. Here are partial bios as examples: 

 

• [Author’s name redacted[ is an Insurance Editor at [Insuretech name removed] in New York City and an expert in homeowners insurance. Previously, he was working as a freelance writer for the  New York State Nurses Association and wrote for the Michigan 

Information Research Service. [Writer] has a B.A. in journalism from [University Name Redacted.]

• [Author’s name redacted] is the Associate Director of SEO Content at [Insuretech] in New York City. His writing on insurance and personal finance has appeared on Betterment, Inc, Credit Sesame, and the Council for Disability Awareness. [Writer] has a degree in English from the [University name removed].

• [Author’s name redacted[ is the co-founder of [Website name removed], a groundbreaking personal finance site for millennials that was named one of Time’s 25 Best Blogs of 2012. [Author’s] work has been published in New York Magazine, Glamour, The Guardian, BuzzFeed and more.

 

Am I missing something? Would the background of ANY of these writers qualify them to be considered an “insurance expert”? I don’t think it does, but the public doesn’t know any better. Calling yourself an expert doesn’t make it so. 

 

Unfortunately, the combination of missing or incorrect policy information and the misappropriation of the title “insurance expert” pushed me to send a rather 

“snotty” email to this group. As of this writing, I have not received a response. Would you like to see what I wrote? Before you read it, remember, I’ve already 

acknowledged I was a bit pompous. With that as prologue, what follows is a slightly edited version of my email.

 

I was reading through several of your homeowners’ and personal auto insurance coverage articles today and wanted to get in touch with you.

 

Yes, insurance can be confusing to those not in the business, but there is a way to explain it so the uninitiated can easily and quickly grasp its concepts and realities.

 

Secondly, I would be very careful calling anyone an “insurance expert” unless he/she has many years of experience in the insurance business - and is well-versed in insurance coverages and concepts. Writing ABOUT insurance in newspapers and blogs doesn’t make someone an insurance expert; neither does being in the financial and investment business. Property and casualty insurance is far more complicated than can be known just writing about insurance. You have to be “covered in the mud of an insurance policy,” you have to have actually read the policy from cover to cover, several times, and you have to know how deep the depths of insurance really are before you can begin to be considered an expert.

 

Further, a true expert doesn’t consider himself or herself an expert. In fact, those who truly do qualify as experts quickly shy away from being called experts; the reason, because they are so well versed in insurance, they know there is far more to know than they already do. Any person who calls or truly believes he or she is an expert doesn’t know what he/she doesn’t know.

 

Someone holding himself or herself out as an “expert” without the credentials to back it up is dishonest and harmful to those depending on the information the so-called “expert” has provided.

 

So, my recommendations are: correct the incorrect information; and don’t refer to anyone as an insurance expert who doesn’t have the necessary time and training to qualify as one.

 

Just my personal recommendations to you; take them or leave them as you so desire. 

 

OK, I realize I let my emotions get the best of me. I also realize nothing I said will change their attitude or actions. And lastly, I know that “insurance expert” is just their way to market their “brilliance.” But it needed to be said. 

 

But this is what I find truly interesting, they note on their site that the information they provide should not be relied upon; in fact, they intimate that agents are the better source of information. Here is the disclaimer: 

 

[Insuretech’s name withheld] editorial content is not written by an insurance agent. It’s intended for informational purposes and should not be considered legal or financial advice. Consult a professional to learn what financial products are right for you.

 

I take certain satisfaction in this disclaimer. Evidently, their “insurance experts” are not as valuable as  insurance agents.

 

Here are some thoughts about being an “expert” of any kind.

 

• True experts worry more about what they don’t know than what they do know, continually looking for ways to fill their knowledge gap. Self-proclaimed experts ignore the breadth of what they don’t know and are satisfied (mainly because they don’t know what they don’t know). 

 

• True experts are rarely absolutely certain. Self-proclaimed experts are rarely in doubt.

 

• True experts admire other experts and desire to learn from them. Self-proclaimed experts don’t see anyone else as an expert, feeling others have nothing to offer. 

 

• True experts listen to and value the opinions and advice of others. Self-proclaimed experts think theirs is the only opinion that matters. 

 

• True experts openly admit when they don’t know the answers. Self-proclaimed experts ALWAYS know the answer - even when they don’t.. 

 

• True experts apply the experience learned from past accomplishments to accomplish more. Self-proclaimed experts rest on past accomplishments. 

 

• True experts don’t really like being referred to as experts. Self-proclaimed experts revel in such an introduction.

 

• True experts desire to give all their knowledge away so others can be better. Self-proclaimed experts hold on to their knowledge so others have to come to them. 

 

• True experts do not proclaim themselves experts - others do. Self-proclaimed experts use the term as a marketing ploy. 

 

• Be wary of anyone who eagerly takes on the mantle of “expert,” they probably aren’t. If you call yourself an “expert,” you probably aren’t. 

 

One last thought, if the word “expert” is used anywhere on your website or in your marketing, you better be one because that is the standard/expectation that you have set. Afterall, who do you expect more from, the apprentice of journeyman electrician or the master electrician? The best course of action is to take the term “expert” off all websites and marketing materials.

 

When you are an expert, you won’t feel like one. If you feel like one, you aren’t one. The more you know, the more you realize you don’t know. And people who don’t know, aren’t experts - at least in their minds. 

Tags:  E&O Risk Management  errors and omissions  insuring Wisconsin  insurtech  wisconsin independent agent  wisconsin independent agent association  wisconsin independent insurance association  wisconsin insurance agency help  wisconsin insurance blog 

PermalinkComments (0)
 

Industry Update: Wisconsin Supreme Court Affirms Agent E&O Win, Strengthens Future Defenses

Posted By Josh Johanningmeier | IIAW General Counsel, Monday, June 1, 2020

 

On May 21st, in Emer’s Camper Corral v. Alderman, the Wisconsin Supreme Court issued a 6-1 majority opinion confirming a rigorous causation standard for negligent procurement E&O claims.

 

The policy at issue? A garage policy from Western Heritage Insurance. Camper Corral claimed its agent promised a $1,000 per-unit and $5,000 maximum annual deductible for hail claims—a peril that Camper Corral had encountered in both 2011 and 2012, leading to six-figure claims and its previous policy being non-renewed. In fact, the new policy had $5,000 per-unit hail deductible with no aggregate limit, which Camper Corral allegedly learned only when a 2014 hail storm damaged 25 vehicles and it incurred $125,000 in deductibles on the loss.

 

In the ensuing E&O litigation, Camper Corral tried to prove its case against the agent based on the fact that a policy with a lower hail deductible was “commercially available” in the insurance market—but Camper Corral did not (and likely could not, based on its claims history) prove that it would have been eligible for such coverage. The trial court found, and Supreme Court agreed, that this was a failure of proof of causation of damages, i.e., Camper Corral could not show the agent’s alleged “negligence was a ‘substantial factor’ in causing its loss under the commercial availability theory without evidence that a policy with the requested terms” was actually available to Camper Corral. According to the Supreme Court, Camper Corral needed to prove that an insurer would actually have sold it the lower deductible policy it claimed it was promised by the agent—and Camper Corral’s owner’s testimony that she was shown a quote was not enough.

 

Camper Corral’s other principal theory was that the agent should have been held responsible under a “detrimental reliance” theory because it relied upon the alleged representation from the agent that he had secured a policy with a lower deductible. According to Camper Corral, if it had it known that its policy actually had the higher deductibles, it would have taken additional steps to protect its inventory. The Supreme Court dispensed with this claim because Camper Corral had introduced no evidence to support it at trial. 

 

The key holding and real win for agents and E&O carriers is the court’s causation holding:

 

"In a cause of action for negligent procurement of an insurance policy, the insured cannot establish the insurance agent’s negligence was a “substantial factor” in causing its loss under the commercial availability theory without evidence that a policy with the requested terms was available to the insured."

 

Emer’s Camper Corral v. Alderman, et al. 2020 WI 46, ¶45. This clear statement of the burden of proof will bolster the defense of future claims in similar cases. Keep an eye on the Independent Agent for a future column breaking down the Camper Corral decision and its impact.

Tags:  Camper Corral v. Alderman  E&O Risk Management  errors and omissions  wisconsin supreme court 

PermalinkComments (0)
 

E&O Risk Management and the Coronavirus

Posted By IIAW Staff, Friday, May 1, 2020
Updated: Thursday, April 30, 2020

By: Swiss RE Corporate Solutions

*This article was featured in our May 2020 Wisconsin Independent Agent Magazine. Click here to read the full May 2020 issue. 

Hospital Hallway

You are all very aware of the events of the last several weeks and the Coronavirus. We are not health experts and there are many others more qualified to give you that advice. We CAN, however, give advice regarding how to reduce the likelihood of an errors and omissions exposure as a result of this event. We have already become aware of some attorneys who are trying to take advantage of this situation for monetary gain against insurance agents. Our advice during this event is no different from what we have said in the past. If your agency has developed good practices, you will be better positioned to avoid problems. Here are the practices of a good insurance agency:

 

• DON’T MAKE CLAIMS DECISIONS! Let the insurance carriers do that. 

• DON’T ADVISE YOUR CUSTOMERS IF CORONAVIRUS related    items are COVERED OR NOT! Let the insurance carriers do that. 

• If a carrier takes the position that losses arising from the Coronavirus are not, or may not be covered, do not engage in advocacy asserting that “We thought it was covered...” That will simply be used by your client to prove that you knew the client wanted coverage for perils like the Coronavirus, but you failed to procure coverage.

• Report all claims and potential claims to EACH AND EVERY    CARRIER that could potentially have a policy that could apply. This includes CGL, Personal lines, Umbrella, Excess, Workers Compensation, Specialty and any other policy in place for your    customers.

• USE THE RESOURCES PROVIDED BY YOU BY THE IIABA. It is a valuable resource for you, your staff and your agency that provides many sources of information. 

• Be empathetic, but don’t tell anyone that something is covered    or not. You can continue to tell them you feel sympathy for all affected by the Coronavirus, but customers MUST report a claim to their insurance carrier to determine if there is any coverage for the event.

• Remember, if you executed an agency agreement with one or more insurance companies, you MUST report all claims or potential claims as required by that agreement, even if your customer tells you not to do so.

• Maintain vigilant contact with your insurance carriers to determine what action THEY want you to take.

• DOCUMENT DOCUMENT DOCUMENT!!! This continues to be

the foundation of sound E&O risk management. DOCUMENT 

EACH AND EVERY TELEPHONE CONVERSATION, EMAIL, 

TEXT, TWEET, OR ANY OTHER TYPE OF COMMUNICATION 

WITH YOUR CUSTOMERS!

• Assume that any telephone conversations with your customers or carrier claims representatives ARE BEING RECORDED. While some states prohibit recording of telephone conversations without advising that they are doing so, IT DOESN’T STOP SOME PEOPLE FROM DOING SO. 

• If you use social media for your business, make sure it is up to    date! Do not make any promises that something may or may not have been covered by insurance companies and policies. 

• DO NOT GIVE ANY STATEMENTS, RECORDED OR OTHERWISE, WITHOUT FIRST CONTACTING YOUR E&O PROVIDER. The Swiss Re Corporate Solutions/Westport Insurance Company/First Specialty Insurance Company claims staff are available if you have any questions about any communications you receive. 

• If you have a conversation with your customer that leads you to believe that they may be fishing to make a claim against you, DO NOT HESITATE to contact our claims department. 

• DON’T MAKE CLAIMS DECISIONS! DON’T ADVISE YOUR 

CUSTOMERS IF SOMETHING IS COVERED NOR NOT! Let the

insurance carriers do that. We know this was stated before, but it must be ingrained in your mind. 

• If the Coronavirus ends up being declared a “catastrophe” by 

the ISO Property Claims Service, you may be eligible under your Westport policy for “Cat Extra Expense” benefits: “CATASTROPHE EXTRA EXPENSE. We will pay up to $25,000 per catastrophe subject to a per POLICY PERIOD aggregate limit of $50,000 for the actual extra expenses incurred by you as a result of a catastrophe during the POLICY PERIOD beginning on the date of a catastrophe and for thirty (30) days thereafter. The extra expense incurred must be incurred by you only to assist in the insurance claims processing needs of your customer(s) who have been affected by the catastrophe. The catastrophe must be a declared catastrophe by the Property Claims Services. A $500 deductible for each catastrophe shall apply. Limits provided by this paragraph are part of and not in addition to the limits

provided by this POLICY.”

 

We hope that this will help you as this event progresses. If you should have any questions, please let us know. 

Tags:  coronavirus  COVID-19  E&O Risk Management  errors and omissions 

PermalinkComments (0)