Claims Pages’ Post

WOW some review of my book! Thank you sir! "Reviewed in the United States on August 13, 2024: Frederick J. Fisher is a true insurance “insider”, an expert on the subject in every possible way that is important to both consumers and to the vast army of agents and brokers who sell the policies. Fisher’s book is a very clear, very accessible, “tell-all” on a subject that affects directly or indirectly, nearly every aspect of economic life: The ability to stay in business after an unforeseen event, arguably the principal purpose of business insurance. For everyone who has ever tried to puzzle out the meaning of the virtually indecipherable language of just about any insurance policy, “Claims-Made Insurance – The Policy That Changed the Industry” translates all that secret argot and what it means into plain English. Fisher explains that policies are often larded with “gotchas”, or coverage exclusions such that: "I can almost hear a corporate directive: Write a policy so we can take the clients’ money and keep it". But his short, succinct book is less a screed than a very revealing history about how the industry, while seeking more “actuarial certainty”, ended up producing a product that has become unfairly tilted against the consumer, as well as well-meaning agents and brokers trying to provide a vital service to their clients. In the book’s most troubling chapter, “Chapter 9 – The State of Play”, Fisher argues that primarily due to the “disruption” of insurance marketing practices by the invasion of private equity investors, agents and brokers have been stripped of the ability to “advise” their own clients. ....Don’t give any advice. It’s the policyholder’s obligation to figure it out". This practice of not permitting brokers to advise their clients about the product being purchased, Fisher notes, “is underscored by the legal precedent of the ‘Order Taker’ Standard of Care, which requires insurance agents to follow the specific instructions of their insurance-purchasing customers and procure the insurance specifically requested by those clients and/or advise them that they cannot get what they want”. ..Fisher writes, “This essentially puts all the onus on the buyer by basically saying, ‘You, client, must make sure I give you what you want’”. Before he’s done, Fisher lays out “best practices” for both the industry, and ten key things for policy holders to always be aware of before buying a policy or filing a claim. Well worth reading. M. Wagner"

I have a client who saved $650,000 in insurance premium. The hard insurance market has caused more of my clients to look at captive insurance programs, and we moved a contracting client into a group captive last year. The contractor has 300 employees, a dozen vehicles, and few claims. The standard insurance market was going to charge this client $900,000 for general liability, workers compensation, and auto insurance. We moved the contractor into a group captive where the company can receive returned premium for having a good loss history. The captive priced the contractor's annual premium at $700,000 based on the historical low claims. The contractor had another great loss year in 2023 so the company is looking to receive $450,000 in returned premium. The net result for this company is going from $900,000 of standard market insurance cost to a net $250,000 captive cost, saving an amazing $650,000 of insurance premium. If you are a company that thinks you are overpaying the insurance industry, let me know. I can run a premium model to see how much money you could save in a captive model.

I have been negotiating Excess/DIC Side A insurance in the US and UK since 2002. In the US, the product uptake increased dramatically beginning in 2002, and is a staple of most US public companies' D&O insurance programs. But not all Excess/DIC Side A policies are created equal, and the delta I am now seeing between "best in class" Excess/DIC Side A insurance and the policies most companies in the US buy is staggering. In the past 18 months, every Excess/DIC Side A policy for a non-client of mine that I have audited had anywhere from 15 to 30 meaningful coverage/wording deficiencies, where each such deficiency could result in no coverage for a claim or loss that the directors and officers of the company would expect to be covered. And some of these audits occurred when the non-client came to me to review an Excess/DIC Side A carrier's denial of coverage for a real-life claim. In one such claim, when I explained to the company why the carrier was denying coverage, the company representative asked me the following question, "Well, can I sue the broker for E&O?" I told that person that I do not advise on broker E&O claims, so they would have to talk to another lawyer to answer that question. But that exchange should be a wake up call to all insurance professionals who work in this space, and a wake up call to all directors and officers of a US public company. So I am providing this PSA to directors and officers of all US public companies. Please do not simply ask your company, "Does the company buy Excess/DIC Side A insurance?" You need to do more than that to assure yourself that you have the protection you need, and quite frankly deserve, to protect your personal assets.

Insider's Guide: Decoding the Insurance Industry for Attorneys Embark on a transformative journey into the intricate world of insurance with our upcoming presentation, tailored exclusively for attorneys seeking a deeper understanding of Insurance Broker E&O cases. Picture this: a unique opportunity to collaborate with senior partners on such cases, yet you realize the knowledge gap in navigating the complex landscape of the insurance industry. In just over 60 minutes, Frederick J . Fisher, J.D., CCP, will unravel the mysteries surrounding the differences between "agent" and "broker," shedding light on the various intermediaries like Program Administrators, MGA’s, MGU’s, and wholesale brokers. He'll explore how these entities often operate within regulatory frameworks set by the National Association of Insurance Commissioners (NAIC), offering crucial insights into their roles and responsibilities. Delve into the nuances of reporting structures, where attorneys may find themselves reporting to Monitoring Counsel, Claims Examiners, or claims personnel from Third-Party Claim Administrators. Ever wondered about the significance of defense costs inside or outside policy limits? We'll address this question and more, providing valuable insights into utilizing state databases for license reviews and exploring filings by admitted insurers regarding rates, forms, and rules. Uncover the intricacies of allegations related to endorsements and unfiled documents, saving you years of piecemeal learning. This presentation is your shortcut to a comprehensive understanding of the insurance industry, ensuring you navigate the complexities with confidence and expertise. Don't miss out on this opportunity to elevate your knowledge and skills in the realm of Insurance Broker E&O cases. This presentation is open to members and non-members. Non-members must pre-register by contacting admin@pldf.org.

#umbrella #insurance is a type of casualty insurance created to protect customers from fateful liability claims that may exceed the policy limits of their primary commercial general liability coverage under a conventional business insurance policy, business auto policy, and other business insurance solutions. Let’s take a look at QR code payments. 📚𝐓𝐡𝐢𝐬 𝐢𝐬 𝐲𝐨𝐮𝐫 𝐥𝐚𝐬𝐭 𝐨𝐩𝐩𝐨𝐫𝐭𝐮𝐧𝐢𝐭𝐲 𝐭𝐨 𝐝𝐨𝐰𝐧𝐥𝐨𝐚𝐝 𝐭𝐡𝐞 𝐏𝐃𝐅 𝐛𝐫𝐨𝐜𝐡𝐮𝐫𝐬: https://bit.ly/3VxitXN It is a cost-effective strategy to considerably raise liability limits to protect against fateful claims in an uncertain world. - Furthermore, major market players are undertaking various strategies to increase the competition and offer enhanced services to their customers. For instance, In February 2021, Umbrella Network announced a partnership with Bridge Mutual, a decentralized #peertopeer discretionary coverage platform for #digital assets. Through the partnership, Umbrella Network will provide secure and scalable price feed data to Bridge Mutual’s platform. With the help of this partnership, the companies delivered more personal approach to umbrella insurance that build customer and bank relationship, which provided a strategic advantage to the company and the umbrella insurance market size. - On the basis of distribution channel, the insurance agents and brokers segment attained the highest market share in 2021. This is attributed to the fact that insurance agents and brokers are investing in digital technologies to provide assistance online and increasing sales and margins. Moreover, the process of converting information into digital formats is known as digitalization. This includes providing agents and brokers with knowledge and techniques in digital formats via insurance websites, digital distribution channels, and website interactions. - On the basis of region, North America attained highest growth in 2021 owing to increased frequency and increased cost of each natural disaster which results in insurance carriers paying out money in claims. Furthermore, various small business owners have gained awareness of this insurance policy, with rise in security concerns. Also, the demand for umbrella insurance market has grown in North America, due to massive increase in natural hazards and loss by theft in developing countries. - According to a new report published by Allied Market Research, titled, “Umbrella Insurance Market," The umbrella insurance market was valued at $72.5 billion in 2021, and is estimated to reach $170.7 billion by 2031, growing at a CAGR of 9.2% from 2022 to 2031.

What the heck is going on with Insurance in California? According to: Insurance News Overview / Press Releases / 2024 Press Releases / Commissioner Lara announces next phase of Sustainable Insurance Strategy to safeguard Californians’ access to insurance. Help is on the way: “Commissioner Lara’s proposed regulation will have major benefits for Californians in the form of: More reliable rates: Insurance consumers will have more stable costs than under current regulations, which have resulted in sudden and steep increases for those at higher risk of wildfire. Greater availability of insurance: Insurance companies will increase their writing because they can better anticipate future losses, rather than making abrupt decisions to non-renew higher-risk policyholders, pause writing, or rapidly increase rates. Stronger oversight: The Department of Insurance will have strong public oversight of modeling, which is already being widely used by insurance companies outside of rate-making and across the nation. The Department will have access to models and build expertise, so California can continue to lead on consumer protection. Safer communities: Catastrophe models can capture efforts taken by federal, state, and local governments, property owners, communities and utility companies to mitigate the exposure of communities to catastrophic events – encouraging and rewarding those efforts.”

𝐖𝐡𝐚𝐭 𝐢𝐬 𝐚 𝐏𝐮𝐛𝐥𝐢𝐜 𝐀𝐝𝐣𝐮𝐬𝐭𝐞𝐫? A state licensed, independent professional that represents the policyholder to help settle an insurance claim. 𝐖𝐡𝐲 𝐬𝐡𝐨𝐮𝐥𝐝𝐧’𝐭 𝐲𝐨𝐮 𝐣𝐮𝐬𝐭 𝐫𝐞𝐥𝐲 𝐨𝐧 𝐲𝐨𝐮𝐫 𝐢𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞 𝐜𝐨𝐦𝐩𝐚𝐧𝐲’𝐬 𝐚𝐝𝐣𝐮𝐬𝐭𝐞𝐫 𝐝𝐮𝐫𝐢𝐧𝐠 𝐲𝐨𝐮𝐫 𝐜𝐥𝐚𝐢𝐦? The adjuster works for the insurance company and serves the best interest of their employer. A Public Adjuster works for you, the policyholder, with your best interests at heart, to ensure that you receive everything you deserve under your insurance policy terms. 𝐖𝐡𝐚𝐭 𝐚𝐫𝐞 𝐭𝐡𝐞 𝐛𝐞𝐧𝐞𝐟𝐢𝐭𝐬 𝐨𝐟 𝐮𝐬𝐢𝐧𝐠 𝐚 𝐏𝐮𝐛𝐥𝐢𝐜 𝐀𝐝𝐣𝐮𝐬𝐭𝐞𝐫? 1. 𝐓𝐢𝐦𝐞 𝐒𝐚𝐯𝐢𝐧𝐠𝐬: After a loss at a property, many homeowners and business owners have more important things to do than handle the demands for documents and data from their insurance company. A Public Adjuster handles this all for you. They will be the point person for you on all the insurance claims issues and handle reaching a proper and fair settlement for your claim. 2. 𝐈𝐧𝐬𝐮𝐫𝐚𝐧𝐜𝐞 𝐏𝐨𝐥𝐢𝐜𝐲 𝐊𝐧𝐨𝐰𝐥𝐞𝐝𝐠𝐞: Insurance policies can be complicated and have plenty of fine print that can be misinterpreted by someone not familiar with insurance policies. This means you may not receive a proper and fair settlement on your claim. A Public Adjuster is an expert in reading insurance policies to ensure you receive a proper and fair settlement. 3. 𝐏𝐫𝐨𝐭𝐞𝐜𝐭𝐢𝐧𝐠 𝐘𝐨𝐮𝐫 𝐑𝐢𝐠𝐡𝐭𝐬 𝐚𝐬 𝐚 𝐏𝐨𝐥𝐢𝐜𝐲𝐡𝐨𝐥𝐝𝐞𝐫: A knowledgeable Public Adjuster understands insurance laws. Understanding the language and process in which an insurance company operates, and the laws that they are bound by, a Public Adjuster can ensure that your claim is being handled fairly and timely. 4. 𝐍𝐞𝐠𝐨𝐭𝐢𝐚𝐭𝐢𝐧𝐠 𝐚 𝐅𝐚𝐢𝐫 𝐂𝐥𝐚𝐢𝐦 𝐒𝐞𝐭𝐭𝐥𝐞𝐦𝐞𝐧𝐭: Studies show that having a Public Adjuster represents you can increase your claim settlement by up to 170% on average. 𝐈𝐟 𝐈 𝐡𝐚𝐯𝐞 𝐚𝐥𝐫𝐞𝐚𝐝𝐲 𝐬𝐭𝐚𝐫𝐭𝐞𝐝 𝐚 𝐜𝐥𝐚𝐢𝐦𝐬 𝐩𝐫𝐨𝐜𝐞𝐬𝐬, 𝐜𝐚𝐧 𝐈 𝐬𝐭𝐢𝐥𝐥 𝐡𝐢𝐫𝐞 𝐚 𝐏𝐮𝐛𝐥𝐢𝐜 𝐀𝐝𝐣𝐮𝐬𝐭𝐞𝐫? YES! We can pick up the ball any time during the claims process to relieve your stress and worries.

2024 brings new opportunities to advocate for important changes to the public policies impacting the accessibility and affordability of property casualty insurance. That’s why Securing Our Future, in partnership with the American Property Casualty Insurance Association is kicking off the new year with a refreshed list of state and federal policy priorities. Learn more about APCIA’s main priorities for 2024: https://bit.ly/41LEOSK

1. Expertise in Insurance Policy Interpretation Public adjusters are skilled at interpreting the complex language of insurance policies, ensuring you understand your rights and what you're entitled to claim. 2. Maximized Claim Settlement Public adjusters work to maximize the compensation you receive by accurately assessing damage and presenting a thorough claim to the insurance company. 3. Reduced Stress and Hassle Filing an insurance claim can be stressful and time-consuming. Public adjusters handle all aspects of the claim process, reducing your stress and allowing you to focus on other matters. 4. Faster Claim Resolution With a public adjuster managing the claim, the process often moves more quickly. They know how to navigate insurance company processes and can avoid delays. 5. Professional Negotiation Public adjusters are experienced negotiators, advocating on your behalf to ensure you receive a fair settlement. They can counter lowball offers and push for a better outcome. 6. Thorough Documentation and Evidence Collection Public adjusters gather detailed documentation and evidence to support your claim. This thorough approach helps ensure a stronger claim and reduces the chance of disputes. 7. Conflict Resolution If there's a disagreement or conflict with the insurance company, public adjusters are skilled at resolving issues and finding solutions that benefit you. 8. Knowledge of Local Building Codes and Regulations Public adjusters understand local building codes and regulations, which can be critical when determining the scope of repairs and the associated costs. 9. Contingency-Based Fees Most public adjusters work on a contingency basis, meaning they only get paid if you receive a settlement. This provides a strong incentive for them to work diligently on your behalf. 10. Level Playing Field Insurance companies have their own adjusters who represent their interests. By hiring a public adjuster, you level the playing field and ensure someone is representing your interests throughout the process.

An interesting bit of insurance history from Coverager: "Ebenezer Hazard could be seen as the insurance world's Eli Copter: his first name means "stone of help" in Hebrew, and his last name—well, you get the idea. Hazard stumbled into insurance in the late 18th century, much like many of us do—unexpectedly. After graduating from what is now Princeton University, he became Postmaster General in the 1780s, streamlining the postal system. But he stirred controversy by replacing stagecoaches with faster, cheaper post riders, disrupting news distribution during pivotal Constitutional debates. George Washington dismissed him over this. Hazard then co-founded the Insurance Company of North America (INA) in 1792 (incorporated in 1794), the first US company to insure both buildings and their contents. INA was a powerhouse. At its peak, the company kept operational expenses below 25% of its premium income—well below the industry average of over 40%. This efficiency allowed it to retain more profit and invest strategically, making it one of the most financially stable insurance firms of its time. Yesterday's INA evolved into today's Chubb through a series of acquisitions. After struggling to compete with direct writers despite diversifying into life and workers' compensation insurance, INA merged with Connecticut General Life in 1982 to form CIGNA. In 1999, ACE acquired CIGNA's P&C operations, including INA. Finally, in 2016, ACE acquired Chubb and rebranded under the Chubb name, transforming INA into part of a global insurance leader through strategic mergers and acquisitions."