Tough questions and best claims handling practices 

This is a time of great uncertainty for your clients.  Emotions and stress levels are at an all-time high as their financial futures are unclear. They are looking to you as their insurance agent to provide them with some comfort that their insurance policy will protect them. You can absolutely review the policies you have in place as well as the exclusion within the policy. Educating your clients on the coverage they have purchased and how this will potentially apply makes you a trusted advisor. However, if your client feels they have a claim and they want to move forward I advise you to submit the claim and allow the carriers to respond to policy language and coverage triggers they may or may not be available.  That is what I mean by, “don’t be a claims adjuster.”

In addition, avoid potential exposure of your own E&O policy by following claims handling best practices:

  • Read your agency agreements with each carrier and understand what your claims notification requirements are as each carrier will be different.  Remember, you may be required to report all claims or potential claims as a requirement of your 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.
  • Assume that any telephone conversation 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 have a conversation with your customer that leads you to believe they may be fishing to make a claim against you, DO NOT HESITATE to contact your E&O claims department or your OIA representative.
  • Encourage your clients to submit coverage questions or claims questions to you in writing if you need clarification from the carrier for an answer. Do not attempt to summarize your client’s question back to the carrier. Having the request in writing will eliminate confusion over the information the client is seeking and allows for clear communication. Once you’ve received the request in writing please submit to the carrier for their response.
  • DOCUMENTATION, DOCUMENTATION, DOCUMENTATION!! 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!

OIA is here to help you with many resources related to the COVID-19 pandemic. As always, it’s our mission to help promote, protect and progress the IA channel and we are committed to providing you with as much guidance and support as possible.  I am here to help, don’t hesitate to reach out or provide feedback.

For more informaiton or to answer any questions, please reach out to Judy Sivy at judy@ohioinsuranceagents.com or  (614) 552-3048

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