In this day of big business chicanery and consumer suspicion (not to mention big business suspicion of consumer chicanery), it might do a CSR good to brush up on ethical issues.
Ethics is the study of morals as they relate to conduct. It's the science, one might say, of honesty.
CSRs are particularly vulnerable to ethical pressures. They must deal with the company on one hand and the insurance consumer on the other, each party jockeying to get the most advantageous deal possible. CSRs tread a tightrope as they mediate these transactions. When does client advocacy cross over into defrauding a company? When does representing a company turn into strong-arming a consumer?
Here are a few ethical guidelines for CSRs:
Relations With Carriers
Everyone tends to favor an underdog. When you see a client making a claim against a big insurance company, you might tend more to see the pain of his or her individual loss than to sympathize with the money troubles of a huge, impersonal corporation.
For example, when a client makes a Commercial claim (let's say, a claim that a toolbox was stolen out of your contractor's truck), you may be tempted to pad the claim a little to help the poor guy out. After all, the company will never miss an extra $1,000.
That's dangerous thinking. The company needs the correct amount on the claim. Too many fraudulent claims will force it to raise its rates, and then everyone suffers-including the honest people (whose ranks would not include you).
On the Personal Lines side, when giving an Auto underwriter a prospect's claim history, you may want to omit mentioning a fender-bender that happened two years ago. You fear that mentioning the accident might raise the rate, driving the prospect to another agency. Well, swallow that fear and do the honest thing. Aside from the immorality of lying, how would you feel if, in the event of an accident, your client was barred from his honest claim because his records were found to be fraudulent?
Is a 'sin' of omission-a failure to reveal the whole truth-as bad as a sin of commission (outright lying)? You'll know the answer to this if you imagine yourself on a flight to Tahiti. The pilot suddenly says over the intercom, 'Oh, by the way, when we took off, I omitted to tell you that we don't have enough fuel to make it another five miles.' The fact that the pilot never outright lied to you about it makes the deed no less criminal.
External Relations With Customers
If the carrier represents one side of the tightrope, the customer represents the other. The CSR must maintain a scrupulous honesty in all client dealings. Pictorial Publishing provided many of the following specifics of customer protection:
- Deceptive Practices During the Sale
As with carrier relations, communications must be kept honest and complete. As a CSR you must do many things, including the following:
- represent products as your agency's only when they are
- represent the coverage you are offering and the legal rights, remedies, and obligations associated with it as honestly and completely as possible
- correctly represent the authority of the parties engaged in a transaction
- say that you represent only the companies you do
- claim that a policy guarantees dividends or covers certain liabilities only when they do
- disclose all information that could substantially affect a client's decision to buy
- refrain from making misleading statements about the cost or worth of a policy, such as claiming that premiums are payable only for a limited time when they aren't, or calling a policy by a name that implies a cash value accumulation
Those are obvious instances of dishonesty, but other examples are so minor that they could be made accidentally. For instance, you may not write 'Corp.' or 'Inc.' about a business that is not incorporated; you may not disparage another business with false, misleading, or just plain derogatory claims ('That agency never gives proper quotes!') -- nor may you encourage or circulate someone else's nasty gossip; you may not predict eventual price reductions if you are unsure they will happen. When it comes to a business as money-intensive as insurance, careless talk must be guarded against with special care.
There are laws against most, if not all, of these practices-but being legal is not the same as being ethical. Selling a family a more expensive policy than they can afford may fall within the confines of the law, but it's not a nice thing to do. Consult your conscience when you come to situations like this; think about how you'd feel if another agent was doing the same thing to someone you love.
- Unfair Trade Practices
As a CSR, you are unlikely to initiate unfair trade practices, but be sure you're not an unknowing accomplice to them.
'Twisting,' for example, is the practice of encouraging policyholders to drop a Life policy in favor of one less advantageous to them. States have specific laws affecting replacement of Life policies, and you should know what they are.
Rebating (offering cash or anything of value to a customer in return for buying a policy) is not, strictly speaking, unethical; car manufacturers and other companies do it all the time. At this time, however, it is illegal in most jurisdictions, so offering a rebate puts your agency at an unfair trade advantage over the law-abiding agencies-and is thus unethical.
Discrimination is another unfair trade practice. You may not cancel, limit, or deny coverage because of someone's sex or marital status, geographical location, or disability; you may charge more only if sound actuarial principles underlie the pricing.
- Unfair Claims-Settlement Practices
Misrepresentation during the settlement of a claim is, as at any other time, unethical. You may not misrepresent facts or policy provisions, nor may you have a claimant sign a full release when partial payment is being made.
Poor performance can also be unethical. Your agency must have reasonable standards for claims investigation, send claims forms promptly, and let clients know whether their claims are covered promptly. Failing to settle when liability is clear, refusing to pay claims without an investigation, regularly awarding claimants lower payments than they would win in a court of law, and simple failure to respond are further examples. If a claim is denied, the legal or contractual basis of the denial should be explained to the client.
Internal Relations
When you're dealing with co-workers instead of customers or companies, ethics is still of paramount importance. Without the trust engendered by honesty, no workplace can run efficiently, much less cheerfully.
Of course, you would never lie to your co-workers, but you might be tempted to fudge. For example, you might put off processing a 'sticky wicket' (say, a troublesome account) while leading others to believe that it's in the works. Such fudging can lead to a lot of grief for co-workers who arrange their schedules according to your information. If something is stuck in the works, talk about it. You may find that someone else has a solution, and at least you won't end up responsible for messing up your co-workers.
Conclusion
What gets people into trouble is putting ends before means-that is, paying more attention to goals than to the methods of achieving those goals.
Thus, in an effort to sell one more account, they might bend a statistic. To please a boss, they might 're-interpret' a schedule. To prove loyalty to a company, they might neglect to reveal other options to a client. It's easy to let zeal cloud one's better self.
The best judge of whether an action is ethical or not is you-you alone, independent of co-workers, companies, and customers. You are the one who has to be able to sleep at night. If you can say to yourself, 'I have my integrity,' you have no need to worry about cause or effect. Let the chips fall where they may-in ethics, the buck stops with you.