https://completemarkets.com/Article/article-post/2794/How-Risk-Assessment-Tool-in-Insurance-Broker-CRM-Improves-Quoting-Precision/
How Risk Assessment Tool in Insurance Broker CRM Improves Quoting Precision
Insurance brokers play a vital role between clients and insurance providers. Risk assessment is the lifeline of their professional practice. Brokers who assess risks with precision build strong business relationships that work for everyone involved.
The precision of quote generation has a direct impact on client satisfaction. Customers who receive tailored quotes feel valued by the insurers, which helps in building trust from the start. This original positive connection guides them toward higher conversion rates and better client retention.
A full picture of risk assessment helps brokers protect themselves from potential liability issues. Brokers who document risk factors and match appropriate coverage shield themselves from claims of negligence. Their professional dedication creates a reputation for reliability that spreads through client networks.
A modern CRM for insurance agency operations makes risk assessment more streamlined. Insurance brokers who utilize specialized insurance agent CRM software work faster while keeping their risk evaluations accurate.
Embedded Risk Assessment Tool in Insurance Broker CRM: Improving Quoting Precision
Insurance agent CRM software serves as a central hub that organizes client data and streamlines communication to boost efficiency. The CRM for insurance brokers does much more than simple contact management. It includes specialized risk assessment tools that revolutionize the quoting process.
The native risk assessment module in insurance CRM solutions enables brokers to evaluate risks using diverse factors. Smart algorithms assess client data, industry trends, and historical data to discover potential risks that brokers might disregard during a manual assessment approach. This enables brokers to recommend coverage options that target certain vulnerabilities rather than generic scenarios.
These platforms come with immediate practical benefits:
Risk assessment tools automatically gather and analyze client information, reducing manual data entry errors. This automation ensures consistent evaluation standards across all client assessments.
Cloud-based systems enable team members to access and update risk profiles from any location. Multiple brokers can collaborate on complex cases without version control issues or communication delays.
Customizable risk templates ensure all brokers follow the same evaluation procedures. This standardization improves quality control and reduces assessment inconsistencies between team members.
CRM for life insurance agents really shines when tracking health changes and life events that affect policy needs. Advanced platforms blend with third-party data services. This gives brokers rich information about properties, businesses, and individuals without needing multiple subscriptions or research tools. Such a combined approach saves time and improves accuracy in assessments.
Visual Metrics Offered By Risk Assessment Tool in Insurance Agency CRM
Visual intelligence leads modern CRM for insurance agency solutions. These powerful graphical tools turn complex risk data into useful information that insurance professionals can understand quickly.
1. Client Risk Scorecards
Client risk scorecards offered by the risk assessment tools show detailed visual snapshots of each client's risk profile. Color-coded scorecards help brokers spot high-risk areas and coverage gaps right away. Insurance professionals can detect patterns and unusual trends to make better recommendations. The scorecards work well as communication tools that explain risk factors to clients and make abstract concepts easy to understand.
2. Portfolio Risk Distribu...
Dynamic visualizations in insurance CRM solutions help brokers understand risk distribution throughout their client base. Insurance agent CRM software with portfolio charts enables professionals to spot risk concentrations by industry, geography, or coverage type. This broader viewpoint helps agencies balance their business and prepare for market changes before they affect profits.
3. Exposure Maps and Geospatial Heatmaps
Geospatial tools create visual maps of risk across locations. CRM for life insurance agents uses these maps to show geographic concentrations of health risks or mortality factors. Property insurance professionals use them to identify natural disaster zones, crime hotspots, and location-based risk factors that shape pricing and coverage decisions.
4. Claims Propensity and Claims Velocity Charts
These visualization tools show past claims patterns and predict future activity. Brokers learn about clients or industries with higher claim frequency. This knowledge helps them tackle potential problems before they turn into losses.
Key Ways Risk Assessment Tool Embedded in Insurance CRM Drive Modernization
Risk assessment tools within insurance agent CRM software are driving a technological revolution in the brokerage industry. These integrated systems are reshaping traditional insurance practices through several key innovations.
I. Enhancing Underwriting Precision with Informed Analysis
Modern CRM for insurance agency operations uses sophisticated analytics to refine the underwriting process. The system assesses client histories, discovers patterns, and forecasts future risk scenarios with greater precision. This enables brokers to make decisions based on extensive factors rather than basic information or intuition.
II. Improving Policy Personalization and Product Suitability
Insurance agencies can invest in the development of a tailored CRM for insurance brokers to manage and access extensive client profiles. CRM for life insurance agents makes it easier to recommend appropriate coverage options that align with their customers' needs. This approach replaces the generic marketing approach that dominated the insurance sector in the past.
III. Accelerating Decision-Making and Policy Issuance
The automated workflows in insurance CRM systems accelerate the quote-to-policy process. Tasks that once took days now take hours or even minutes to accomplish, improving policy issuance effectiveness and client satisfaction.
IV. Strengthening Fraud Detection and Prevention Mechanisms
Smart risk assessment algorithms in insurance CRM systems can discover suspicious patterns or inaccuracies that might denote fraudulent activity. These tools flag potential problems before policy distribution, which protects the reputation of insurance firms.
V. Supporting Regulatory Compliance and Risk Governance
The CRM for insurance brokers meets complex regulatory requirements by automating compliance checks and documentation. Agencies can remain compliant while focusing their energy on serving clients instead of managing paperwork.
Final Words
Modern risk assessment tools in insurance broker CRM systems are reshaping how professionals assess client needs and create accurate quotes. These tools help brokers make evidence-based decisions instead of relying on gut feelings or limited data. So, agencies now offer precise coverage recommendations that target specific risks rather than one-size-fits-all solutions.
Risk scorecards, distribution charts, and geospatial mapping give brokers quick insights that once took hours to analyze. Professionals can spot patterns fast, predict problems, and explain complex ideas to clients clearly. This better communication builds trust and strengthens client relationships right from the first meeting. These integrated systems represent more than just better operations. They signal a transformation toward precision, personalization, and proactive risk management.
https://completemarkets.com/Article/article-post/2229/INSURANCE-AGENT-BROKER-LICENSING/
Insurance Agent/Broker Licensing
INSURANCE AGENT/BROKER LICENSING by Marcus Ramsey Growing your agency's business might require you to obtain licenses in other states. Most experienced agents/brokers comprehend and are willing to do what it takes to ensure that the commercial side of the transaction succeeds. However, some seem to forget all this hard work is wasted if project planning fails to allow adequate time to obtain proper licensing in the target state(s). 'Ramsey's Rules' outlined below will direct you toward obtaining and maintaining proper licenses to help your new venture prosper. (I assume that anyone who reads this article already holds insurance licenses in one or more states but needs (at least one) additional license in another state to take advantage of a business opportunity. RAMSEY'S RULE #1: NEVER RELY SOLELY ON THE FREELY GIVEN ADVICE OF OTHERS. I am constantly reminded of the number of intelligent, thoughtful agency executives who for all intents and purposes jeopardize their business by accepting half-baked advice from someone they would not trust with their car and daughter on prom night. Obtaining the licensing information as the first step of your new project/program (not your third, 15th or 23rd step). How do you go about obtaining this information? Contact the agent licensing section of the department of insurance of the target state and request a copy of its agent/broker license instructions and application forms (see the State Insurance Department Directory in back). Most states have their own specific, easy-to-follow instructions on the licensing process. Get this packet and quickly read through it even if you intend to delegate the project of obtaining the license to a member of your staff or retain a consultant or licensing service. In fact, reading over the instructions will give you a good idea of the time and effort involved in obtaining the necessary license and whether you or a staff member will have the time to prepare, file, and follow up on license issuance within the time constraints you are working under. You should consider retaining outside assistance when you plan to seek licenses in several states at the same time. Be sure that whoever is going to do this work can focus the necessary attention on the project to complete it as quickly as possible. RAMSEY'S RULE #2: IF SOMEBODY ELSE IS DOING THE WORK FOR YOU, MAKE SURE YOU KNOW AT LEAST GENERALLY WHAT IS INVOLVED, REQUIRE PERIODIC PROGRESS REPORTS, AND QUESTION ANYTHING THAT SEEMS WRONG TO YOU. Remember, it is YOUR business and you had better look out for its best interests unless you are looking for a career change. RAMSEY'S RULE #3: RELATE THE LICENSING REQUIREMENTS TO YOUR ACTUAL BUSINESS SITUATION. Clearly define how you intend to operate and identify the key points to be covered in licensing. Licensing services and consultants who do licensing work usually ask the client to complete a form which requests most of the information contained on state application forms. This information is then typed onto the appropriate state forms and returned to the client for rechecking, signature, and attachment of the proper fees. The problem with this approach is that planned operations might not match license authorization. That can mean trouble later, unless someone is willing to take a couple of extra minutes to be sure everything is right. The answer to simple questions such as, 'Will you write Life/Disability or Property/Casualty coverages or both?' and 'Do you intend to open an office in the target state or do you plan to operate from your existing office?' will help define the types of licenses needed. Whether you intend to conduct business as an individual, partnership, or corporation can have a direct bearing on whether a license can be obtained for that entity (a few states, such as Alabama, issue nonresident licenses only to individuals, not to partnerships or corporations). If you are seeking a license for a corporation, make sure that an application for individual licenses are also filed. When you receive an approval, make sure you have approval for the corporation and all individual transactors. By carefully outlining how operations will be conducted, you can dictate whether you need to seek licensure as an agent, broker, managing general agency, surplus line broker, etc. Sometimes you find that you do not need to obtain a license in another state. For example, some states, such as California, do not require nonresidents to obtain a license to insure risks with incidental exposures in the state as long as the unlicensed nonresident does not enter the state to solicit, service, or inspect the entities insured; However, other states, such a Texas, do require nonresidents to be licensed under the same circumstances. Keep in mind that 'entering' the state may include obtaining information by mail and telephone as well as physical presence inside the state. Also, many states will not issue a surplus line broker's license to a nonresident except in connection with a risk retention group. If your activities will involve related services by the same or by one or more related entities, such as a third-party administrator or claims adjuster, check to see if those activities require licensing as well and, if they are, be sure that those licenses are obtained as well for the corporations and all individuals involved. 'FC&S Bulletins' published by the National Underwriter Company and the 'State Licensing Requirements Guide' published by Pictorial, Inc. offer helpful summaries of state licensing procedures and provide invaluable overviews of each state's licensing and continuing education requirements. Even if someone else is going to do the licensing work for you, you should at least review the state's overview/summary. RAMSEY'S RULE #4: OBTAIN AND REVIEW EACH STATE'S INSURANCE CODE. If someone else will actually do the licensing work for you, it may be enough for you to review a state overview or summary during the application process. However, the individual handling the licensing work for you MUST obtain and review all applicable sections of the target state's insurance code. Once the license has been obtained, you will need access to a copy of the state insurance code, regulations, and bulletins. How can you obtain another state's insurance code? Some state departments of insurance sell or can refer you to a source for a relatively inexpensive copy of the state insurance code, the department's regulations, and the department's bulletins. Otherwise, contact the National Insurance Law Service (NILS) or another law book publisher. If you are comfortable 'surfing the net,' you will find pricey but instant access to on-line law libraries on the Internet. Another possible source is the law library maintained by a local bar association or a nearby law school. RAMSEY'S RULE #5: IF THE WORK NECESSARY TO OBTAIN THE LICENSE(S) SEEMS TOO EASY OR QUICK, YOU ARE PROBABLY ON THE WRONG TRACK. This sounds cynical, but the people who drafted agent/broker licensing laws and regulations never considered whether the requirements being adopted would make it easier for the agent/broker to make a living. Just filling out the forms won't suffice. Most states require that you provide a copy of your license certified by your home state insurance department. If you are seeking licenses for a corporation, you probably will also need to obtain a copy of the articles of incorporation and/or certificate of good standing certified by your home state's Secretary of State. As a rule of thumb, it takes 30 to 60 days to gather all the information necessary to file the application. Once the application has been filed, don't expect to receive the approval by return mail: approval time frames of 60 to 90 days or even longer are not uncommon in certain states for certain types of licenses. Because the licensing process can be terribly slow (even when the process moves quickly, it is very slow), you need to begin as soon as possible. Since you cannot start writing the program/account until you have the necessary licenses, processing delays may push you beyond your frustration tolerance level. However, all you can do is relax, breathe deeply, and try to make sure that you aren't the reason for the delay. Keep the ball in the department's court by making certain the application and any required supplemental information are complete in every respect. Many states will simply return an incomplete application without action. Once the application and all necessary supplements have been submitted, your application will be 'ripened' according to the season of the year in a big pile of similar forms. Discount any claims by license services or consultants that they can obtain the license you need significantly faster than anyone else on earth. To deliver on such a promise, it would be necessary to overcome the Universal Laws of Orderly Bureaucratic Work Flow and Form Processing. While occasional triumphs over this inertia have been reported, they are rarely confirmed by reliable sources or any documented evidence. Only a complete application will allow unimpeded progress step to step. Again, if you make it your business to know generally what's involved in obtaining the license(s) you need and if you monitor activities through periodic progress reports, you should be able to assess the quality and timeliness of the work being done on your behalf. RAMSEY'S RULE #6: ONCE YOU OBTAIN THE NECESSARY LICENSE, KEEP IT CURRENT TO AVOID REPEATING THE RIGMAROLE. You should apply this rule to all licenses, permits, and/or corporate authorizations held. For example, don't assume that meeting your home state's continuing education requirements will be sufficient to retain the license(s) obtained from other states. If your home state does not have a continuing education requirement, you will probably need to meet the continuing education requirements for each state in which you are licensed. Also, maintaining corporate authority usually requires making one or two filings each year. Make sure that you, your attorney, a consultant you have retained, or someone on your staff is assigned to monitor and ensure that all requirements are met when due, that all necessary filings are made in a timely manner. Demand that your files be clearly documented to show what must be done, what has been done, when it was done, who received copies, the check number, the date, the amount of any fees paid, etc. In summary, obtaining agent/broker licenses in new states can sometimes be a frustrating, humbling, time-consuming exercise which is nonetheless a necessary part of an agent/broker's success. In many ways, producer licensing is a lot like building a campfire: In the warmth of the glow, one can scarcely remember gathering the wood. STATE INSURANCE DEPARTMENT DIRECTORY Alabama, 135 S. Union St., Montgomery, AL 36130, (205) 269-3570 Alaska, P.O. Box 110805, Juneau, AK 99811, (907) 465-2515 Arizona, 2910 N. 44th St., #210 Phoenix, AZ 85018, (602) 912-8466 Arkansas, 1123 University Ave., #400 Little Rock, AR 72204, (501) 686-2900 California, 700 L St., 4th Floor, Sacramento, CA 95814, (916) 322-3555 Colorado, 1560 Broadway, #850, Denver, CO 80202, (303) 894-7499 Connecticut, P.O. Box 816, Hartford, CT 06142, (203) 297-3800 Delaware, 841 Silver Lake Blvd., Dover, DE 19901, (302) 739-4251 Dist of Columbia...) 266-8699 Wyoming, 122 W. 25th St., Cheyenne, WY 82002, (307) 777-7401 This article was written by Marcus Ramsey, CPCU, principal of Ramsey Consulting Services, 14026 Donart Drive, Poway, CA 92064, (619) 748-6315.
https://completemarkets.com/Article/article-post/2729/Tips-To-Forward-Your-Career-As-An-Insurance-Broker/
Tips To Forward Your Career As An Insurance Broker
If you think you’re right for a career in insurance, you’ll have to know the right path to travel to reach the peak of your potential. Networking and internships should help you get started in the industry while you’re still being educated, but there’s much more to come after you’re done with school.
Take some time to start planning for the future, and make the moves you need to succeed. Here is a brief look at a few tips to help you forward your career as an insurance broker.
Determine a clear goal within the insurance sector
There are nine different ways you can go when you’re working your way into an entry-level position in insurance. It’s important to mark out your path early on in your journey, so you can properly prepare for what’s to come.
You can choose to go the route of a broker, underwriter, loss adjuster, risk manager, claims investigator, loss control specialist, actuary, marketing representative, or appraiser. Each position has its own specialties, so figure out what to learn while your journey is young.
Work to obtain a professional designation
The path you choose for entry into the insurance world will require specific certifications and licenses, but you can also work towards the CIP (Chartered Insurance Professional) designation.
A CIP designation shows that you have the foundational qualities to meet basic industry standards. If possible, do what you can to start this designation while you’re still in school.
Research employers and thoroughly prep for interviews
When it’s time to step into your profession, you don’t want to take a position that doesn’t really fit. Research is key. Just as there are several entry points in insurance, there are many different types of insurance companies.
When you’re applying for a job in the field, you need to clearly identify your goals. Your goals are important for identifying your own path, but they also look good on your application.
Remember you’re always selling yourself
If you’re in the business of insurance, you’re selling much more than a coverage policy. Whether you’re on the job or just working towards getting a job, you need to be able to sell yourself as well as the insurance.
Once you’re practicing your specialties, you'll need to know how to market what you are selling as well. If you want to be an overachiever for your agency or yourself, learn how to apply SEO to insurance. Taking your profession to the digital level is always a great way to expand your business potential.
Work on developing your communication skills
Working in insurance means you’re working with people. If you don’t have good people skills, you may not have the desired outcome in the long term. Invest in developing your communication skills on a business and personal level....
https://completemarkets.com/Article/article-post/674/The-Five-Ways-Agents-Get-Fired/
The Five Ways Agents Get Fired!
Independent agencies and brokerages are facing a growing threat to their middle market Commercial clients. These firms are being squeezed from below by the commodity sellers and from above by the resource providers. Previously, the competition for these larger accounts has been based mainly on price, coverage, and a single relationship. But now, the determining factors in the selection process have shifted with the awareness that price does not differentiate brokerage firms except in the commodity environment -- and this shift is having some dire consequences.
Changing distribution systems have caused our clients to be more selective in the brokerage firms with whom they chose to do business. The expectations of these sophisticated clients have increased, as their perception of a firm's expertise has become the standard on which they base their decision of who to use. They have realized that in today's marketplace, price is readily available, and the insurance policy is a commodity. More and more, they're selecting brokerage firms based primarily on their ability to solve problems and provide resources.
As competition for these middle-market accounts increases, the incumbent broker/agent is extremely vulnerable in several situations. However, this vulnerably doesn't generally center on their ability to provide the desired insurance policies or price. Instead, the competition is based on relationships and the perception that other venues might offer superior resources.
Here are five classic examples of why agents can wind up getting fired in these situations. The purpose of this article is not to upset or depress you, but rather to help you know what to look out for and how to best protect yourself.
Why Agents Get Fired! #1 - The New CFO
Has it happened to you yet? You've just been introduced to the newly hired Chief Financial Officer of your largest account. In a flash, your previous relationship and all the personal loyalty it engendered are gone. There's no warmth, just the coldness of a new agenda -- an agenda that probably doesn't include you or your firm.
Why should you be concerned when you've done a good job providing for the account and have the service record to demonstrate it? Here's why!
The new CFO has a financial background. He or she judges the value of the service you've provided based on resource capabilities and quality information. This person has a higher level of expectations. In the event the new CFO came from one of the Big Five, he or she is accustomed to global capabilities and team service. The person might well have relationships with one of the major international brokers. Your record of competitive pricing and personal service won't mean much to him or her.
Take these steps to protect yourself:
Find out why the new CFO is there. In most cases, either the firm is in difficult financial straits or it's positioning itself to go public. If you know the reason for the new CFO, you can determine the agenda.
Get the background of his/her prior job. In many cases, a new CFO brings in the same brokerage firm who assisted them in their prior position. You need this information to protect yourself from being blind-sided.
Provide a Stewardship Report ASAP! You must demonstrate to the new CFO how important your role has been to the development of your client. Remember that this person has no history with you and might not be aware of all the things your organization has done for the client.
Test the Relationship. You have a problem if your calls go unreturned, your lunch meetings are unaccepted, or your recommendations are ignored. The client is getting advice from somewhere. Don't be afraid to be fired! Sometimes you need to have a serious discussion with the new CFO regarding your position. If need be, look this person in the eyes and say, 'My sense is that you might be happier to be represented by another brokerage firm.' This might well begin a dialogue that will lead to a understanding.
Why Agents Get Fired! #2 - The Initial Public Offering
I recently spoke with an agent who told me that his firm 'just didn't get involved' with lPOs. 'They're just too messy,' he said. 'We let the other guys do those.'
This kind of thinking is completely counter-productive and shortsighted. How can you be in the Commercial insurance business and not work on lPOs? Although public offerings used to be reserved for large organizations or high tech start-ups, today they're prevalent in all industries from construction to transportation. They're the new brass ring for owners of smaller businesses.
Yet, many agents still don't see the bullet coming because they don't realize that the rules have changed. The initial public offering injects two new entities into the relationship, and agents who aren't prepared to accommodate these new entities will almost certainly lose the account.
The two entities are investment bankers and the Securities and Exchange Commission.
Investment bankers might either provide private placement capital or underwrite a public offering. In either event, they bring their own professional advisors into the transaction. One of these advisors is usually an insurance brokerage firm.
Once the Securities and Exchange Commission is in the game, your client is playing by a new set of rules. The SEC mandates confidentiality requirements, statutory filing requirements, and accounting rules. Your client will need advisors who can provide counsel in these transactions.
If you're not prepared to address these changing circumstances and needs and able to answer the concerns of the investment bankers and SEC, you will almost surely lose the account. So, when an IPO is in the wind, take these steps to protect yourself and preserve your account:
Understand the Deal. With the signature of confidentiality agreements, professional advisors can obtain access to the private placement documents or preliminary information. This is critical, as they will outline the strategy and issues going forward. In some cases, you can obtain public information on the Web. However, it's usually too late if the information is public, since someone else acted as an advisor to reach that point.
Know the Steps and Timeframes. There's usually some lead time between the decision to bring in the investment bankers and the action. This is the period for you to position yourself as the advisor. Then, when the investment banker is chosen, you will already be in place as the professional advisor and your position will be secure.
Know the Investment Banker and the Board. The investment banker and the board members might have favored professional relationships. It's important that you know who they are. Otherwise you might be surprised and excluded. The more you know about a person's background, preferences, style, etc., the better your ability to fit yourself into their existing dynamic.
Know the Other Current Professional Advisors. You're not the only professional advisor who's vulnerable. Other advisors such as the local banker, accountant, and attorney firm are also at risk. An alliance with these individuals can be to your benefit. Together you can present a united front with a comprehensive action plan that coordinates all the various needs and services.
Get Help! Recognize the fact that you're no longer in an insurance transaction. Your long-term value lies in the ability to bring information and solve problems. Align yourself with industry experts who have worked in this arena before. Your major competition has these experts. You need them, too.
Why Agents Get Fired! #3 - The Request for Proposal (RFP)
Visualize for a moment the construction of an atom. There's the impenetrable material of the nucleus with a variety of particles circling around it, trying to get in. That's basically the picture of an RFP. The client and his/her advisors sit in the center, while brokers and agents all spin in orbit trying to figure out the key to success.
This is a critical time in your relationship with your client. In most cases, the RFP process is a smokescreen from behind which your client intends to change brokers.
What many agent/brokers don't realize is that the Request for Proposal is not really intended as an insurance transaction. Buyers know that anyone can obtain the insurance at the same competitive rates. What they're really judging is the expertise and resource capabilities of your firm. Often they've already been shown a standard of capabilities they desire elsewhere and are simply going through the motions of the RFP to justify moving their account.
Here's my advice to anyone invited to compete in the RFP: Unless you created the opportunity, or are intimately familiar with the issues, walk away! You'll be part of the window dressing while the incumbent gets fired, and the firm who created the RFP gets hired. You'll expend time and energy pursuing a goal that's almost assuredly already out of your reach.
So how does a firm successfully compete in an RFP?
If you're the incumbent, don't let it begin. Stay on top of the issues and resource requirements of your client. This process takes place throughout the year, not just at renewal. Use stewardship reports as a way to demonstrate ongoing value.
If you're not the incumbent, create the opportunity. By developing issues and demonstrating superior resource capabilities, firms put themselves in a dominant position. Creation of an RFP is merely the method in which the client anoints them.
Understand the issues. Most RFPs occur because the incumbent agent has lost touch with the issues. These issues can be technical, resource, or relationship based. The successful participant must be fully versed on these issues and prepared to resolve them.
Develop Spheres of Resource. Be prepared to reach outside your immediate organization for resources to assist your client/prospect. These resources will allow you to create the perception of adding value. In many cases, the perception of superior resources is what attracted the client in the first place.
Learn Conceptual Presentation Techniques. In most cases RFPs require team presentations with visual and written materials. The ability to produce and deliver these effectively is critical to your success. These presentations are based on the creation and demonstration of ideas, not price. It will be too late to develop the needed skills once the RFP has been issued. Prepare now by learning presentation and material development skills.
Why Agents Get Fired! #4 - The Acquisition or Merger
An agent friend of mine received a call at 11:30 p.m. one Friday from his largest client telling him that he had just returned from signing the deal that sold his company. The client just couldn't sleep until he told his agent/friend about the sale. Guess who didn't sleep the remainder of that night!
Although you might be happy for the success of your associate in a situation like this you'd be naïve not to worry. Usually these deals involve other multi-state or multinational firms and the acquiring firm has an established relationship with another broker. Someone must go, and the other broker is going to do everything possible to make certain it's you. So you have to do everything you can to make sure it's he:
Become an advisor in the deal. Someone needs to perform due diligence on the risk-financing program. There are usually two appetites for risk, and the one program might not fit the other. What happens if one of the programs contains massive unfunded reserves in a cash flow program? What will the newly combined program look like on a pro-forma basis?
Get the horsepower. Reach outside your immediate organization for the resources you need. In the case of a multi-state or multi-national merger you might need to form strategic alliances with other brokers in those locations.
Be ethical. If you're the advisor in the deal, providing the due diligence, you'll need to place the client's interests above your own. It's quite possible that you might discover flaws in the program that could create problems inside the deal. You must disclose these at any cost, including your risk of being fired. Failure to do so will have significant consequences, as these flaws will eventually be discovered. Furthermore, though it might not always seem the case, ethics are valued and your willingness to do the right thing even at the risk of losing the account will make a highly positive statement about you.
Why Agents Get Fired #5 - Depend on the Carrier or Product for Differentiation.
Independent agents and brokers have traditionally relied on the product as a basis of differentiation. 'We represent XYZ Company', they say. 'XYZ has an excellent program for people in your industry.' Yet in most cases they're not the only firm who has access to XYZ. They haven't distinguished themselves, they've merely tied their fate to the commodity/product.
Sophisticated buyers recognize that the product is readily available at virtually any price from numerous sources. They want and expect more from their agent/broker than simply the ability to place insurance. The insurance program is usually the last criterion of which agency/brokerage will represent them.
Successful agents/brokers of the future will learn how to differentiate themselves -- first by demonstrating that the placement of insurance is just one of the tools they can provide to clients. They will learn how to be compensated on a fee basis, and provide value outside the insurance policy.
It will be critical to be able to prosper without being tied to the commodity. Ways to do this include:
1. Learn 'Consultative Brokerage' Techniques. The ability to develop issue-based prospects, build relationships, introduce resources, institutionalize clients/prospects, and exercise broker control will differentiate successful agent/brokers from the competition. These consultative brokerage techniques allow an agent/broker of any size to create perceived value.
2. Learn How to Compete Conceptually. Conceptual competitions aren't based on the product, but how a firm intends to provide value to the client. This value is based on many things besides the insurance carrier or policy.
3. Institutionalize Your Franchise Accounts. Make certain your current major accounts are bulletproof before looking elsewhere for new business. Your largest accounts are probably targets for other brokers. They're an excellent way to practice and implement consultative brokerage techniques.
4. Master the Five Pathways to New Business. There are only five ways to create new revenue: Seminar selling, active prospecting, request for proposal, networking, and cross-selling. The firm that learns and masters these will control its marketplace.
5. Lead Change. Our industry is changing more rapidly than ever. New distribution systems are developing that are not dependent on traditional agents and brokers. For your organization to provide value in the future, you must establish a culture change that matches client expectations.
CONCLUSION
As competition intensifies for larger accounts, the successful agent/broker will learn how to match capabilities to buyers' expectations. Hopefully they will not experience the bitter lessons of Why Agents Get Fired!...
https://completemarkets.com/Article/article-post/932/DEVELOPING-BROKER-SERVICES-AGREEMENTS/
https://completemarkets.com/Article/article-post/2564/Its-a-Small-World-Doing-Business-Abroad/
It's a Small World: Doing Business Abroad
The international insurance market offers a variety of benefits to independent agents and brokers. It provides a perfect tool for solidifying your Commercial Lines accounts and insulating them from inroads being made by alphabet house brokers. International insurance operations also offer an entree to new product lines and markets that will expand your facilities abroad. For example, U.S. agents can introduce their expertise in such lines as Auto, Medical, Surety, and Workers' Compensation to third-world countries that are privatizing these coverages. Canadian brokers can expand their expertise in out-of-country private Medical insurance and, potentially, Workers' Compensation.
Doing business abroad can introduce agents and brokers to new international markets, both primary (with such carriers as AGF, Allianz, Generali, and Winterthur), and reinsurance/variable insurance programs (financial reinsurance, stop-loss reinsurance, catastrophe reinsurance, etc.). The international market encompasses the national accounts division of major companies, offering creativity, capacity, and flexibility, enabling the agent or broker to approach accounts on a broad basis. Examples include Aetna, AIG, Chubb, Great American, The Hartford, and Reliance National.
Agents and brokers can access the captive market either by establishing a captive for a corporate client or renting a captive to facilitate international exposures, self-insured retentions, and a potential profit center. The international market has captive facilities in such locations as Bermuda, Barbados, Ireland, Guernsey (the Channel Islands), and Luxembourg.
BUILDING EXPERTISE AND INTERNATIONAL KNOWLEDGE
AIG Chairman Hank Greenberg highlighted the success of operating internationally at the 1992 IMMS convention in Scottsdale, AZ. Greenberg has led his very successful organization to develop business in China, the United Kingdom, Europe, South America, Canada, and the United States. For example, AIG has extended its expertise in financial banking to U.S. corporate clients that do business in Asia but find their U.S. bankers unwilling to take the risk of providing financing abroad. Similarly, many IMMS members are large surety brokers with a wealth of expertise and knowledge of their corporate clients. They can extend this expertise internationally by working with companies such as AIG, which understand foreign markets.
FREE TRADE AND THE WORLD INSURANCE MARKET
The U.S.-Canadian Free Trade Agreement has accelerated the growth of Canadian firms into the United States, while mid-sized U.S. firms have expanded into Canada. There has been some growth in Mexico but not to the extent experienced in Canada and the U.S.
Anticipating passage of the Free Trade Agreement, many companies began to position themselves in the Canadian market during the early 1980s. They saw Canada as an entry-point for export into the United States because Canadian laws are less punitive, particularly in the areas of product liability. Many of these firms are insured by the multinational alphabet-house brokers who provide extensions of coverage from a master program established in Europe or Japan.
A few IMMS members have succeeded in meeting some of the essential insurance requirements in such lines as Products Liability through major insurers in Canada, particularly those with operations in the United States. Agents have been able to access U.S. insurers that frequently include Canadian exposures under their U.S. coverage.
European insurers are following their European manufacturing accounts into North America. Canadian brokers and U.S. agents are involved in placing insurance in Canada or the United States on behalf of the European insurers and their clients. Generally, European insurers believe in long-term arrangements and are eager to work with IMMS member agents and brokers to facilitate this business.
The trend is to ensure an international account with a major insurer that will issue policies in the various countries either through its own subsidiary or with a friendly insurer, participating in the risk taking. The underwriting is done centrally from the parent insurer with a broker appointed in the foreign country based on regulatory requirements and facilities under the direction of a master broker.
THIRD WORLD INVESTMENT AND INSURANCE
The insurance industry has traditionally followed the growth of other industries. Investment from the United States and Canada in such developing regions as Eastern Europe, South America, and Asia offers opportunities to insure the manufactured and exported products. A recent example is Canadian investment in manufacturing portable sawmills in Eastern Europe, which are exported to 20 countries, including the United States and Canada. The Canadian client has requested insurance for the sawmills. In this regard, the coverage can be placed in the Canadian, U.K., or U.S. markets.
ALL BROKERS AND CARRIERS AREN'T CREATED EQUAL
Here are a few recommendations for choosing a CORRESPONDING BROKER:
Look for individual expertise and enthusiasm.
Set an equitable commission split. In most cases, this should be on a 50-50 basis. However, if the corresponding broker does the majority of the work in placing the account, its split should be higher.
Negotiate a non-competition agreement.
Offer the broker one or two accounts to determine the level of interest and service.
Meet with the corresponding broker at least two to three times per year.
Set up separate portfolios for the international business within both brokerages to measure the amount of business and related expense.
To select a CARRIER for your international accounts, I would suggest that you:
Bear in mind that most insurers have problems with international accounts because of policy wording, regulations, accounting, currency, and organizational differences.
Work primarily with the corresponding broker in the placement of the account. Additionally, a number of excellent international insurers and regional insurers can provide local underwriting, engineering, and support of an international account.
Qualify the insurer using these criteria:
Financial stability-a Best's rating of "A" or higher
Corporate culture
Multi-state facilities
Ability to work with a captive
Ability to "front" if required
Technical expertise by specific lines of business: Personal Lines, Commercial Lines, Automobile, General Liability, Life and Health, Workers' Compensation, etc. Do not necessarily seek an all-lines insurer, since the carrier might not have the expertise across the board. What's more, the insurer might not want to write in certain regions, such as Florida, Texas, Massachusetts, British Columbia, or Quebec. Selecting the appropriate international insurer will be depend on the region, expertise, capacity, and flexibility in the strategic classes of business for your client (i.e., Auto, Product, Liability, Workers' Compensation, etc.).
OF LAWS AND REGULATORY REQUIREMENTS
Agents and brokers need to be aware of significant technical, legal, and regulatory differences between the U.S. and Canadian market. The U.S. requires more detailed filings for all products sold. Canada requires filings only for Auto insurance. In addition, U.S. agents are required to provide detailed rating and statistical codes for most product lines when seeking quotations from insurers.
The regulatory issues for agents and brokers are generally similar, with carriers and agents/brokers regulated on the state or provincial level. In Canada, provincial regulation dovetails with self-regulation for brokers in the provinces of Quebec, Ontario, and British Columbia. Canadian insurers may be regulated by the government of the province in which they are domiciled. However, most insurers are federally regulated, which allows them to operate nationwide. U.S. insurers are required to obtain licensing in each state in which they do business.
Some Canadian provinces, notably Ontario and Quebec, impose a sales tax on insurance premiums. This means the broker has to collect this tax and remit it to a provincial regulatory department. There are also rigorous requirements on brokers regarding the placement of insurance with non-licensed insurers, which could affect your international accounts.
Some significant differences are found in such product lines as No-Fault Auto insurance, Environmental coverage, and Workers' Compensation. For example, since there isn't subrogation under Workers' Compensation for most industries in Canada, Comprehensive General Liability in the construction field does not have the same exposures as a similar situation in the United States would.
TWO PEOPLES DIVIDED BY A COMMON LANGUAGE
Agents and brokers should also consider cultural differences between the United States and Canada that can affect the conduct of business across the border. For example, the United States tends to be more forms oriented. Accounts are also larger because of the population (approximately 10 times greater than that of Canada) and the inclusion of substantial Workers' Compensation premiums. This results in a U.S. agent receiving a larger commission and anticipating a similar type of revenue in servicing a subsidiary of a Canadian account. Unfortunately, the premium account size tends to be much smaller for Canadian accounts, which leads to limited interest by some U.S. agents.
The Canadian decision-making process tends to be faster. Insurers on international accounts and generally larger accounts will respond within 30 days. The process in the United States is usually much longer (60 to 90 days) because of the detail required and multi-state involvement.
REVERSE FLOW BUSINESS: ON THE RISE
"Reverse flow" business-involving domestic subsidiaries of foreign parents-is playing an increasingly important role in the international insurance market. These accounts will continue to grow as smaller to medium-sized U.S. accounts expand into Canada. Canadians have high technical skills in aviation, automotive, steel, and automation, competing actively on a global basis. For example, all of the Ford Windstars for the North American market are now made in Oakville, ONT. Such economic activities result in Canadian IMMS member brokers working with IMMS member agents in the United States to insure these accounts.
This business can be expanded in Life & Health insurance, pension consulting, and possibly placement of insurance in emerging third-world countries. Such nations as Argentina, Brazil, Chile, China, the Czech Republic, Malaysia, Mexico, Thailand, and Vietnam are on a fast track for economic development. This growth offers a perfect opportunity to expand the IMMS network, with U.S. and Canadian members leading and coordinating the Commercial accounts for business extended or originating in these countries.
MAKING YOUR MOVE
Here's some advice for any agent or broker who'd like to have a piece of the action in the international insurance market:
Target your existing and prospective clients who either export or provide work for international companies on a joint venture or licensing basis.
Identify their exposures: Auto, Health, Marine, Products Liability, Workers' Compensation, and so forth.
Make an arrangement with IMMS correspondent brokers principally in the following states: California, Illinois, Maryland, New York, Texas, Washington, D.C., Washington State.
Try your first account with the corresponding broker before aligning on a permanent basis.
Create a system to follow in placing your international accounts.
Identify key individuals in the brokerage to handle the international accounts.
Reach an agreement with the corresponding broker on the priority of international accounts.
Visit your corresponding broker in advance and frequently thereafter.
Talk to selected insurers about facilitating international accounts.
...
https://completemarkets.com/Article/article-post/1707/INSURANCE-DISTRIBUTION-TRENDS-AND-THE-EFFECTS-OF-CHANGE/
Insurance Distribution Trends And The Effects Of Change
INSURANCE DISTRIBUTION TRENDS AND THE EFFECTS OF CHANGE It's remarkable that the insurance industry has experienced only evolutionary - not revolutionary - change in its structure, processes, systems, and culture over the past 50 years. This is due partly to the regulatory nature of the industry and partly to exclusive and/or vertical agency agreements between insurance providers and agents. In this regard, the insurance industry is similar to banking and many other investor-owned utilities that are price regulated by the states and obligated to serve society. This situation is about to change because several external and internal factors are putting increasing pressure on the industry at a faster pace. The drivers of change include financial pressures, consolidation, advances in technology, regulation, and rising consumer expectations and empowerment. Interestingly, these are the same forces that are already impacting other industries in profound ways. Financial pressures in the personal computer industry caused by declining margins, rapid product obsolescence, and growth of the consumer market created havoc among franchised distribution companies such as ComputerLand and Entre. This resulted in the formation of a two-tier distribution system (distributors and dealers) as a means of addressing both financial constraints and market demand. Now companies such as Dell and Gateway are trying to shift the distribution system further by selling directly to end users. The rapid growth of the Internet is clearly responsible for the unprecedented market cap of Charles Schwab in contrast to the largest securities brokerage firm, Merrill Lynch. Electronic trading, available 24 hours a day, seven days a week, is restructuring commission fee arrangements and transforming brokers from order takers into financial advisors and knowledge workers. Rapid deregulation of the airline industry in the late 1970s and early 1980s permanently reshaped the relationship between airlines and travel agents. Today travel agents are more focused on the end-user (corporate and consumer), and are becoming fee-based service providers. Furthermore, many are consolidating and becoming super-retailers to counterbalance the power of bigger airlines and global alliances. The exclusive franchise system that has served the automobile industry for generations is giving way to the popularity of auto superstores such as CarMax and AutoNation, a consequence of channel consolidation and rising consumer expectations. This recent transformation is propelling auto makers such as Ford and General Motors to buy out their independent dealers and form separate equity-owned distribution companies, similar to what Coca-Cola did with its independent bottlers through the creation of Coca-Cola Enterprises in the mid-1980s. This research study attempts to uncover the changes that have occurred in other industries confronted by the same drivers of change. We chose travel agencies, personal-computer dealers, securities brokerages, and automobile dealers for the reasons discussed above. We also interviewed independent insurance agents for their opinions and observations of necessary and desired changes that the independent insurance agency system must engage in the coming years to survive and grow the business. It's inevitable that insurance agencies will continue to consolidate to become full-service agencies on a national scale. However, small boutique insurance agencies specializing in niche marketing or unique insurance products will also keep growing. Similarly, independent insurance agents will be disintermediated (eliminated as the middleman) by the Internet, although only for selective product lines, e.g., low-margin commodity products that consumers are willing to purchase without an agent's advice. At the same time, there will be fee-based reintermediation (in which intermediaries are introduced into new relationships or their roles and responsibilities are expanded). And insurance agents will emerge as infomediaries. Finally, both insurance companies and independent agents will learn to cooperate and collaborate with each other to serve end users more effectively and efficiently. At the same time, it's likely that some insurance companies will acquire or invest in their distribution partners in the same way pharmaceutical companies dealt with their distributors (Merck buying Medco and Baxter acquiring Hospital Supply Corp.). Not all the observations, conclusions, and recommendations found in this report will be applicable to all independent insurance agents. Each one will have to analyze their own context and drivers of change and attempt to use lessons learned from other industries and other independent insurance agent companies to determine their own path. MAJOR TRENDS OUTSIDE THE INSURANCE INDUSTRY Embrace of technology. Regardless of the industry, suppliers and distributors alike are embracing the Internet and other advances in technology to propel their businesses to new levels. Those who adopted the Internet early on seem to love the new playing field, while latecomers are scrambling to catch up. Channel shifting. Financial pressures and consumer expectations are driving suppliers to distribute their lower-margin products through the most economical channels, sometimes bypassing intermediaries or reducing their commissions in pursuit of profitability. But this is only one side of the story. New roles in sales and service. A growing number of suppliers is viewing the product sale as the acquisition cost for securing long-term customer relationships. Increasingly, their intention is to find ways to free their distributors from the low-profit transaction and allow them to concentrate on higher-profit, value-added service and support. Consumers paying for service. As the roles of the supplier and distributor change, so do the distributor's compensation models and sources of revenue. Value-conscious consumers are clearly willing to pay for services rendered, but the greatest challenge to distributors in moving to a fee-for-service model is establishing price. Successful sales strategies. Growth opportunities will always exist for boutique-sized businesses as they provide specialized services to compete with the largest-volume players. Whether through volume or specialization, success is reserved for those with vision, courage, and an instinctive orientation toward consumer needs. Integration of supplier-distributor efforts. Suppliers recognize that the distributor ultimately controls the relationship with the customer. To assure that distributors can and will sell their products, suppliers are increasing their efforts to integrate marketing and communications with their distributors to ensure that a consistent message reaches the consumer. New efforts in cross-selling. The Internet as a medium has made cross-selling more advantageous than ever before to suppliers and distributors. The synergy of products and services offered is providing a tremendous convenience for consumers in their quest for one-stop shopping. Changing relationships between suppliers and distributors. In just the last few years, relationships between suppliers and distributors have undergone dramatic changes, forcing a reevaluation of commitment and responsibility to one another. While no single course of action has emerged as the standard, the suppliers and distributors who value their existing partnerships are working more closely together and as a result creating stronger, more unified relationships with their customers. CHANGE WITHIN THE INSURANCE INDUSTRY Here are some important questions for the independent insurance agency system: Are we responding to consumers' changing needs and desires? Is what we're providing today materially better than what we provided five or 10 years ago? Have we embraced the available technology? Do we understand what business we're in (i.e., selling insurance to buyers or helping them manage risk)? Are we prepared for the new competitors on the horizon (if not in our face) who will embrace technology, operate efficiently, and respond to the needs of the consumer? Are we improving the quality and efficiency of our working relationships with our business partners? Are we asking for and expecting more from ourselves and our business partners? Are we actively and aggressively finding ways to eliminate inefficiencies, duplication, and waste? Do we know where we can best strategically position ourselves for the future? Unfortunately, for many within our industry, the honest answer to several of these questions is "no." For them, the future is bleak. Fortunately, many agencies and carriers are aware of the changes, see this as a time of tremendous opportunity, and are actively doing something about it. We hope that this study will educate, stimulate, and motivate our industry to action. For some, it's a wake-up call. For others, it'll provide direction and ideas on what to do. For still others, it'll confirm what they already know and provide some additional perspectives that may allow them to further develop and make positive future efforts. STEPS TO SUCCESS The following steps will help to ensure the future of the independent insurance agency system: Stay attuned to change. Assume an optimistic attitude and perspective. Focus on serving the customer better. Match customers, products and services, and distribution channels. Pursue strategic affiliations and alliances. Develop and implement a technology strategy. Elevate relationships between agencies and carriers. In most of life's endeavors, the attitudes and perspectives of the individuals involved will be the most crucial factors in determining the level of success achieved. This is as true in the world of business as it is in sports. When conventional ways of doing business are challenged and the level of performance must be improved or materially adapted, positive attitude and perspective become imperative. TEN REASONS TO BE OPTIMISTIC ABOUT THE FUTURE In the current economy, the one who controls the customer is king. Insurance agencies have direct contact and good relationships (or their potential) with their customers. Most insurance isn't a commodity product. Buyers of nearly all lines of business require technical and professional assistance to understand and to purchase the most suitable product. This complexity makes insurance difficult to sell on the Internet. Even insurance that could be considered a commodity product can be confusing, considering the volume of options and alternatives available and the significant implications of purchasing the right coverage and limits with a financially stable insurance company. As a result, advice and professional assistance are needed. Technology can empower small independent agents by giving them and their customers access to products, services, and information that historically has been only available to larger organizations. Although compensation for selling insurance may go down, compensation for servicing and providing professional advice is going up. Many insurance companies that historically have distributing their products through captive agency systems are beginning to utilize the independent distribution system. Attractive opportunities exist for agencies to create alliances with other firms and so gain better access to prospects, capital, technology, and other resources. Existing challenges and opportunities are great. The reality is that many agencies won't respond proactively, which presents tremendous opportunity for those that do choose to take action. Many of the factors that are critical to the long-term success of an insurance agency are within the agency's control. There's abundant room for improvement in almost every aspect of our business. ELEVATING RELATIONSHIPS BETWEEN AGENCIES AND CARRIERS The central focus of this study is the distribution system, particularly the relationship between suppliers and distributors. As we've seen in other industries, changes are occurring in the relationships between these parties, including the roles and responsibilities assumed by each, the nature and quality of the end product being delivered to the customer, and the overall success being achieved by each party. The recent threat of disintermediation has haunted distributors in many industries. Many have questioned whether insurance agents will soon find themselves cut out of the insurance delivery system. The research in this study suggests that widespread disintermediation won't occur. For every example of intermediaries being squeezed out of the picture, there are comparable examples of reintermediation. If an intermediary is adding value to the transaction, its position is secure. We see both good and bad in many agency-company relationships. On the positive side, carriers and agents/brokers have provided valuable services and quality products to a large segment of the economy. At the same time, significant opportunities exist to improve the quality of these products and services. Additionally, there's enormous room for improvement in the efficiency and quality of the relationships between insurers and agents/brokers. For insurance carriers, agents, and brokers to enhance their relationships, a number of things will have to occur: Each will need to focus on improving the quality of their own performance and partnering with those who hold themselves to similar standards. Decisions need to be made with the recognition that each is dependent on the other and that helping the other succeed will enhance individual success. The level, depth, and substance of communications need to be improved. Investments need to be made on both sides in proactive and visionary strategic planning. Mutual commitments must be honored. The hallmark of the performance-based relationship is accountability. Concerted efforts need to be made to eliminate existing duplication of effort, inefficiencies, and unacceptable error ratios. Automation and technology need to be mutually embraced by all parties to allow for quantum improvements in productivity and to increase the quality of service provided to customers. Agents need to recognize that they are sales and service providers, and insurers need to provide the necessary tools, resources, and support to enable agents to effectively distribute their products and services. Compensation needs to be performance based. As roles and responsibilities shift, compensation needs to appropriately reflect the additional responsibilities assumed by each party. This study was written for the Independent Insurance Agents of America (IIAA) by Reagan Consultants, an Atlanta-based management consulting firm that serves insurance agents, brokers, and companies, as well as financial institutions. You can contact them at (800) 261-4422. ...
https://completemarkets.com/company/CompleteMarkets/Articles/content-package/IMMS-Library/TabCategory/article-post/623/E-O-Failure-To-Read-A-Policy-Is-No-Defense/
... 00 AM by Al Diamond , CompleteMarkets Editor This content has not been rated yet. Although the case cited in this article centers on a New Jersey ruling, it highlights the potential for exposure in all states. Our subsequent conversation revealed a simple method of avoiding this E&O issue. See our remarks at the end of this article about how to protect yourself In a malpractice suit against an insurance broker by its customer, the New Jersey Supreme Court decided that insurance brokers may not rely on a customer's failure to read his insurance policy as the basis of a defense of comparative negligence. Aden v. Fortish, 169 N.J. 64 (2001) Before this decision, there have been numerous decisional pronouncements that an insured had an obligation to read the policy provided to them. Indeed, ... Appellate Division had upheld the right of an insurance producer to raise the issue of comparative negligence, and had held that the issue was one for the jury to decide in the context of comparing the negligence of two parties and determining proximate cause. In Aden v. Fortish, a fire damaged a condominium owned by the plaintiff and the condominium association's policy failed to cover the damage to the interior of the premises. Because the plaintiff's policy only provided $1 ,000 of coverage, plaintiffs were required to pay about $20,000 in repair costs. Plaintiffs sued the broker for allegedly neglecting to procure adequate coverage for the risk of loss. The broker filed an Answer contending that the plaintiffs failed to read their policy to determine if what they received is what they ordered, and that this ...
https://completemarkets.com/Article/article-post/1337/RESERVATION-OF-RIGHTS-LETTERS-A-RISK-MANAGERS-GUIDE/
Reservation-Of-Rights Letters: A Risk Manager's Guide
RESERVATION-OF-RIGHTS LETTERS: A RISK MANAGER'S GUIDE Reservation-of-rights letters often leave risk managers scratching their heads in shock and anger. What does the insurer mean? How should the risk manager react to the letter? How does one deal with gray coverage areas? This article examines some key facets of reservation-of-rights letters and discusses ways to react when one is received. 'Does a reservation of rights mean I have no coverage?' Not necessarily. It does suggest that a cloud hovers over your coverage. It signals that the insurer thinks there might be grounds to deny coverage for at least part of the claim. A claim can allege some counts that the policy may or may not cover, such as intentional torts, financial loss with no property damage or bodily injury, or a matter clearly outside the policy scope. A claim may include both covered and excluded matters. Months may pass before an insurer knows enough to tell whether coverage exists. Only a full investigation or trial might determine if facts support a denial of coverage. In the meantime, the clock ticks. Insurers must enter an appearance, hire a defense lawyer, and file an answer to the lawsuit. If an insurer does not reserve rights and defends a claim, but later discovers that 'questionable' allegations raise coverage issues, the insurer may be estopped from raising a coverage defense. Courts could say that by its acts, an insurer waived its right to deny coverage. Rather than deny coverage outright-a high-stakes gesture that might trigger a bad faith lawsuit- or proceed as though nothing was awry, the insurer seeks middle ground by ending a reservation-of-rights letter. The latter says in effect, 'We are investigating this claim but preserve our right to later deny coverage if investigation shows that it is not a covered loss.' Insureds cannot claim that the insurer, by its actions, led the policyholder to believe that coverage existed. As confrontational as reservation-of-rights letters tend to be, they steer insurers between the twin perils of total acceptance or total denial of coverage. Reservation-of-rights letters allow the insurer to keep its options open. If no strong coverage defenses emerge, it has not lost face. Reservation-of-rights letters give insurers more time to investigate a claim or unearth facts through the discovery process. Erring on the side of caution, an insurer can disclaim coverage if investigation reveals that the facts do not support coverage. There are several options for risk managers who receive reservation of rights letters. Ignore it. Maybe the insurer is correct in reserving its coverage rights. For example, maybe a suit seeks punitive damages and your policy clearly excludes them. Or perhaps your policy does not exclude them but your state law forbids coverage on public-policy grounds. In some cases, insureds and brokers report a loss simply for due diligence, or to test the coverage waters, not because they expect that the loss will be covered. Dispute the reservation. If you disagree with the reservation of rights, promptly go 'on record,' advising the insurer of your reason(s). This paper trail will be helpful if the case ends up in court. Maybe the insurer has misinterpreted a state law regarding insurance coverage for punitive damages. Or perhaps its interpretation of 'occurrence' is unduly narrow in light of policy language. Spell out your rationale, send it to the claims rep via certified mail return receipt requested, and set a deadline for a response. This turns up the heat on an insurer to reassess its position, or provide further insight as to whether you are on solid footing. Press for specifics. Some insurers believe that reservation-of-rights letters should be vague. The rationale is that this leaves the insurer with more options. Policyholders and risk managers should counterattack vaguely worded reservation-of-rights letters. Do not tolerate fuzzy letters that do not specifically refer to policy language and policy provisions, chapter and verse. Press for particulars. Start your stopwatch. Once an insurer has reserved its rights, it must eventually declare whether or not it is covering the claim. In other words, reservation-of-rights letters have limited shelf lives. An insurer must eventually get off the fence. If not, a court may decide the issue or an insurer may be estopped (through inaction) from using its coverage defenses, notwithstanding its reservation. Moral to risk managers: after receiving a reservation of rights, keep after the insurer periodically to either disclaim or accept coverage. Seize the initiative. Advise the insurer that after a reasonable amount of time you are entitled to a definitive stance as to coverage, or else the carrier is estopped. Be a nag! Recognize what new doors and options this opens. If the insurer reserves its rights, you may be entitled to hire a lawyer of your choice-not the insurer's-at the insurer's expense. When an insurer hires the lawyer and reserves rights, it creates a potential conflict of interest: the lawyer hired by the insurer may uncover some facts that if disclosed to the insurer might cloud coverage. To avoid putting lawyers in this position and to minimize the odds of mischief to policyholders, many courts allow insureds to retain their own counsel when an insurer reserves its rights. In California, for example, this has created a whole cottage industry of Cumis counsel, taken from the name of the court case. A reservation of rights might be a blessing in disguise, to the extent it opens the door for you to hire a lawyer who works for you and is not beholden to any insurer, but whose fee is still paid by the insurer! Insurers don't like this, but it may work out better for you in the long run. Seek a declaratory judgment action. This will get the coverage issue settled before proceeding on with the merits of the underlying claim. Do you need a lawyer? Again, the answer is, 'It depends.' If a company has an in-house legal department and has knowledge of the issues involved in the claim, maybe not. For a small business, seeking the advice of a lawyer may be prudent. If you and your lawyer feel strongly that coverage exists, you may want to seek a declaratory judgment. In fact, if the insured seeks a 'D.J.,' it can often influence the state, jurisdiction or forum where the court will hear the case. This is key, since some parts of the U.S. are much more congenial to policyholders and hostile to insurers. Thus, seeking a preemptive strike via a D.J. action may make sense to force an insurer's hand. The prospect of spending more legal fees to handle a D.J. action may also inspire an insurer to reconsider its coverage position, and it may even relent, seeing things your way. Sue the insurer for coverage and for additional damages. Consider this the 'nuclear warhead response.' First, though, make sure that you're actually in a war. An understandable question arising for policyholders receiving reservation-of-rights letters is, 'Do I need to seek legal counsel?' In lawyerly fashion, the answer is both yes and no. If you feel an insurer's position is groundless, capricious, or done simply to harass, then you can sue your insurer for bad faith, punitive damages, and breach of contract. Seek legal advice to determine whether you have a strong case. If your lawyer says yes, then raise the ante. Simply threatening to play this card may make the insurer sweat. Insurers do not make sympathetic defendants in courtrooms. They know this, and will often avoid the specter of a whopping jury hit and publicity black eye. If the reservation of rights is genuinely premised on a 'gray area' in insurance policy interpretation, then a suit against the insurer for money damages may not be viable. Still, recall that insurance policies are adhesion contracts, and courts usually interpret reasonable ambiguities in the policyholder's favor. Your idea of a reasonable ambiguity and the insurer's may not coincide, though. If you and your attorney feel the issue is black-and-white and that the insurer is reserving rights on specious grounds, consider a suit rooted in breach of contract and/or bad faith claims handling. Or perhaps-better yet -- threaten such action. Sabre-rattling will, at least, likely get the claim file bucked up the corporate hierarchy and may inspire some agonizing reappraisal on the insurer's part over its coverage stance. This is a use-only-in-emergency remedy, not one to deploy cavalierly. Once used, it may get your claim file off the desk of that adjuster trainee and into the domain of the V.P. of Claims, where cooler and more seasoned heads might prevail- in your favor. As drastic as this step is, it should be within any astute risk manager's armory. Look to your broker. Another question insureds may have is, 'Why didn't my broker notify me that this was coming?' Good question! Astute brokers will be attuned to coverage issues and will forewarn you of the possibility of an insurer reserving rights. Conscientious brokers will err on the side of caution in reporting a loss to a carrier if there is any chance of coverage. Acting otherwise might create an E&O exposure for the broker. Value-added brokers should 'prep' their clients in gray area coverage matters and guard against raising false hopes and unrealistic expectations. (Insurers also can try to cushion the blow before sending out the reservation-of-rights letter by phoning the risk manager or policyholder to explain, forewarn, and encourage open lines of communication.) Sadly, many brokers treat claims as an afterthought, and their involvement here is limited to demanding a faxed loss run from the incumbent insurer a few days before renewal. Astute brokers will add value to their service by Forewarning insureds as to the possibility-or likelihood-of a reservation of rights Discussing such letters with the insurer-preferably before they are issued Explaining to insureds in clear, understandable terms the meaning and import of a reservation-of-rights letter Functioning as the insured's advocate in the coverage matter, if the facts support that stance Advising the insured as to its options (see above) -- Extracting lessons from this episode to repair coverage holes and gaps in a pro-active way, come next renewal time Deciding whether a switch of insurers may be warranted One frustrating issue is that all insurers do not use uniform criteria when issuing reservation-of-rights letters. While in theory, any gray area coverage topic should trigger one, one insurer's ambiguity is another's clear issue. Some insurer claim departments or adjusters may neglect to issue such letters out of oversight, overwork, inexperience or plain difference of opinion. Other carriers are aggressive in staking out any coverage issue, challenging insureds or testing the outer limits of the coverage envelope. In fairness to insurers, it is no more realistic to expect all carriers to take the same position than it is to expect all attorneys to agree on a certain point of law or all doctors to agree to one diagnosis in the face of certain symptoms. An experienced insurance broker should be able to help alert you to those carriers that are hard-nosed on coverage matters and those that accommodate policyholders. When in doubt, the broker should practice preventive brokering by zeroing in on possible ambiguities and excising them from policies via endorsements, manuscript forms, or collateral letters of understanding. Unfortunately, in the zeal to sell, brokers can often gloss over possible sources of coverage strife and silently hope that they won't arise or that everything works out. Reservation-of-rights letters are a symptom of a possible coverage gap. To that end, wise clients will treat them as 'red flags' and opportunities to diagnose the health of their own insurance and risk management programs. New challenges bring new opportunities and, in this light, the policyholder can transform the coverage issue into a plan to patch up a possible 'hole' in coverage or consciously decide to retain or self-fund. In the Chinese language, the character for the word 'danger' connotes a double meaning of 'opportunity' as well. In a similar vein, reservation-of-rights letters carry overtones of danger, the danger of an uncovered loss. Viewed in a more positive light, however, such letters may flag an opportunity for companies to strengthen their own insurance and risk management programs, learning from the past to avoid future perils. This article originally appeared in the Risk Management Letter, published by risk management consulting firm Warren, McVeigh & Griffin, Inc. © C...ght 1994 Griffin Communications, Inc., Newport Beach, CA 92660. No reproduction without permission. (714) 752-1058.
https://completemarkets.com/Article/article-post/985/ERRORS-AND-OMISSIONS-CONSIDERATIONS/
Errors And Omissions Considerations
ERRORS AND OMISSIONS CONSIDERATIONS by Carol Hammes The old saying 'The cobbler’s children go unshod' could apply to many insurance agencies today. Thousands of agents don’t carry any E&O insurance at all, and many more might not have the right coverage. Although they analyze risks and review policy forms to give their prospects and clients the best and most comprehensive insurance plans, they often don’t give their own situations the same type of evaluation. With the expanded responsibilities that agents have taken on, such as fee-based consultative services or providing underwriting decision-making assistance for insurance companies, comes additional professional liability exposure. The available E&O coverage has been changing dramatically, too. There’s no standard policy anymore, and having the wrong coverage can literally bankrupt a firm. If a claim isn’t covered by the policy or is in dispute, the legal costs alone can be devastating — not to mention the settlement. Agents need to review their E&O policies 60-90 days prior to renewal for potential gaps in coverage and to see whether they can get better coverage and better pricing. A policy can and should be customized to fit your situation. Are you doing anything beyond the traditional agency’s scope, such as placing business in or having an ownership interest in a captive? Are you involved in reinsurance, TPA, or risk management consulting? Do you sell annuities, mutual funds, or other securities, particularly in situations that might involve ERISA? What about the joint venture that was just completed with the local bank — is it covered? In short, a full financial-service insurance agency is not traditional, so a normal E&O policy might not cover it. Rather than accept the standard policy provided by major insurers, you might consider finding a specialty broker with the background to address your specific exposures. Or perhaps your insurer can modify the standard policy. Some policies offer first-dollar defense, others do not. Some include EPL coverage for a much lower endorsement premium than the full premium on an EPL policy would be. What about exclusions for punitive damages or carrier insolvency? What are the cancellation provisions? Do your homework on your own risk in order to give your clients the best protection. If your agency gets into legal and financial difficulties, you won’t have time for your insureds’ needs. It’s important to have appropriate insurance in case of a loss, but it’s far better to make sure a loss doesn’t happen in the first place. More than two-thirds of all E&O claims are settled without payment, but the expenditure of valuable management and sales time to fight the battle can be very costly. The impact on employee morale and the agency’s reputation often can’t be measured, either. To avoid claims against your agency, instill your insureds with the confidence that the agency and its personnel can adequately meet their needs. Your personnel must also have the comfort of knowing that the situation was handled properly. A professional atmosphere, continuing education, and training are the keys to developing that confidence. Every employee, producer, and principal should have a formal training and education program that includes external and in-house activities. Discuss the training program as part of the performance review, and place a written confirmation in the personnel file. Traditional insurance product updates are important, but in this new environment, also include such subjects as effective use of automation and communication skills. In some cases, business writing, spelling, and grammar will also be a key part of the training. The first step in preventing E&O problems is to have well-trained employees who can service accounts and handle production and risk management. More important, however, is for agency principals to make sure the employes are managed effectively. Most E&O claims result from poor management rather than lack of knowledge. Owners who practice 'crisis management,' running to put out fires that shouldn’t have started in the first place, will tend to face E&O problems more often than those who run tight ships. Imposing rules and procedures designed to avoid problems will instill the kind of disciplined operation that will make for a better organized and eventually more profitable agency. And better organization will permit you to give even better service to the insureds, making claims less likely. One of the worst things agency principals and managers can do is to focus on the commissions salespeople produce rather than on the quality of the business they bring in. Producers who’ll promise anything to get an account, lie on applications, insist on doing things their own way, force service reps to bend the rules, constantly interrupt others, and continually create crisis situations because of their own poor time management can’t be allowed to continue to behave that way. Some owners think the top line is so important that they must tolerate such behavior to keep a high-volume, egocentric producer. Unfortunately, they’d rather raise their E&O coverage limits instead of disciplining the producer for fear of clipping their wings or losing the large book of business they’ve produced. Principals who are watching out for the agency’s profitability, productivity, and value know better. First of all, tolerating unprofessional behavior increases the chance of a successful lawsuit against the agency. Secondly, producers who don’t follow procedures and other control measures almost always create more work for the service and support personnel, hurting productivity, morale, and often the agency’s internal or external selling price. E&O CONSIDERATIONS AND GUIDELINES Legally, an insurance agent operates in a fiduciary capacity, so they’re held to the high standards demanded of a trustee. In other words, the law considers an agent to be more than a salesperson; the agent must act in good faith and candor. In most jurisdictions, an insurance agent is obligated to use reasonable care, diligence, and judgment to obtain adequate coverage for a client. The courts have held that an insurance agent must adhere to the professional standard of the industry and will be held responsible for any deviation from that standard. As insurance agents become more professional and are viewed as such, the standards to which they can be held will rise. Also, note that if a plaintiff can prove that most of the other agencies in your marketing area practice a certain procedure or do certain things for their insureds, you may be legally expected to do so, too, even if your agency has never done so. The number of E&O claims increased significantly in the late 1980s and early 1990s, then fell off. That’s no reason to be complacent, though: what with overextended insurance companies, a litigious society, and the number of attorneys hungry for work, plenty of claims — legitimate, questionable, and frivolous — will be filed. Most agencies can expect that at least one will be filed against them within the next five years, and some will have more. These are the most common types of E&O claims, in order of frequency: Plaintiff alleges that the agency failed to obtain proper or adequate coverage. Generally, a client may recover from the agent the loss they sustained because of inadequate or nonexistent coverage when the agency undertook to procure the insurance or failed to notify the customer/prospect properly if they were unable to obtain the requested coverage. At least half of the E&O claims filed during the past 20 years fall into this category. Plaintiff alleges that the agency misrepresented the coverage. In such cases, either the agency led the client to believe that coverage was in force or that the policy covered certain perils that it did not. Plaintiff alleges that either the agency or the company failed to properly notify them of a pending cancellation. It’s important to note that in direct billing, in which cancellation notification is the insurer’s responsibility, an agency may jeopardize itself by contacting the insured when they receive a lapse notice. The insurer holds the agency harmless unless the agency injects itself into the situation. Plaintiff alleges that the agency failed to promptly and appropriately renew coverage that was in force or failed to obtain a renewal policy with comparable coverages. This problem mostly arises when there hasn’t been sufficient communication about renewal options. The best way to protect your agency from E&O claims is to make sure your risk management and servicing procedures cover the important bases. A commitment to standardization starts with a quality-control program that: Outlines all procedures in writing Gives a designated E&O Coordinator the responsibility and authority to periodically audit accounts Builds accountability into the performance evaluation process In addition to handling the audits, the coordinator can also review the trade press and company bulletins for loss control suggestions and coverage changes and inform everyone of them. The coordinator should also maintain and update the procedures manual as new computer upgrades are installed and new positions are filled. Review all procedures thoroughly at least every two years and/or when the agency acquires another agency or book of business. After establishing your procedures, make sure everyone follows them at all times. Standardization is the key to preventing and defending lawsuits. Deviation from your procedures, no matter how minor, can lead to legal action and the possible loss of a lawsuit. Agency principals must set the example by following the rules themselves. Also, they must be willing to monitor the performance of the staff and, more importantly, the producers. In fact, the salespeople should be watched more closely than the other employees, because most successful E&O suits result from something a producer did or didn’t do. LOSS CONTROL PROCEDURES You can learn about quality-control systems, standardized procedures, and loss-control measures from the trade press and seminars. Any knowledge gained in an E&O seminar is important and should be incorporated into your agency operations. Principals and other employees who’ve been in the business for some time may stubbornly and shortsightedly dismiss new methods as impractical, unnecessary, or too time-consuming. However, following these procedures will result in better service to the insureds, less chance of successful litigation, a better working environment for the employees, more profits, and a higher agency value. Some of the most basic loss-control procedures, the ones all insurance professionals know they should follow, are often the ones that aren’t implemented. Or they may be in the agency guidelines, but management doesn’t mandate compliance with them. Here are some of the more crucial procedures to help you prevent and defend lawsuits. This list isn’t all-inclusive, but it will give your agency a starting point in developing an effective E&O loss control program. Have written procedures for every transaction and make sure all employees (including owners) follow them. Document every conversation with insureds and company personnel either in the computer or manually. Producer notes from client meetings that aren’t entered into a laptop at the time should immediately be clipped to the paper file or entered into the computer when the producer returns to the office. Use standardized checklists for every piece of new business and every renewal. Never 'renew as is.' Create standardized transmittal letters and proposal forms with pre-approved descriptions of all coverages, deductibles, coinsurance clauses, and so forth. Always obtain a signed written rejection when a prospect or insured turns down recommended coverages or limits and when they ask to have coverages removed or limits reduced. If you tell someone you’ll get coverage for them, you have an obligation to do so. If you tell them you’ll survey the market and see what you can find, your legal level of duty isn’t so high. Whatever you promise, follow up in writing as soon as possible after you get an answer, especially if the answer is negative. Maintain centralized expiration and suspense controls on the computer, and make sure all employees use them all the time. Learn the risk management needs of industries to which you’re niche marketing. If you pass your agency off as expert, you’ll be held to a higher standard. Never use 'all risk' or 'fully covered' in any communication, and be careful with the term 'replacement cost.' Review all agency accounts (including Personal Lines) annually. Watch for missing coverages, such as flood or business interruption, limits that are too low, and exclusions that might cause a problem. If you feel that an account is too small for such a review, get rid of it. You can’t afford the exposure. Use certified mail to issue all cancellations out of the agency. If the insurance company requests a cancellation, have them contact the insured in an appropriate manner. Don’t sign an application for an insured, and don’t make up missing information. It’ll come back to haunt you, and the commission just isn’t worth the risk. Report all claims promptly, and leave it up to the insurance company to accept or deny them. Make sure everyone in the agency knows your binding authority with each insurance company (this should be in the procedures manual) and that binders are numbered, recorded, and faxed/e-mailed to the company immediately. Have separate procedures for handling E&S, nonadmitted placements, and insurance companies with ratings lower than A-minus, and include a written sign-off from the insured acknowledging that they understand the placement risk. Never follow up on direct bill lapse notices. If you’ve done so in the past, stop and send a written notice to the insureds that you won’t do so in the future. Unless you have a specialty program or an MGA, don’t place risks for other agents and brokers. Avoid prospects and insureds who have poor loss experience, want the cheapest program, or don’t qualify for financing programs. Cutting corners just to get an account isn’t worth it. Give clients bad news immediately, and present them with a plan to solve the problem. These guidelines are only a starting point. In establishing an agency’s approach to E&O loss control, owners and managers have to decide how far to go in setting up duplicative procedures to prevent claims. It’s important to have proper documentation of conversations and written records of all coverage-sensitive issues, but at some point the people in the agency must have the freedom to sell and service insurance. If you want to be completely free of the risk of a lawsuit, you’ll need to shut your doors. If you stay in business, you take a certain amount of risk. Deciding how much risk is up to the agency principals. Set up procedures that will treat customers fairly and respect their intelligence and decision-making capabilities. Keep them informed of good news and bad in a timely manner. And meet their needs with courtesy and professionalism. A satisfied insured is less likely to call a lawyer if things don’t go their way. The late Carol Hammes, principal of the Middleton Group, was one of the Independent Agency System’s most widely respected management consultants. She will be sorely missed. Reproduced, with permission, from The Middleton Letter. ...