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...olic, went out for two shots and a glass of beer on the day of his injury. Lat...ontracts, and deals with employer's liability and other tort liability claims involving workers.

...olic, went out for two shots and a glass of beer on the day of his injury. Lat...ontracts, and deals with employer's liability and other tort liability claims involving workers.

... a methodology to convince the adjuster that the insured's/agent's interpretation for coverage is just as valid as the adjuster's initial basis for claim denial. However, sometimes a claim denial arises that defies logic and reason. Here's a Personal Lines example of such a claim that another faculty member passed along recently: An insured who was moving loaded clothes and personal property into her car. She placed a magnifying glass on the leather seat of her car and left it there for a few hours. When she returned, she discovered that the focused sunlight had burned a hole in the seat. The adjuster denied the claim on the premise that it wasn't within the definition of accident' in the policy as a sudden, unexpected, and unintended occurrence. The policy defines a loss' to include direct and accidental ... exclusion in this way would mean that insurers would never have to pay a negligence claim and policyholders' premiums would plummet by at least two-thirds! Everybody wins! We argued that because the insured foresaw that the door could fall on him, it was an act of self-defense, triggering the exception. We also cited the state's bad faith settlement provision that's triggered when a claim isn't paid even though. liability has become reasonably clear. Although we provided 39 pages of authoritative documentation to support coverage, the carrier still refused to pay this $827.69 claim. At that point, the agent turned our file over to the insurance department. Their investigator telephoned the company on April 11. In a letter dated April 12, the insurer's claims manager stated, In the spirit of compromise we will send our insured ...

..._____% Crime/Fidelity/Glass _____________% _____________% _______...

..._______% ________% Crime/Fidelity/Glass ________% ________% ________% General Liability ________% ________% ________% CPP/...

...quipment, including: Safety glasses, goggles, or face shields for eye p...

...o her car. She placed a magnifying glass on the leather seat of her car and le...a claim isn’t paid even though '... liability has become reasonably clear.' Al...

... ____ ____ Location address ____ ____ ITEMS: 1. 19_ 19_ FORECAST 19_ Written premiums $ _____ $ _____ $ _____ Gross commissions $ _____ $ _____ $ _____ &# 160 2. Estimated Agency Mix of Business - Property/Casualty PERCENTAGE OF TOTAL 19_ 19_ 19_ Fire/Allied/Marine ___% ___% ___% Crime/Fidelity/Glass ___% ___% ___% General Liability ___% ___% ___% CPP/BOP/Package ___% ___% ___% Commercial Auto ___% ___% ___% Workers Compensation ___% ___% ___% Other Commercial Lines ___% ___% ___% Personal Auto ___% ___% ___% Homeowners ___% ___% ___% Other Personal Lines ___% ___% ___% ... 100 % 100 % 100 % &# 160 3. Estimated Agency Overall Loss Ratio 19_ 19_ Personal Lines ___% ___% Commercial Lines ___% ___% 4. Total Number Of: Personal Lines accounts ____ Personal Lines policies ____ Commercial Lines accounts ____ Commercial Lines policies ____ 5. Commercial Accounts: Five Largest, written Premium 1. $ _____ 2. $ _____ 3. $ _____ 4. $ _____ 5. $ _____ 6. Staffing: Total Number Includes Principals NUMBER % OF TIME SPENT A. Personal Lines customer service representative or underwriter ____ ____ B. Personal Lines clerical support ____ ____ C. Commercial Lines customer service representative or underwriter ____ ____ D. Commercial placer ____ ____ E. ...

... Premium $ _____ $ _____ $ _____ Gross Commission $ _____ $ _____ $ _____ &# 160 2. Estimated Agency Mix of Business - Property & Casualty Lines &# 160 Previous Year Current Year Forecast &# 160 Fire & Allied ___% ___% ___% Marine ___% ___% ___% General Liability ___% ___% ___% Crime/Fidelity/Glass ___% ___% ___% SMP & BOP ___% ___% ___% Commercial Auto ___% ___% ___% Workers Comp ___% ___% ___% Personal Auto ___% ___% ___% Homeowners ___% ___% ___% All Other Lines ___% ___% ___% Total 100.0 % 100.0 % 100.0 % &# 160 3. Estimated Agency Loss Ratio &# 160 ... 1. Previous Year Current Year Forecast &# 160 Written Premium $ _____ $ _____ $ _____ Gross Commission $ _____ $ _____ $ _____ &# 160 2. Estimated Agency Mix of Business - Property & Casualty Lines &# 160 Previous Year Current Year Forecast &# 160 Fire & Allied ___% ___% ___% Marine ___% ___% ___% General Liability ___% ___% ___% Crime/Fidelity/Glass ___% ___% ___% SMP & BOP ___% ___% ___% Commercial Auto ___% ___% ___% Workers Comp ___% ___% ___% Personal Auto ___% ___% ___% Homeowners ___% ___% ___% All Other Lines ___% ___% ___% Total 100.0 % 100.0 % 100.0 % & ...

... Crime, Fidelity, Surety, and Glass General Liability Commercial Package/Businessow...e. Some types of risks may be high-liability exposures and thus surplus lines...