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... these factors and actual claim occurrence. Consider these examples: ...kers see genuine investment in their health and safety rather than just claims...

... a loss. These types of circular definitions don't hold up well in court. This alone is enough to warrant redrafting the contract. The key word is accidental. Was this accidental, ' as defined by the policy? Was this a sudden, unexpected, and unintended' occurrence? It's unlikely that the insured intended to burn a hole in her car seat — which means the damage was probably unexpected. That leaves sudden. Because the loss took place over a period of time, perhaps the adjuster interpreted it as not sudden. However, most ... I jointly developed a seminar with a faculty member called How to Win Friends..and Influence Adjusters. The seminar focuses on policy gray areas and, through case studies (actual claims and court cases), applies 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 ... Merriam-Webster) . In other words, sudden' means unexpected or unforeseen, a surprise — and it appears likely that the insured did get a surprise. Here's another example, involving a Commercial Lines claim. The insured cement contractor was pouring a concrete driveway at a home in a new subdivision. As nightfall approached, he inadvertently caused cement to be splattered on a nearby garage door, necessitating its replacement at a cost of $827.69. The owner of the home made a claim for his negligence. The insured received a letter ...

...den, unexpected, and unintended occurrence.' The policy defines a 'loss' to in...horitative documentation to support coverage, the carrier still refused to pay...

...alespeople tell us that certain occurrences propel individuals to consider Lif...he customer define the policies and coverages they should purchase, any more t...

...mage resulting from an array of occurrences. Your policy will cover the cost o... you review your options and tailor coverage that best meets your needs. ...

...k a few years, there may be old occurrence policies that apply, particularly i...nable at will, the employer should be careful not to muddy the waters with oth...

... , make the insured aware that they might not have the protection of the guarantee fund to fall back on if the carrier fails. Also provide them with the most current Best's rating information on the carrier. Moving back and forth between "claims made" and "occurrence" policies can also be a problem, especially with Surplus Lines carriers, because provisions might vary between the two. Also, because many Surplus Lines carriers don't use standard forms, a careful review of the contract is important. When the policy is on an ... business and interview the insured. Inspect large Homeowners and Personal Lines accounts annually. If not, send a renewal questionnaire that asks about any primary or incidental business activity, works of art, antiques and other collectibles, hobbies, activities, or anything that needs scheduled coverage. Include a return postage-paid envelope with the questionnaire, and require the insured to sign and date it. Also, request photos of any unusual or high-value items or activities that might pose a coverage problem or require special handling. That way, you can determine ... inspect, or does the inspection after the fact, you might be liable for any problem that arises. More important, if a problem does arise, you might lose credibility with the carrier and the client. What about Homeowners accounts? Although in theory, every home should be inspected, in reality, it just isn't practical to inspect every home each year. What you can do, however, is to set some guidelines and make arrangements for a personal visit to the client every three years, take photos at that time ...

...orth between “claims made” and “occurrence” policies can also be a problem, es...ts to cover a situation in which no coverage exists because the agency made a mistake in binding or arranging coverage. The problem you solve and the “f...