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THE RISKS INHERENT IN DIMINISHING LIMIT POLICIES

“Diminishing limits policies create a host of potential problems for insurance company claim departments. As is well known the insurance industry has long been plagued with “nuisance” claims. While in some instances insurance companies make quick settlements of nuisance claims to avoid defense cost expenditures, in others, insurers will attempt to resist such claims to avoid setting a precedent, thereby sending a message to the plaintiff’s bar that nuisance claims will not be honored. Considering that defense costs are deducted from the policy’s aggregate limits, either course of action places an insurance company in a difficult position. … “

CLAIM AUDITING

The claims audit is the anathema of day-to-day claim operations. Nothing is more disruptive. Yet, if properly defined, nothing is more informative and helpful in improving a claim management program. This article will examine the need for a regular auditing program and provide a recipe for a three-dimensional approach to the process in order to maximize the accuracy of the audit results.

The need to conduct regular claims audits has already been widely discussed. With the magnitude of self-insured claims programs (including self-funded programs) and the millions of dollars spent on claim administration fees, what better way to verify whether the money spent has been justified or wasted? In essence, an audit of closed and open claims should accomplish several things.

A Review of the Modern Claims Made Form

“Since its creation, “claims made” wording’s use has expanded outside of the “profession” and professional liability realm, finding use in diverse liability coverages. But the roots of “claims made” wording, and its most common use still, is found in covering the exposures created by a “professional’s” activities. As seen by the list of true “professions,” professionals are individuals who provide a service to society which, if done poorly, could cause extreme or irreparable personal or financial harm. …

The expansion of claims made policy forms beyond “professions” caused the basic “claims made” concept to diverge and evolve into two distinct forms. One evolutionary branch commenced in professional liability coverages (known also as “errors and omissions” coverages in this series) and the second branch grew out of the financial services industry and the need for directors and officers liability protection, fiduciary liability and employment practices liability (referred throughout this series as “executive liability” coverages).

Although both branches attach to the tree at the same point; greatly different “claims made triggers” have resulted. Additionally, coverage terms, conditions and definitions differ between the two branches.”

The World Trade Center Property Insurance Trial: Lessons Learned?

Insurers: To Rescind or Not to Rescind?

Agency Networks Aid Agency Net Worth

The advantages and disadvantages of joining an Agency Network…and the issues to be considered in selecting a suitable Agency Network.

Olie R. Jolstad

Olie Jolstad is an insurance expert with over 40 years of professional insurance experience in commercial and personal lines insurance claims handling, coverage analysis, managing general agent, and agent/broker procurement of insurance. Mr. Jolstad holds the Senior Claims Law Associate (SCLA) designation, as well as being a Fellow in the American College of Forensic Examiners…

Charles C Hewitt

Chuck Hewitt is a veteran insurance claims executive with 45+ years of multi-line claim department experience and leadership at national and regional carriers. Particular strengths in coverage analysis, creation, and teaching; bad faith defense; technical and management training; claims management; cyber liability; employment practices liability; litigation management; customer relations; reinsurance; and runoff operations. Multiple appearances…

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