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Underwriting - P&C

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.”

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.

The World Trade Center Property Insurance Trial: Lessons Learned?

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…

Frederick C. Berry

Bachelor of Science degree in Insurance (1969) and a Juris Doctor degree (1973) from Arizona State University. Deputy Director of Insurance of the State of Arizona from July 1, 1976 through September 30, 1978. Chartered and Property and Casualty Underwriter (CPCU) in 1981 and Chartered Life Underwriter (CLU) in 1983. Member of the State Bar…

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Craig Andrews

Craig Andrews is a Senior Consultant with Malecki Deimling Nielander & Associates, LLC.  Craig entered the property-casualty industry as a producer in an independent insurance agency in Defiance, Ohio in 1977.  A few months later, he established his own independent agency “from scratch”.  He operated the agency successfully until selling it in 1996 to join…

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James J Moore

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies…

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