My recent article on the hard market in Agent for the Future

The insurance industry has always been cyclical, going through periods of “soft” and “hard” market conditions that can last several years. Today’s agents have been thrust into what the insurance industry has historically called a “hard market.” However, this market cycle seems a bit different than those in the past and perhaps may not soften as quickly as we’ve seen in some cycles.

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“The Musk Story: A Template or Warning for Claim Operations?”

Walter Isaacson’s new best-selling biography of Elon Musk has stirred much discussion over the management style of the billionaire entrepreneur. The book is riveting in its depiction of Musk, and this article identifies management practices that work for Musk but might be dysfunctional for sound claim management operations. feel free to check out this article…

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Business Interruption Explained

Andrew Sall The Business Interruption Guy Episode 709 This week we welcomed Andy Sall of Complex Claims Resolution, LLC for a show on Business Interruption. What would happen to your business if there was a fire, flood or cyber attack that wiped out your income overnight? Would your insurance cover you? Are you confident that…

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Trends and Pressures on Today’s Claims Department

“By investigating a case aggressively at the outset, it was often possible to have a developed factual matter for analysis within 90 days, maybe as long as 6 months, depending on the cooperation of any third‑party claimant and other sources of information. By having that development, one could set accurate reserves earlier. The insurer would know where it stood, and actuaries could also have access to that data and reassess a particular book of business or a particular program to see how profitable it may be over time and make adjustments, rather than canceling a program as unprofitable, should development and accurate reserve setting take longer, such as years versus months.

Another important function was the interaction between claims handlers and underwriters. The two go hand in hand. Underwriters have a certain view of the world and ways they want to approach coverage, but it’s the claims people who must handle the result and keep up to date with the latest case law affecting liability and/or coverage. Such teamwork results in tighter and more successful programs including decisions as to whether or not policy language needs to be changed or the need to add additional exclusions based on developing appellate decisions that might create new perils. That level of communication was important, especially for innovative insurance companies. Where the intent is to cover something as communicated to the applicant, the claim department might not be aware of it, resulting in a claim denial.”

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Determining Bad Faith in Claims Handling Litigation

A court that concludes that an insurer acted in bad faith may have overlooked important factors.  The article examines how attorneys and claims professionals can take an holistic approach, as to a fragmentary approach, to potential bad faith on the part of an insurer to provide a supportable conclusion.

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How to Properly Deny Claims

When insurers receive a claim or suit from an insured or third party, they must first make sure that subsequent actions by all parties are in accordance with the conditions required by the policy and applicable laws and regulations. Violating such conditions and guidelines can lead to unintended consequences. For example, courts could refuse to uphold claims denials and possibly recognize bad faith suits, instead. Or an insurance department could find that the insurer broke a law and subsequently impose regulatory penalties. This article discusses how to avoid such outcomes by discussing important, but basic, dos and don’ts, illustrated through real-life examples.

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Subtle Problems with Extended Reporting Coverage — and Creative Solutions- Part 3 of 3

“Overall, many of the more common issues were explored in previous articles. That is not to say, however, that these are complete solutions. I have long been of the belief that extended reporting provisions, when invoked, are an incomplete solution for long-term protection. That is because one is taking a limit of liability and stretching it across at least one year and sometimes six years or more. The limits, thus, are never refreshed. So, if there are any claims during the extended reporting term, policy limits are being eroded. This could mean that policy limits could be extinguished by claim frequency, and the benefit of runoff would be lost when that happens before the term had even run out.”

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