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Damian J. Arguello

Damian is an insurance coverage attorney, expert witness, and former adjunct law professor whose legal practice focuses on representing and counseling commercial policyholders, business and trial attorneys, and insurance agents and brokers regarding insurance issues. In his consulting and expert witness practice, Damian also draws from his pre-law school experience as a claims adjuster for…

In A Hurry To Get To Destinations Not Considered

It is often said that the police and firemen run towards the danger when others are running away from the danger. Thing is, the danger is generally a known danger, not an unknown one.

Agents – Your E&O Coverage May Be For More Than You Think

Your responsibility to not breach your fiduciary duties to the principal (insurer) are a large part of your professional /ethical responsibilities and the reason for your E&O coverage as an insurance agent… and here you thought the Insurers demanded that you to carried E&O was only for the policyholde’s protection. 

AAIMCo Members Featured in latest CLEW Newsletter

•Wrongful Designation by Thomas M. Braniff, JD, CPCU and Robert P. Gaddis, JD;
•The Essential Bookshelf for Expert Witnesses by Kevin Quinley, CPCU, ARM, AIC;
•The 411 on Becoming an Expert Witnesses by Elise M. Farnham, CPCU, ARM, AIM, CPIW;
•Working as an Expert Witnesses by Douglas R. Emerick; and
•“Be Careful What You DON’T Ask For” By Bill Wilson, CPCU, ARM, AIM, AAM.

Contingent Business Interruption Claims, What Happens When the Loss You Experience is Not Your Own?

In today’s business climate more focus is placed on lean operations. This trend is becoming increasingly more commonplace as corporations are divesting of business lines and returning to core competencies. As decentralization continues to grow and corporations are relying on supply and sales agreements with non-related parties, the impact of a supplier or customer’s loss on a business’ operations increases substantially.

The Business Behind Business Interruption, A Forensic Accountant’s Approach to BI Claims.

Preparing business interruption claims takes thoughtful planning and insightful
analysis, clearly communicated to all of the parties involved in the claims process. One
of the most important factors is the breadth and depth of analyzing relevant financial
information related to interrupted business operations. Although this may seem like an
intuitive step, there is often a gap between the internally prepared financial information
and the analysis to determine lost profits. Application of due diligence results in a
smooth claim process, quicker payment from the insurer and a fair and equitable
recovery.

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.”

Technical Aspects Of Professional Liability Claims

“To the uninformed, “a claim is a claim is a claim.” To some extent this is true. Any type of liability claim requires proof that the insured owed a duty to another person or entity, that the insured breached this duty, and that the breach was the proximate cause of quantitatively measurable damages suffered by the person or entity to whom the duty was owed. Thereafter, it becomes a matter of determining whether or not there are any defenses such as comparative or contributory negligence on the part of the claimant. Finally, there is the question of coverage—the issue of whether or not the policy will respond to the claim. ….

There are significant differences between managing professional liability claims, compared to those arising out of more standardized coverages. …”

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. … “

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