Howard Candage Insurance Blog

Have you had a client whose claim was denied but you felt really uncomfortable about the coverage determination?

I have been working on quite a few denied claims in the recent future.   It have become apparent to me  that Insurers are using a strategy to issue a “bluffing letter”.    It looks like a denial and will discourage all but the most resolute Insured or Agent.

The letter basically says, “We don’t this covered and gives a litany of reasons.”   We will not indemnify or defend this claim….!”         The Insured files it and basically goes away without questioning it.    Some of these claims should be covered.  I have gotten several paid recently and in some we have filed suit.   (Of course, there are also many legitimate denials.)

Agents…  Don’t let your Insureds be taken advantage of this way.  ALWAYS follow up and when you need to involve an insurance expert such as myself, call us!.    “My business is knowing your business”. Let us help you protect your Insureds!   We can likely keep you out of an E & O claim!

For over ten years I have been discussing the “narrowing” of coverage due to the increased pressure from reinsurers  and rating agencies for increased profits and decreased loss ratios.   One of my key examples has been a broadening definition of “pollution”.

In the past two months I have either been involved in or heard of several claims being denied for “skunk spray”. This is a perfect example of profiteering.   A skunk is neither a vermin nor is skunk spray pollution.      But, beware…   Some have denied altogether and some have denied coverage for contents, EVEN WITH AN HO 15 ENDORSEMENT!

Fear in organizations ruins strategic initiatives.    Self interest and fear run together.   I am not talking about people literally quaking in their boots, I am talking about people being afraid that YOUR strategic initiatives will undermine their position or their power. Fear is a drastic impediment to teamwork!  Fear is a terrible impediment to  living our lives fully.

Seek out the fear in your organization. Communicate at all levels openly. Make communication the norm and accept it without judgment.   Fear destroys initiative.  FOLLOW the FEAR you’ll FIND the problem. What are the FEARS in your organization? Can YOU really find out?

In our strategic planning sessions, we find fears and make them advantages!

Your people will not tell you their fears unless they feel safe.   Be an effective leader and learn to listen.

Have you recommended earthquake coverage to your clients?    Today we even felt a slight tremor right here on the dear old Portland Fish Pier!     Earthquakes happen, they happen on fault lines, and WE ARE ON A FAULT LINE!

We need to point out to our clients that they need to at least think about buying earthquake coverage.    When they are trying to hang you out to dry for NOT RECOMMENDING earthquake coverage, they are going to call me and ask me, as an expert witness, “Mr. Candage, do you consider it “state of the art insurance practice” to recommend earthquake insurance?”

Before today I would have had to say “yes, we are on a known fault line.”    After today I am patting myself on the back because I am correct!    Put earthquake on your checklists, on your renewal questionnaires, put earthquake on the big screen for everyone in your agency!  It is important for you NOT to deprive the client of the knowledge they could buy it FROM YOU!

This discussion of Commodities centers on recent attempts by insurers to circumvent agents and sell insurance products over the internet.    I am convinced that insurance is not a commodity as it is not a product that can be sold in an unmodified state and be used properly.   It would be like purchasing an unassembled, complicated piece of equipment and having no directions for assembly.  It appears to me that is the case with “unbundled” “risk bearing” or to put it another way, the thing Insurance companies sell is a “risk finance” mechanism.    Agents add value to this product by showing purchasers how to use it and by adding their own body of knowledge to the process!

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In my quest to determine if I think Insurance is a commodity, I am surprised at my opinion.    I think perhaps “Insurance” is a commodity in that it is a raw product used in the chain of “production” for “protection” of your insured (speaking from an agents standpoint.)

“Risk bearing” (an insurer) is risk finance, but as I pointed out earlier, risk bearing without risk management advice is not really an end user product, as much as some insurers would like to think so.   BOTH the Insurer and the Insured need to advice of the agent to write or use the product effectively.

My opinion turns out to be that risk bearing is a commodity but insurance is not.  No bias intended here… the use of insurance without the benefit of risk management advice is rather foolish. Consumers are not trained in how to use risk management tools, how financial decisions in this area do or do not make sense, consumers do not understand relative pricing nor insurer reputation and consumers do not understand the consequences of making inappropriate decisions that cannot be changed AFTER the loss.

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What the consumers  know will not hurt them.

What they do not know will not hurt them, as long as they know they do not know it.

What the consumers do not know, and do not know they don’t know, will create real post loss problems.

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The independent advice of your agent is invaluable, both before and after the loss!