RISKY BUSINESS

Did you know that how you handle client claims can increase your E&O exposure? Like many internal workflows of the agency, not having clear guidelines and procedures for employees can lead to poor client claim experiences as well as an E&O situation. A few key reminders should be shared among ALL staff, regardless of role and experience.

It is common for independent agencies to want to be involved in the claim experience for customers, especially within personal lines business. The claim experience can be emotional for clients, so it does make sense that an agency would want that relationship touchpoint and offer their assistance. The danger is when there is insufficient training to help agency personnel remain helpful and empathetic without confirming or denying coverage in the policy.

1. Fortunately, strong claim-handling practices start with a few quick and easy reminders. 2. Never confirm or deny coverage when speaking with the customer about a claim. This is the carrier's decision and responsibility, and the customer may be withholding additional information important to the claim outcome. 3. Always report the claim promptly to the carrier.

A claim reported to the agency is considered a claim reported to the carrier, so it is absolutely the responsibility of an agency to make the report as soon as possible. 4. Your client’s information is confidential and should only be shared with the carrier and no other third party without written permission. 5. Document! Document! Document! Keep strong written documentation of client conversations and carrier conversations. Always confirm phone calls in writing and utilize activities and reminders to follow up on open discussions. 6. Have a standard process. This could include utilizing dedicated staff to handle claim calls, setting reminders to follow up on a claim call, or simply assisting with the claim reporting process and then informing the customer they can reach out with any questions or concerns. Just. Be.

Consistent. 7. Be proactive. Before a client ever has a claim, have a standard document or process to help the client understand the claim process from the inception of their policy. Set expectations and a clear understanding of the client-agency-carrier relationship.

All agency personnel should feel comfortable handling claim calls and can maintain a strong relationship with the client during the process. Remember, not everyone is fortunate enough to work in the insurance industry and clients may have unrealistic expectations of how the claim will be handled. Be honest and responsive and always have a plan in place. If a claim may be denied or if the agency made an error in issuing the policy, do not try to make it right. Generally speaking, an E&O claim arises when a customer has an uncovered loss, so it is imperative that the claim handling process is clear and consistent.

If the process of handling claims is not clear and consistent within the agency, feel free to reach out to Mallory Cornell (mallory@iiaw.com) for assistance.

Join our March 2nd Personal Lines Task Force webinar to hear James Redeker, SwissRe Vice President of Claims, discuss current trends, best practices, and agency claim handling procedures. Registration is free (1 WI CE credit pending approval).

iiaw.com/ClaimsWebinar

We're looking for volunteers to serve on the IIAW's councils and task forces. Each council and task force will act as a sounding board for the IIAW and will only have three virtual meetings per year. Participation in the IIAW task forces and councils gives you access to industry experts, exclusive networking events and even FREE CE opportunities during virtual meetings when content allows.

Personal Lines Task Force Commercial Lines Task Force

For individuals who are interested in or who have a role in Personal Lines insurance

Virtual Meeting from 9 a.m. to 11 a.m. on 3/2/23 and 7/13/23

For individuals who are interested in or who have a role in Commercial Lines insurance

Virtual Meeting from 9 a.m. to 11 a.m. on 3/1/23 and 7/12/23 Employee Benefits Task Force

For individuals who are interested in or who have a role in Employee Benefits

Virtual Meeting from 9 a.m. to 11 a.m. on 3/9/23 and 7/20/23

Industry Relations & Operations Council

For insurance professionals who have an operational or leadership role within an agency or company Virtual Meeting from 9 a.m. to 11 a.m. on 3/7/23 and 7/18/23 Government Affairs Council

For individuals interested in staying informed and providing feedback to the IIAW's Board on Wisconsin & national legislative and political happenings. Virtual Meeting from 9 a.m. to 11 a.m. on 2/28/23 and 7/11/23 Emerging Leaders

For insurance professionals looking to cultivate their skills for a successful career by engaging in association activities, professional development, education and events.

Virtual Meeting from 9 a.m. to 11 a.m. on 3/8/23 and 7/19/23