A SECRET TOOL FOR RESOLVING INSURANCE COVERAGE & CLAIMS DISPUTES

A S E C R E T T O O L F O R R E S O L V I N G I N S U R A N C E C O V E R A G E A N D C L A I M S D I S P U T E S

In my book “When Words Collide: Resolving Insurance Coverage and Claims Disputes, ” I give many examples of how I’ ve been able to get initially denied claims paid by referring to authoritative interpretive sources. In several of these claims, the source of the information was the actual regulatory filing that addressed the policy provision cited as the basis for the denial.

So, how do you get access to these filings? The answer can be found in an online National Association of Insurance Commissioners tool called “SERFF, ” the NAIC’s System for Electronic Rates and Forms Filing. Here you can find filings from advisory organizations like ISO and AAIS or individual insurer filings over the past decade.

The problem I have always had with the SERFF system is that it was unintuitive and clunky to use. However, the good news is that my frustration was not (hardly) shared by Tim Dodge, AU, ARM, CPCU of the Independent Insurance Agents and Brokers of New York. After mercilessly hounding Tim for many months, I finally browbeat him into sharing his tips and tricks in effectively using the system.

The result is an online tutorial Tim put together on how to use the SERFF system:

How to Search For and Find Carrier Filings

According to the instructions: Bill Wilson July 12, 2021

Several years ago, the National Association of Insurance Commissioners (NAIC) made insurer form, rate and rule filings accessible to the public online. The records go back only to 2010, but they are a treasure trove of information. Want a copy of a specific carrier’s Businessowners Policy form or additional insured endorsements? With a little digging, you should be able to find them. Click the image below for a slideshow tutorial in PDF format on how to use this valuable tool.

In my “When Words Collide” book, I talk about the legal issues involving the use of extrinsic information to support policy interpretations in litigation. However, my book is premised largely on resolving claims without litigation. Likewise for coverage issues. As a result, I have found regulatory filings to be of significant value in determining the intent of the form drafter, that intent sometimes clearly in conflict with the adjuster’s claim denial or the underwriter’s coverage opinion.

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Bill Wilson Founder at InsuranceCommentary.com

One of the premier insurance educators in America on form, coverage, and technical issues; Founder and director of the Big “I” Virtual University; Retired Assoc. VP of Education and Research from Independent Insurance Agents & Brokers of America. Reprint Request Information