Statutes of limitations: A primer for agents
In the insurance world, a notice of claim refers to the time in which an insured has to file an insurance claim. And, a statute of limitation refers to the amount of time that an insured has to file a lawsuit against an insurance agent or a carrier for a perceived error or omission.
A client is responsible for filing a timely claim
Once an incident happens—such as an auto accident or home burglary—the clock starts to tick. A client only has so much time to file a claim with his or her insurance carrier before it denies the claim for failure to report in a timely manner. This time limit can vary depending on the type of the claim, but it can be as short as 30 days.
Agents can only know about a claim if a client brings it to their attention. However, agents can work proactively to prove the value of working with an insurance agent. An agent can be a trusted adviser to clients, and offer them advice on how to get the most out of their insurance policies.
Educate your clients about prompt reporting:
3 Remind your clients about the importance of filing an insurance claim quickly and accurately. Let them know that claims may be denied if they are not reported promptly.
3 Encourage your clients to read their insurance policies so they are aware of any deadlines they may have regarding claims reporting.
3 Use your annual review time to open a dialogue with your clients and remind them about their responsibilities regarding their insurance policies.
3 Offer advice on the best ways to document a claim to lessen the likelihood of a denial.
An agent’s best defense
There is only so much time for a client to initiate legal action against your agency. These statutes are set by state and federal law, and there is a six year breach of contract statute of limitations that applies to an agent’s E&O.
Clients can sue their insurance agents for myriad reasons:
3 Failure to secure the correct type and amount of insurance.
3 Failure to provide accurate advice or recommendations.
3 Failure to fill out the application for the insurance policy properly.
3 Failure to inform the client about important changes to an insurance policy.
What agents can do to prepare
A best defense is documentation Prior to a possible lawsuit:
3 Keep your agency files in order— conduct periodic audits to ensure that everyone on your staff is following the same procedures.
3 Make sure to document every conversation with your clients (e.g., in-person meetings, phone calls, text messages, emails).
3 When you have discussions with your clients, write up your understanding of what the clients are asking you to do, send it to them, and ask them to sign off on the action, or to contact you with any changes. Retain the signed documents in your files.
If you get served with a lawsuit:
3 Do not say or do anything that may be considered an admission of guilt.
3 Consult your agency’s E&O policy.
3 Consult your attorney.
3 Document everything.
During the litigation process:
3 Cooperate with your counsel (attorney and E&O carrier).
3 Don’t tamper with any evidence.
3 Keep those who need to know what’s going on informed.
3 Don’t contact the client who has initiated the lawsuit.
Third-party litigation funding, and its effects on insurance
Third-party litigation funding has seen a trending uptick over the last couple of years—to the point that some states have introduced bills to increase transparency in its use. But, how is it affecting the insurance industry?
What is third-party litigation funding?
Third-party litigation funding is when a person or business receives financial backing from an outside investor (a third party) to help pay for a lawsuit. In return the funder gets a portion of any successful settlement or court-awarded damages. However, if the case is lost, typically the plaintiff doesn’t have to pay back the funder.
This type of financing is common in high-cost legal battles such as:
• personal injury claims (e.g., car accidents, medical malpractice);
• business disputes (e.g., contract breaches, intellectual property fights);
• class-action lawsuits; and
• whistleblower cases.
Concerns with this funding
Third-party litigation funding can help reduce a plaintiff’s personal financial risk, and level the playing field by helping individuals and small businesses take on large corporations with large cash reserves.
However, there are several causes for concern, such as:
Ethical issues. Critics worry that funders may influence legal strategies or encourage unnecessary lawsuits.
Transparency concerns. In many cases, defendants don’t know a lawsuit is being funded by an outside party.
Potential for abuse. Some people fear that this funding could drive up legal costs and make settlements harder to reach.
How it impacts insurance rates
Longer legal battles. One of the biggest concerns for the insurance industry is how third-party litigation funding affects claims costs and, ultimately, insurance premiums. When outside funders finance lawsuits, plaintiffs may be less willing to settle quickly, hoping to push for a higher payout. This can lead to longer, more expensive legal battles, driving up the costs that insurance companies must pay to defend claims and settle lawsuits.
Higher premiums. As litigation costs rise, insurers pass those expenses on to policyholders (higher premiums).
This is especially true in liability insurance—such as auto, medical malpractice and business insurance—when large settlements or jury awards can impact insurers’ financial exposure significantly.
Some studies suggest that third-party funding contributes to social inflation—a trend in which legal system costs, including jury awards and settlements, increase at a faster rate than overall inflation, leading to higher insurance rates across industries.
Possible solutions
As of the end of 2025, at least 21 states have taken legislative or regulatory action to address this funding. While approaches vary, these efforts offer valuable lessons for states considering their own regulatory frameworks. States have focused on six key areas:
Fee limitations. Fees of the gross recovery from a legal claim for the total charges would be capped. The percentage of the cap varies from state to state but it would ensure that funding costs remain proportional.
Clear contract disclosures. Contracts would need to outline the funded amount, all associated charges, and repayment terms—in bold, easy-to-understand language.
Right to rescind. Plaintiffs would be able to cancel a contract within 10 business days of receiving funds with no penalty. Licensing and oversight. Companies would have to register with the state, undergo fitness reviews, and report annual activity to the Department of State.
Attorney safeguards. Attorneys would be prohibited from having financial interests in funding companies or receiving kickbacks for referrals.
Settlement control restrictions. Contract provisions that allow funders to dictate or influence the outcome of settlements would be prohibited. This ensures that litigation decisions remain in the hands of plaintiffs and their attorneys—not financial backers.
These protections would rein in the worst abuses while allowing legitimate, regulated providers to operate responsibly.
The future of litigation funding
The litigation funding industry has grown rapidly, with major investment firms getting involved.
If you’re considering litigation funding, it’s important to understand the agreement fully, and consult a lawyer before accepting any funds.
Even with careful planning, one unexpected claim can reach the primary limits, leaving the board at risk.
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Blurred lines: How agents can build trust when legal questions arise
Grahame Cohen Founder and CEO, Epoq North America
Sometimes, independent insurance agents field uncomfortable client questions that seem better addressed by an attorney: “Can I evict a tenant who stopped paying rent?,” “Does my subcontractor dispute fall under my policy?,” or “My parents never wrote a will, what now?”
These questions aren’t about coverage. They are about legal matters. And for agents, they create a dilemma. Offering legal advice risks crossing into the unauthorized practice of law. But simply telling clients that the issue isn’t covered by their insurance policy, and that they should call a lawyer can leave clients frustrated and erode trust.
The challenge is clear: How can agents support clients facing common legal risks without overstepping professional boundaries?
Legal risks clients face
Many policyholders assume their insurance will help with legal problems, but that is rarely the case. Common issues that branch off from insurance matters for individuals can range from estate planning and family law affairs to contractor disputes and property rental agreements. For entrepreneurs and small- to mid-size business owners, these matters can span organizational governance and regulatory compliance issues to employee agreements and vendor or subcontractor contracts.
When these issues arise, clients can be disappointed to learn their insurance policies fall short of their expectations. The result: costly legal bills, limited recourse and heightened stress.
The agent’s dilemma
Agents work hard to go beyond simple policy transactions. They want to be trusted advisers, helping clients navigate uncertainty. But legal questions present a tightrope walk and the risk of hard feelings with valued clients.
This challenge can create tension in the client-agent relationship. Consider two scenarios many agents have encountered:
The landlord’s predicament. Homeowners rent part of their house. When the tenant stops paying rent, the landlord assumes the homeowners policy will cover lost rent or damages. It doesn’t. Nor does it cover the legal costs of eviction. Without a clear lease agreement, the landlord has little recourse and faces expensive attorney fees.
The contractor’s conflict. A general contractor hires a subcontractor only to face disputes over work quality and payment terms. The contractor’s liability policy doesn’t cover contractual disagreements. Without a written subcontractor agreement, the business owner risks litigation that can put the contractor’s company at risk.
In both cases, insurance has limitations unknown to clients, running the risk of disappointing them. The uncovered legal exposure leaves them vulnerable and makes the agents look—at worst—as if they didn’t anticipate a common risk. At best, in these scenarios, the agents can appear to fall short in the clients’ eyes.
While directing clients to seek competent legal counsel is the right response, the drive to improve customer service puts the right response in the wrong light. Clients wanted solutions from one person, not referrals to other professionals with additional, unpredictable costs.
Emerging options
The good news is insurance carriers—which are increasingly focused on customer service issues—are beginning to evolve. Some now offer resources that help agents guide clients toward proactive legal risk management without straying into advice. These may include:
• document tools to create contracts, leases and subcontractor agreements;
• attorney access programs for policyholders to seek guidance or mediation; and
• educational resources that raise awareness of legal risks before they escalate.
This isn’t new. Standalone legal-expense insurance began to take off in Europe in the 1920s, with legal insurance increasingly sold alongside coverage in the 1970s. Today, there are several insurance bolt-ons that offer access to attorneys for document review and drafting.
For agents mindful of the common risks that exist for individuals and small businesses when their insurance coverage cannot cover legal matters, there exists opportunities to seek out insurance carriers that offer legal bolton services or advocate that their carriers consider adding them. Rather than leaving clients to fend for themselves, carriers are implementing solutions that complement traditional coverage.
The agent’s role in building trust with clients
Agents don’t need to be legal experts to demonstrate continued value when legal questions come up. Instead, they can focus on four practical approaches:
No. 1: Guide, don’t advise. Make the distinction clear: you cannot offer legal answers, but you can point clients
to carrier-provided resources or recommend they secure documents and counsel to limit or prevent exposure.
No. 2: Highlight coverage gaps. Use one-on-one policy reviews as opportunities to flag where insurance stops and legal risks begin. Real-world stories— like landlords without leases or contractors without agreements—make the risks tangible and memorable.
No. 3: Promote proactive risk management. Encourage clients to put protections in place before problems appear. A well-drafted agreement or early mediation option can save both money and frustration.
No. 4: Push carriers for more support. Ask carriers what legal resources they provide. The more carriers invest in solutions, the easier it becomes for agents to meet client needs without overstepping.
Why it matters
Trust is the currency of independent agents. It’s built not by having every answer, but by ensuring clients they know where to find answers. When those answers are needed most, agents
who guide clients to appropriate resources reinforce their role as problem-solvers—not just policy sellers.
For clients, that distinction matters and can help de-escalate painfully challenging situations. For agents, it’s a path to stronger relationships, reduced liability and long-term loyalty.
Takeaway
Blurred lines between insurance and law will continue. By understanding where coverage ends, recognizing common legal risks, and guiding clients to the right resources, agents can build trust without crossing into legal advice.
The result is a stronger value proposition: not just selling insurance policies, but helping clients manage risk in a broader sense. For an industry built on trust, that balance is the key to lasting success.
Cohen is founder and CEO of Epoq North America (www.epoq.co), a legal InsurTech protecting businesses and consumers from legal and compliance risks since 1997, with services provided to more than 60 major brands and insurance carriers in the U.S., Canada, United Kingdom and Republic of Ireland. Reached him at grahame@ epoqlegal.com.
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You’re Closer to Your CIC Than You Think
If you’re a risk and insurance professional who has completed your CISR Commercial Casualty I and II courses, you already may be on track to receive full course credit for CIC Commercial Casualty—at no cost!
Opt-in to The Alliance’s CISR-to-CIC Cross Credit Program to save time, effort and money on your journey to CIC accreditation. For more information, contact PIA Northeast’s Education Department at education@pia.org
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‘I am going to sue you!’
Utica National Insurance Group E&O Risk Management
We all hope that clients appreciate how hard your agency staff works in providing a high level of customer service.
Hearing “thank you,” “great job,” “your agency is the best,” and similar phrases can bring out some positive emotion and a tremendous degree of pride.
While it would be great to hear these praises, the difference you make in a client’s life may not always be positive. For example, perhaps you just told a client that he or she doesn’t have any coverage for a recent flood loss, or the client’s liability limits are not enough.
These conversations can be difficult and emotional. As a result, instead of hearing “we love your agency,” the six frightening words “I am going to sue you” may be spoken. Knowing how many errors-and-omissions claims have happened over the years, there is a good chance that words threatening legal action have been said more than a handful of times.
Be prepared
It is vital to understand that because someone threatens to sue you, it does not mean you did anything wrong. The client is emotional, and he or she may simply be venting. In fact, a significant number of E&O cases are settled with no loss payment—other than possibly some defense costs. So, when you have a customer threatening a lawsuit, it is best to stay calm.
Getting on top of these issues is critical, so promptly report these scenarios to the designated person in your agency who handles them. Don’t take the approach of “they probably didn’t mean it.”
Be prepared to provide information pertaining to your client, including name, address, phone number and a detailed description of the claim or incident. Provide as much detail as you can, including dates that the error allegedly was made and the client’s specific coverage in question.
It is suggested this be done in one-on-one sessions. Don’t send an email to your boss stating: “I think I messed up,” as this type of communication has the potential to be admissible in the court of law.
Take direction from your manager or designated internal E&O contact person to determine any next steps and, to reiterate, stay calm.
What not to do
Now that you know what you should do, here’s a reminder about actions you should not take once the statement: “I’m going to sue you” is spoken by a customer.
Written statements. Do not provide any recorded or written statements concerning the alleged error involving your agency.
Admissions. Do not make any admissions of liability. You will probably feel bad, but do not admit that your agency made a mistake—even if that is what you believe.
Payments. Do not make or commit to a payment.
Alterations. Do not alter or make changes to the account/ file in question without authorization from management. Changes made after the “I’m going to sue you” notification may be revealed, which will not position your agency well.
Limit discussions. Do not discuss the matter with anyone other than your manager/designated internal E&O contact person. In addition, do not allow the inspection, copying or removal of your records without approval from the E&O carrier.
E&O claims happen. It is key to stay calm, report the matter to your manager/internal E&O contact person, and then let them do their job.
This information and any attachments or links are provided solely as an insurance risk management tool. They are derived from information believed to be accurate. Utica Mutual Insurance Company and the other member insurance companies of the Utica National Insurance Group (“Utica National”) are not providing legal advice or any other professional services. Utica National shall have no liability to any person or entity with respect to any loss or damages alleged to have been caused, directly or indirectly, by the use of the information provided. You are encouraged to consult an attorney or other professional for advice on these issues.
BRADFORD J. LACHUT, ESQ. DIRECTOR OF GOVERNMENT & INDUSTRY AFFAIRS, PIA NORTHEAST
Trusted adviser or order taker?
An agent’s standard of care and legal responsibility to the client
Ifind a great way to start an article is with a meandering hypothetical about ordering food at a restaurant. So, let’s get right to it: In a restaurant, you order a hamburger. The server nods, jots something down, and disappears into the kitchen. Twenty minutes later, the server returns—not with a hamburger, but with a veggie burger. Now, pause the scene. There are a few ways this could play out.
In one version, the server checks the order slip and sees that the hamburger was written down correctly. The kitchen made a mistake. The server apologizes, takes the plate back, and promises to fix it. In this case, the server did her job—the server took the order accurately and relayed it. The error wasn’t her.
In another version, the server looks at the slip and realizes he wrote down burger instead of hamburger. Maybe he was distracted, maybe he misunderstood. Either way, the mistake happened in the ordering process. The server didn’t deliver what the customer asked for, and the responsibility falls on him.
Now imagine a third version: the server wrote down hamburger, but decided—based on the customer’s health profile (which she somehow had access to)—that a veggie burger would be a better choice. In this case, the server has gone beyond her role as an order taker and assumed the role of an adviser.
So, what does this have to do with insurance brokers?
These scenarios mirror the kinds of misunderstandings that can occur between brokers and their clients. And, they help illustrate the concept of the standard of care—what brokers are expected to do, what happens when things go wrong, and how expectations shift depending on the relationship.
The standard of care: The ‘order-taker’ model
In most states, insurance brokers are held to a standard of reasonable care and diligence. In practical terms, this means brokers are expected to fulfill the requests made by their clients—accurately and efficiently. If a client asks for a specific policy, coverage limit or endorsement, the broker must try to obtain it. If it’s unavailable, the broker must inform the client.
But beyond that, there’s no general obligation to advise, to recommend coverage to or to educate clients. Often, this is referred to as the order-taker model. The broker’s role is to take the client’s request and deliver the product. The broker is not expected to anticipate needs, suggest alternatives or evaluate whether the coverage is sufficient.
This model works well when both parties understand the boundaries. The clients know what they want, the brokers deliver it, and everyone walks away satisfied. But as with our restaurant scenario, things can get complicated when expectations aren’t defined clearly—or when the broker’s role begins to shift.
It’s also worth noting that this model assumes a certain level of sophistication on the part of the client. When clients are
experienced business owners or insurance-savvy individuals, the order-taker approach may be appropriate. However, when clients are less informed or rely heavily on the brokers’ expertise, the line between order taker and adviser can blur quickly.
Beyond the order taker: When advice becomes liability
Just like our hypothetical server, brokers sometimes go beyond simply taking orders. They offer advice, make recommendations or position themselves as experts. Many brokers pride themselves on their expertise and view the offering of guidance as an integral part of the profession.
But, how much advice can brokers provide before they cross into a different legal territory—one governed by a heightened duty of care?
This is when the concept of a special relationship comes into play. When brokers consistently advise clients, make recommendations or take on responsibilities beyond placing coverage, courts may find that a special relationship exists—one that carries additional legal obligations.
These obligations can include a duty to monitor coverage adequacy, notify clients of changes in the market or even ensure that policies remain in force. In short, the broker may be expected to act more like a risk manager than an order taker.
For more on special relationships, see the article Special relationships happen on a case-by-case basis, which originally appeared in the December 2023 issue of PIA Magazine, and can be found on PIA Northeast News & Media (www.blog. pia.org).
Long-term relationships and the risk of heightened duty
As mentioned, generally, brokers are required to obtain the coverage and limits requested by clients—or inform them if those requests can’t be fulfilled. What’s not typically included in that duty is a responsibility to continually or proactively advise clients about available products or the sufficiency of their coverage.
Those two words—continually and proactively—are critical. On the one hand, brokers need not worry that meeting with clients to discuss their insurance needs will trigger a heightened duty automatically. The absence of a continual or proactive obligation implies that some level of contemporaneous advice is acceptable.
On the other hand, brokers who do consistently advise clients, offer unsolicited recommendations or take on renewal responsibilities may be stepping into a higher standard of care—one that could expose them to greater liability. This risk is especially pronounced in long-term relationships. Over time, clients may come to rely on their brokers not just for placement, but for guidance. If the broker has historically provided reminders, renewal notices or coverage reviews, courts may interpret that pattern as evidence of a special relationship—even if no formal agreement exists.
Case study
A recent case from Connecticut illustrates these principles in action. In Deer v. National General Insurance Co., 1 the Connecticut Supreme Court addressed whether brokers had a duty to notify clients when their homeowners insurance policy was not renewed.
Lee and Keleen Deer purchased a homeowners policy through their broker. The policy provided coverage from June 27, 2019, to June 27, 2020. After an inspection revealed missing exterior siding, the carrier requested repairs and and proof of those repairs by March 27, 2020. When the documentation wasn’t received, the carrier issued a nonrenewal notice via certified mail.
Despite multiple delivery attempts, the Deers claimed they never received the notice. Their policy expired, and weeks later, their home was destroyed by fire—resulting in a denied claim and a lawsuit against both the insurer and the broker. Did the broker have a legal duty to notify the Deers of the nonrenewal?
The plaintiffs argued that their long-standing relationship with the broker—nearly two decades—and their reliance on his expertise meant he had a duty to keep their insurance active and up to date.
The Connecticut Supreme Court ruled in favor of the broker. The court emphasized that, under Connecticut law, the duty to notify an insured of nonrenewal rests with the insurer, not the broker—unless there is a specific agreement or course of conduct suggesting otherwise.
The court reviewed emails, conversations and the overall broker-client relationship, and found no promise—written or verbal—that the broker would handle renewals or send nonrenewal notifications.
Learning from the case
While the Deer decision is specific to Connecticut, its reasoning would likely apply in many states. The key fact was that
In most states, insurance brokers are held to a standard of reasonable care and diligence … this means brokers are expected to fulfill the requests made by their clients—accurately and efficiently.
the broker had never provided nonrenewal notifications in the past. If the broker had done so previously—or if the agency routinely provided such notices—a heightened duty might have been found.
The case offers a cautionary tale for brokers navigating the boundaries of their professional responsibilities. One of the most important takeaways is the need to approach proactive service with care. While going above and beyond for a client may seem like good customer service, it can unintentionally create additional obligations. A broker who routinely offers unsolicited advice or takes on tasks, like renewal tracking, may be seen as stepping into an advisory role—one that carries a higher legal standard.
Clear communication is essential. Brokers must ensure that clients understand exactly what services are being provided—and just as importantly—what services are not. Setting expectations early in the relationship helps prevent misunderstandings and protects both parties if disputes arise.
Documentation plays a critical role as well. Every interaction should be recorded, including:
• what the client requested;
• what the broker offered; and
• what was ultimately declined.
These records can serve as a vital defense if a claim or lawsuit emerges, demonstrating that the brokers fulfilled their duty of care.
Consistency is another cornerstone of risk management. If an agency chooses to provide policy change notifications or renewal assistance, those services should be delivered uniformly across all clients. Inconsistent service—where some clients receive reminders and others do not—can create exposure to errors-and-omissions claims and can undermine the agency’s credibility.
Related to the documentation and consistency, is the adoption and use of standardized procedures and internal policies. Agents should consider developing written protocols for:
• handling policy renewals;
• nonrenewal notifications; and
• client communications.
Training staff to follow these procedures consistently can mitigate the risk of oversight and ensure compliance with legal requirements. In the event of a claim or lawsuit, demonstrating established, uniform practices add credibility to the agency’s defense, and supports the position that the standard of care was met.
Back to the table
Let’s return to our restaurant one last time.
The customer ordered a hamburger. He got a veggie burger. Maybe the server wrote it down wrong. Maybe the kitchen messed up. Maybe the customer didn’t speak up. Whatever the case, the outcome wasn’t what anyone wanted.
In insurance, the stakes are higher than dinner. Misunderstandings can lead to uncovered losses, legal battles and damaged relationships. That’s why the standard of care matters. It’s not just about taking orders—it’s about knowing what role you’re playing, and making sure your client knows it too.
Because in the end, everybody wants the same thing: to get what they ordered—and to know they’re being taken care of. Lachut is PIA Northeast’s director of government & industry affairs.
1 Lee Deer, et al. v. National General Insurance Co., et al. (SC 21045)
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Avoid the hazards of certificates of liability insurance Current
legal requirements by state
Certificates of liability insurance were first created by ACORD in 1976, known as ACORD 25. However, the providing of evidence of financial responsibility for liability exposures dates to the late 19th century and early 20th century. The problem with COIs is that they are not issued as proof of insurance, and one must understand the nuance between evidence and proof of insurance. This nuance has caused years of litigation and forced some states to regulate COIs heavily.
Understanding the nuance between these two words has been further complicated by requests for additional insured coverage, primary noncontributory language and subrogation waivers. In this article, we will explain—in general terms—the nuance and how the states in PIA Northeast’s footprint have come to regulate COIs.
It is clear from the inception of the COI that it was never intended to be absolute proof of insurance for the certificate holder to which it was issued, but rather the COI is issued only as evidence of insurance at the time that it is issued—with the understanding that it is subject to the terms, conditions and endorsements of the policy to which it refers.
In fact, along those lines the current disclaimer on the ACORD 25 COI states, in part:
This Certificate Is Issued As A Matter Of Information Only And Confers No Rights Upon The Certificate Holder. This Certificate Does Not Affirmatively Or Negatively Amend, Extend Or Alter The Coverage Afforded By The Policies Below.
For years, those who have utilized COIs have been using and abusing them to create coverage where no coverage exists. To that end, many states have taken it in their own hands to regulate the use of COIs. Specifically, in this article we will focus on what New York, New Hampshire, Connecticut, New Jersey and Vermont have done to regulate COIs.
New York law
In 2014, New York enacted Article 5 of New York Insurance Laws entitled Certificates of Insurance. Article 5 under Section 501(a): states “‘certificate of insurance’ means any document or instrument, or addendum thereto no matter how titled or described, prepared or issued by an insurer or insurance producer as evidence of property/casualty insurance coverage.” New York Insurance Law Section 502 goes on to prohibit:
Christopher B. Weldon, Esq. Partner, Winget, Spadafora & Schwartzberg LLP
Any person or governmental entity from willfully requiring an entity or person from issuing a COI that is not in “a form promulgated by the insurer issuing the policy referenced in the certificate of insurance;” or “a COI issued by industry standard-setting organization and approved by the Superintendent of the Department of Financial Services or any other form approved for use by the Superintendent.” NY Insurance Law Section 502(a).1
The law makes it illegal for any entity or person to require the “inclusion of terms, conditions or language of any kind, including warranties or guarantees,” in the COI that the insurance policy referenced in the COI does not include. 2 Finally, the law states: “A certificate of insurance shall further not confer to any person any rights beyond those expressly provided by the policy of insurance referenced therein.”3
The takeaway from these provisions is that New York state will no longer allow any COI that has not been approved by the DFS, nor will it allow a COI to amend any term, condition or endorsement of an insurance policy reference in the COI. Moreover, the state has made it a crime if any person violates Section 502 of the New York Insurance Law, punishable by a $1,000 fine for the first violation, and a $2,000 fine for each violation thereafter.4
New Hampshire law
While New Hampshire has codified its requirements relative to issuing a COI, it does not have a specific penalty if one violated these requirements. In 2011, New Hampshire enacted Section 412:6-b titled: Certificate of Insurance. New Hampshire prohibits any person from issuing a COI that:
• does not comply with the subparagraphs of NH Rev Stat Section 412:6-b.II.(b);
• is misleading, deceptive, or encourages misrepresentation; and
• violates any law.5
New Hampshire requires all COIs contain the following disclaimer language:
This certificate of insurance is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend, or alter the coverage, terms, exclusions, and conditions afforded by the policy or policies referenced herein.6
It also further prohibits the following:
• any person from demanding or requiring an insurer, producer or policyholder to issue a COI that contains false or misleading information about the policy it references;
• any person from issuing a COI that contains misleading information;
• any person from issuing a COI that purports to amend, alter or extend coverage provided by the policy it references with the exception that the COI can reference an umbrella/excess limit lower than set forth in the reference policy to meet the particular requirements of an agreement or contract to which it is being issued for;
• the reference to any contract other than a contract of insurance unless such reference is in relation to coverage or other requirements of the insurance contract; and
• the designation of the certificate holder’s right to notice of cancellation unless the certificate holder is an additional insured and the insurance contract or an endorsement requires such notice to be provided.7 New Hampshire—unlike the other states we are examining—allows an insurance producer to charge a reasonable fee for providing COIs if the fee accurately reflects the effort and cost to the insurance producer in issuing such COIs.8
The New Hampshire Insurance Department insurance commissioner may impose fines upon a person between $500 to $10,000 for each violation and $1,000 to $25,000 for each willful violation.9 In addition, the insurance commissioner may suspend, revoke or refuse to issue or renew a license for an insurance producer if the insurance producer is found to have violated any of these laws.10
Connecticut law
Connecticut began to address how COIs should be handled in Bulletin S-14 issued on Nov. 9, 2010, titled: Use of Certificate of Insurance. However, in 2024, Connecticut enacted Connecticut General Statute Section 38a-322a titled: Certificate of insurance. Prohibitions. Investigation. This section of the law basically codified the Bulletin S-14 and prohibits any person from:
• preparing, delivering or issuing a COI that is misleading about the coverages referenced therein;
• representing that the COI confers new or additional rights to any person beyond what is referenced in the COI; and
• attempting to amend, alter or extend coverage in the insurance policy referenced in the COI.11
Moreover, a COI may not warrant that the referenced policy complies with the insurance or indemnifications of a contract.12 Finally, no person may request or require a person to
perform any act that violates this section.13 This is all backed up with the granting to the insurance commissioner the right to conduct an investigation of any person it believes violated any of the provisions of this section of law.14
CGS Section 38a-322a also is backed up by Connecticut Unfair Insurance Practices Act of Conn. Gen. Stat. Sections 38a-815 and 38a-816(l )(a), “which provides that it is an unfair insurance practice to make, issue or circulate a statement that ‘[m]isrepresents the benefits, advantages, conditions or terms of any insurance policy ... .’”15 Any violation of this provision leads to an insurance producer being fined— “license revocation, suspension or orders of restitution” also are possible punishments.16
Connecticut has put teeth behind its enforcement of misuse of COIs by insurance producers under the enactment of CGS Section 38a-322a. And, in Bulletin S-14, it urges insurers to review the oversight procedures of their insurance producers who are issuing COIs.
In New Jersey
Unlike all the other states we discuss in this article, New Jersey has not enacted any laws or regulations that dictate how COIs are to be handled. However, it has one of the most stringent duties of care for an insurance agent and/or broker. Specifically, “[a]n insurance producer acts in a fiduciary capacity in the conduct of his or her insurance business.”17
What does this mean regarding the issuance of a COI in New Jersey? An insurance producer’s fiduciary duty runs to the issuance of a COI, and he or she is expected to exercise good faith and reasonable care in advising an insured on the issuance of its requested COI. In addition, the insurance producer’s duty of care not only falls to the insured, but it also falls to other foreseeable parties—such as the certificate holder.
While New Jersey has not enacted any statute or regulation to address COIs, it has enacted provided tools for the state to stop improper actions with COIs.18 Specifically, the statute allows the Department of Banking and Insurance commissioner to levy civil penalties, suspension, revocation and refusal to issue or renew licenses when the commissioner finds an insurance producer has:
• intentionally misrepresented the terms of an actual or proposed insurance contract, policy or application for insurance;
• admitted or been found to have committed any insurance unfair trade practice or fraud; and
• used fraudulent, coercive or dishonest practices, or demonstrated incompetence, untrustworthiness or financial irresponsibility in the conduct of insurance business in this state or elsewhere.19
Thus, while not having enacted a statute, New Jersey has the necessary tools to stop improper action by an insurance producer in the issuance of an COI.
In Vermont
Like New Jersey, Vermont does not have a statute or regulations that specifically regulate the issuing of COIs. However, like most other states, there are statutes that indirectly control how COIs are issued in Vermont.
For example, the Vermont statutes state: “No person shall engage in any trade practice that is determined under this chapter to be an unfair method of competition or an unfair or deceptive act or practice in the business of insurance.”20
More specifically, Vermont statutes may find that a COI is in violation of its statues if it “misrepresents or fails to adequately disclose the benefits, advantages, conditions, exclusions, limitations, or terms of any insurance policy … .”21 Any violation of this statute allows the commissioner for the Vermont Department of Financial Regulation to assess penalties—$1,000 for each violation, and up to $10,000 for each violation it finds willful.22
Uniquely, while most states hold the COI out for information purposes only, the Vermont Supreme Court has looked to a COI to assist in determining the intent of the insurance carrier stating in relevant part: “[t]he certificate of insurance, like the terms of the insurance policy, demonstrate that the insurance company and the insured contemplated indemnification coverage.”23 Finally, Vermont does have a statute that requires that all COIs be “filed with the commissioner for approval prior to issuance or use … .”
Even though Vermont does not have a statute that directly dictates the legal requirements in the issuance of COIs in Vermont, it has enough control in its statutes to regulate how COIs are issued, and the state will penalize producers who improperly issue COIs for any other purpose than to be issued for information purposes only.
Conclusion
What is clear is that these states—and the rest of the states across the country—are no longer going to put up with the misuse of COIs, and they are using the heavy hand of the law to stop the abuses.
Insurance agents and brokers also must police themselves, and they must report any misuse of COIs that they see.
While there has been a big push to regulate the issuance of COIs by the states, there has been an increase in misuse of COIs, and insurance agents and brokers need to be vigilant to confirm these misuses are not occurring in their agencies. Remember, COIs are not proof of insurance, but rather they are evidence that insurance is in place at the time the COI is issued.
Winget, Spadafora and Schwartzberg LLP concentrates its practice in representing insurance agents and brokers in all aspects
of their business, including but not limited to, defense of E&O claims, E&O loss counsel and education, insurance coverage analysis and litigation, insurance regulatory matters, mergers & acquisitions and drafting of agency, brokerage and producer agreements. Reach Weldon at weldon.c@wssllp.com or by mail to the Main Office of Winget, Spadafora and Schwartzberg, LLP, at 45 Broadway, 32nd Floor, New York, NY 10006, or call (212) 652-2697. The law firm also maintains offices in Jersey City, N.J.; Stamford, Conn.; Boston, Ma.; Philadelphia, Penn.; Miami, Fla.; Houston, Texas; Boulder, Colo.; Chicago, Ill.; and Los Angles, Calif. Copyright 2025 Professional Insurance Association and Winget, Spadafora and Schwartzberg LLP
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1 Relative ACORD 25 COI, the superintendent of insurance has only approved two versions of the form, Version (2014/01) and Version (2016/03). Every agent and/or broker issuing a COI in New York state should regularly confirm the approved forms at the DFS’s website (tinyurl.com/4pnwhv8d).
2 See, New York Insurance Law Section 502(b)
3 See, New York Insurance Law Section 502(c)
4 See, New York Insurance Law Section 503
5 See, NH Rev Stat Section 412:6-b.II.(a)
6 See, NH Rev Stat Section 412:6-b.II.(b)(1)
7 See, NH Rev Stat Section 412:6-b.II.(b)(2)-(7)
8 See, NH Rev Stat Section 412:6-b.II.(e)
9 See, NH Rev Stat Section 412:20
10 See, NH Rev Stat Section 402-J:12.I.(b)
11 See, CGS Section 38a-322a(b)(1)-(3)
12 See, CGS Section 38a-322a(c)
13 See, CGS Section 38a-322a(e)
14 See, CGS Section 38a-322a(f)
15 See, CGS Section 38a-816(1)(a)
16 See, CGS Section 38a-817(e)
17 See, Weinisch v. Sawyer, 123 N.J. 333, 340, 587 A.2d 615 (1991)
18 See, New Jersey Revised Statute Section 17:22A-40
19 See, NJ Rev Stat Section 17:22A-40(5), (7) and (8)
20 See, 8 V.S.A. Section 4723
21 See, 8 V.S.A. Section 4723(1)(A)
22 See, 8 V.S.A. Section 4726
23 See, Utica Mut. Ins. Co. v. Central Vermont Ry. Inc., 133 Vt. 292, 295 (1975)
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Lessons from a sales team’s rise from failure to No. 1
John Chapin President, Complete Selling
The following is a case study that highlights the dramatic transformation of a sales team at one of the largest companies in the world.
I’ll spell out at the end of the article what separates top-performing teams from mediocre and poor-performing teams, along with the keys required to build a winning culture.
Sales team rises from failure to best in the nation
Background. The Atlanta-based regional sales team—of one of the largest companies in the world—consistently ranked between 12th and 18th out of 24 regions nationwide. Despite a decade of efforts by the tenured regional vice president to enhance performance, the team’s sales numbers remained stagnant.
Catalyst for change. At the company’s national convention, the regional vice president attended a three-hour Mental Toughness Training session. Inspired, he invited the speaker to Atlanta to conduct an in-depth assessment of his team. Research findings. The assessment revealed a significant “delusion factor” within the team:
• 82% of the salespeople considered themselves “worldclass,” despite average or below-average results.
• 9-out-of-12 district managers self-identified as “world-class” managers—mirroring their teams’ poor performance.
• 70% of the sales team failed to meet their daily call quotas.
• 80% of the team reported being satisfied with their sales results.
• 75% of the team resented being pressured to achieve better results.
Leadership response. The regional vice president was surprised by these findings, and he made a bold decision to make the consultant’s psychological performance training
mandatory, which created tension on the team. The team agreed to participate in a three-month pilot program—starting with the district managers.
Pilot program kickoff. The six-hour, in-person seminar began contentiously, as numerous team weaknesses were highlighted. District managers were challenged to promote changes in personal and interpersonal behaviors within their teams. By day’s end, managers committed to a 12-month Mental Toughness Process for their teams.
Implementation. The team was presented with identified problems and corresponding solutions. Initial cooperation was mixed:
• The lowest performer in each district was transitioned out.
• Twelve new salespeople were hired using the Mental Toughness Process, to help ensure readiness from day one.
• Weekly calls with a Mental Toughness Coach gradually shifted the team’s culture.
Within six months, a winning team dynamic emerged. District managers observed an attitude shift in 80%-85% of their teams and worked to elevate the remaining members.
Results. Further personnel adjustments included the removal of six more salespeople, who were replaced by new hires. Key performance metrics improved:
• average daily calls increased from six to eight;
• pre-call planning exceeded 90% for the first time;
• post-call analysis reached 95%; and
• engagement scores rose from 65% to 85%.
The team broke into the top 10 nationally for the first time. Motivated, they maintained momentum during typically slow periods. The regional vice president noted unprecedented enthusiasm. The team finished the year ranked No. 1 nationally, surprising corporate leadership.
Aftermath
Despite their success, peers doubted the team’s achievement, attributing it to luck. This skepticism further unified the team. They declared their intent to retain the top ranking the following year—a feat never accomplished in the organization. With management’s support and enhanced incentives, the team repeated its success, securing the President’s Award for the second consecutive year, and setting a company record.
Lessons learned
The biggest takeaway? Sales success is about more than just product knowledge and basic selling skills. Championship teams are built by combining:
• a commitment to excellence;
• a proven sales process and systems;
• advanced sales skills (objection handling, value-building, closing at top-tier pricing);
• mental toughness, which enables resilience, persistence and emotional control; and
• accountability and tough love, when needed to drive performance.
Just a note on mental toughness, many representatives misinterpret buyer resistance as rejection—especially during cold calls or follow-ups. Often, the prospect is simply busy, not disinterested. Mental toughness helps salespeople stay grounded in reality, and keeps them moving forward despite rejection—real or imagined—found mostly in the initial and presentation portions of the sales process.
Refocus: Common sales leadership mistakes
No. 1: Focusing on low performers. Spending too much time, money and energy on low performers who won’t make it means you are diverting your resources from top performers.
No. 2: Micromanaging top performers. Overburdening top producers with tedious rules and reporting, which are most effective for getting and keeping the lower performers on track.
No. 3: Delaying consequences. Tolerating poor performance and allowing it to continue without consequences will increase the likelihood that you won’t meet your sales goals.
No. 4: Subsidizing underperformers. Allowing high performers to subsidize
underperformers will allow your underperformers to continue to skate by— and increase the likelihood of burnout for your high performers.
Note: Most people who think they are great, stop working and do the bare minimum. Ironically, it’s usually the top performers who are never happy with where they are and who continue to work hard to improve.
Takeaway
As I travel the country and work with hundreds of sales teams—both large and small—the teams that struggle have research results like the team in this case study.
Transforming a team starts with shifting their thinking. When salespeople are trained to think like champions— and held accountable to high standards—the results can be extraordinary. Chapin is a motivational sales speaker, coach and trainer. To have him speak at your next event, go to www.completeselling.com. He has over 37 years of sales experience as a No. 1 sales rep and he is the author of the 2010 sales book of the year: Sales Encyclopedia (Axiom Book Awards). Reach him at johnchapin@completeselling.com.
Certificates, business records, lawful discrimination and more
PIA technical staff
Have a question? Ask PIA at resourcecenter@pia.org
Conn.: An employee’s right to sue under voluntary workers’ compensation coverage
Q. If an employee is not subject to the Workers’ Compensation Law and the employer chooses to voluntarily cover the employee with workers’ compensation benefits, does the employee retain the right to sue his employer?
A. The short answer is yes, but there are conditions. The employee may accept the workers’ compensation benefits— which are paid immediately and regardless of fault—but only if the employee surrenders his right to sue.
Alternatively, the employee may reject the workers’ compensation benefits and sue the employer, but then the employee must prove negligence on the part of the employer, and wait maybe years to obtain a settlement or judgment.
Whether the employer voluntarily provides workers’ compensation coverage to an employee, the employer should consider the same factors in choosing the employers’ liability limits.—Dan Corbin, CPCU, CIC, LUTC
N.H.: Rebating–charitable exception
Q. We are considering offering a donation to a children’s charity for every policy written or renewed through our agency. Can we legally do this without it being considered rebating?
A. It depends. It is against the law for a producer to give a client or prospective client anything of value—directly or indirectly—as inducement to insurance. In this case, a charitable contribution would be considered an indirect inducement, as it would be in connection with the sale, solicitation, and/or negotiation of insurance and it can be interpreted as being used to influence clients’ decisions. While some states have a specific exception for charitable contributions, New Hampshire is not one of those states. Instead, for the contribution to be legal, it must meet one of the rebating exclusions found in RSA 417:4(IX)(b).
The easiest way to ensure that the contribution qualifies under the rebating exceptions is to have the amount donated be $100 or less. The law states:
the giving of a promotional item or items to a consumer in connection with marketing of contracts of insurance provided the item or items have a fair market value of $100 or less per consumer, per year …
So, if you kept to the $100 limit, it would not be construed as a practice included within the definition of discrimination or rebating.—Bradford J. Lachut, Esq.
Vt.: Exclusive remedy
Q. Can an employee sue his or her employer for negligence in causing an injury? Can the employee sue a third party who caused the injury?
A. Generally, an employee cannot sue his or her employer for workplace injuries under the following exclusive remedy provisions of the Labor Law Section 622:
Except as provided in Subsection 618(b) [uninsured penalty] and Section 624 [third-party recovery] of this title, the rights and remedies granted by the provisions of this chapter to an employee on account of a personal injury for which he or she is entitled to compensation under the provisions of this chapter shall exclude all other rights and remedies of the employee, the employee’s personal representatives, dependents or next of kin, at common law, or otherwise on account of such injury.
One exception occurs when the employer has not complied with its obligation to secure compensation (typically, by purchasing a workers’ compensation policy). Not only does the employee have a right to sue the employer, but the employer is deprived of defenses; namely, fellow-employee negligence, comparative negligence and assumption of risk.
The other exception permits the injured employee to seek recovery from a third-party tortfeasor who is not the employer. Such recovery will be offset by the amounts paid as workers’ compensation benefits.—Dan Corbin, CPCU, CIC, LUTC
Certificates
of insurance–how much information is enough
Q. How much coverage detail is needed on a certificate of insurance? If a contract requires a $1 million umbrella but the client has $5 million, should we list the full amount or just the required $1 million? Also, what if the additional insured is only covered up to the contract limit?
A. I know of no definitive answer to this question. Based on discussions within the insurance industry, it appears that opinions are split equally between showing the actual limits and showing the requested limits.
The only objective criterion I can locate is the instructions ACORD offers to complete the ACORD 25 Certificate of Liability Insurance form. It states: “As used here, the limit should be listed as a whole-dollar amount, as governed by the policy.”
However, in 2013, ISO revised all its additional insured endorsements to better align coverage in the endorsement to the coverage required in the underlying written contract and the coverage legally enforceable in that jurisdiction.
First, language is added to only afford coverage to an additional insured within the constraints of law. In other words, if anti-indemnity statutes, for example, restrict the extent of coverage permissible, the additional insured will be limited to that coverage.
Second, language is added to restrict the coverage afforded to an additional insured to the coverage requested in the underlying written contract. For example, if the written contract does not require personal and advertising injury liability coverage, then this coverage will not be applicable to the additional insured.
Third, language is added to restrict policy limits to the lesser of the amount required by the underlying written contract or the maximum amount available under the policy.
If these endorsements are put in use by your insurers, you will be justified in showing the limit required by the contract on the certificate, because that is the limit “governed by the policy.”
—Dan Corbin, CPCU, CLU, LUTC
Business records subject to audit
Q. What can and can’t a company require by way of business records in connection with a premium audit?
One of our clients owns apartment buildings. The insurance company wants to see copies of contracts our client entered into with service companies. We write the commercial general liability policy on these buildings. Is the company within its rights?
A. The company appears to be asking for records that may lie beyond the scope of its audit privileges under the policy’s conditions. The commercial general liability’s common policy conditions allow the company to “examine and audit your books and records as they relate to this policy at any time during the policy period and up to three years afterward.”
At audit, the company has a right to examine records that would shed light on whether the risk is classified and rated properly. Apartment buildings are rated based on the number of apartment units. The company needs to justify its request to review your client’s service company contracts in terms of verifying:
• the classification and the number of units involved; or
• the existence of any exposure (or exposures) that need to be
classified separately and rated under the rating exceptions listed in Note 6 to the classification table (e.g., indoor parking, swimming pools).
A company’s audit privilege is not a license to conduct a fishing expedition through your client’s office. It needs to present a convincing argument that the records it requests are related to a legitimate line of inquiry.—Dan Corbin, CPCU, CLU, LUTC
Lawful auto rate discrimination
Q. How can auto insurance companies discriminate and charge different rates for credit, age, gender, etc.? Is that legal?
A. There is actuarially justified and fair discrimination, but there also is unfair discrimination. Unfair discrimination is prohibited by law.
Everybody knows that youthful operators have greater loss experience, and to the extent this is actuarially justified, insurers are permitted to charge higher rates for these operators (legal discrimination).
Sometimes—even though discrimination is actuarially justified—public opinion turns against it, which results in prohibition. When I started out in this business, insurers discriminated against certain occupations that had greater loss experience. However, most states passed laws to prohibit discrimination against people based upon a lawful occupation. Credit scores have undergone similar prohibition or restriction, despite the overwhelming empirical evidence that supports its use.
So, there are two hurdles that need to be overcome to make discrimination legal. First, it must be justified in respect to loss experience; and second, it must not otherwise be prohibited by law.—Dan Corbin, CPCU, CLU, LUTC
NEW ENGLAND COMPANY PARTNERS
As of publication date. For more information go to pia.org.
PIACT 2025–2026 Board of Directors
OFFICERS
President
Kevin P. McKiernan, CIC, CPIA Abercrombie, Burns, McKiernan & Co. Insurance Inc. Darien, CT
President-elect
Katie Bailey, CPIA, ACSR, CLCS The Russell Agency LLC Southport, CT
Kimberly A. Tompkins, CIC, CPIA, AIS, AINS, PHM, CRIS, ACSR
The Mutual Group/GuideOne Mutual W. Des Moines, IA
Secretary
Jeffrey A. Krar
Joseph Krar & Associates Inc. Southington, CT
Immediate Past President
Nick Ruickoldt, CPIA, CISR The Russell Agency LLC Southport, CT
PIA NATIONAL DIRECTOR
Jonathan Black, LUTCF, CPIA, CLTC, NAMSA, NSSA Johnson-Stevens-Curran Danbury, CT
DIRECTORS
Scott Burns XS Brokers Insurance Agency Inc. Hartford, CT
Anthony DeSalva Georgetown Financial Group Redding, CT
Ryan Kelly USI Connecticut Bridgeport, CT
Nicholas Khamarji Jr. New England Insurance Easton, CT
Justin Sloan OneDigital Farmington, CT
CTYIP
REPRESENTATIVE
Justin Sloan OneDigital Farmington, CT ACTIVE PAST PRESIDENTS
James R. Berliner, CPCU Berliner-Gelfand & Co. Inc. Monroe, CT
Mark Connelly, CIC Fairfield County Bank Insurance Services Ridgefield, CT
John DiMatteo, CPFA, CFP DiMatteo Group Financial Services Shelton, CT
J. Kyle Dougherty, CIC Dougherty Insurance Agency Inc. Stratford, CT
Peter Frascarelli, CPIA Ferguson & McGuire Wallingford, CT
PIANH 2024–2025 Board of Directors
OFFICERS
President Casey Hadlock Hadlock Agency Inc. Littleton, NH
Vice President
Jeffrey Foy, AAI E. Kingston, NH
Secretary/Treasurer
Alex Kapiloff, CPCU, CLU, CIC, AAI Kapiloff Insurance Agency Inc. Keene, NH
Immediate Past President
Keith T. Maglia Insurance Solutions Corp. Plaistow, NH
National Director
Lyle W. Fulkerson, Esq. HPM Insurance Amherst, NH
ACTIVE PAST PRESIDENTS
Lisa Nolan, CPCU Cross Insurance Manchester, NH
John Obrey Obrey Insurance Agency Inc. Londonderry, NH
DIRECTORS
Anthony Inverso North American Insurance Alliance Hampton, NH
Erik Liguori Brown & Brown of New Hampshire Inc. Merrimack, NH
Paul Riley Safety Insurance Boston, MA
Lori Sherman New England Indemnity Co. Bedford, NH
Michael F. Keating
Michael J. Keating Agency Inc. W. Hartford, CT
Howard S. Olderman Olderman & Hallihan Agency Ansonia, CT
Bud O’Neil, CPIA C.V. Mason & Co. Inc. Bristol, CT
Gerard Prast, CPIA XS Brokers Insurance Agency Inc. Quincy, MA
Shannon Rabbett, CIC Rabbett Insurance Agency dba JMG Insurance Group Windsor, CT
Augusto Russell, CIC NFP West Hartford, CT
Timothy G. Russell, CPCU The Russell Agency LLC Southport, CT
