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	<title>Professional Liability Tidbits &#187; Coverage</title>
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	<description>For the Insurance Professional in the Know</description>
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		<title>Claims, claims everywhere&#8230;</title>
		<link>http://www.pltidbits.com/2011/03/claims-claims-everywhere/</link>
		<comments>http://www.pltidbits.com/2011/03/claims-claims-everywhere/#comments</comments>
		<pubDate>Tue, 08 Mar 2011 03:48:38 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[claims]]></category>
		<category><![CDATA[Coverage]]></category>
		<category><![CDATA[contract]]></category>
		<category><![CDATA[countersuit]]></category>
		<category><![CDATA[economy]]></category>
		<category><![CDATA[risk mitigation]]></category>

		<guid isPermaLink="false">http://www.pltidbits.com/?p=332</guid>
		<description><![CDATA[Increasing claim frequency could easily be a result of the economy's drag on insureds and their clients.  Desperate times call for desperate measures, and an insurance policy can look like easy pickin's.]]></description>
			<content:encoded><![CDATA[<p>I’ve seen a steady and disturbing uptick in claims over the last 18 months.  Less disturbing to me personally due to  not having a pen right now, but a bit disturbing for the industry, and I am disturbed by proxy on behalf of all my underwriter-friends.</p>
<p>I can’t help but think that the economy is largely responsible for these increased claims, but other than insureds going bankrupt and incurring D&amp;O claims due to such bankruptcy, or EPL claims when laying off a substantial number of employees,  the connection may not be all that apparent.</p>
<p>I put on my noodling hat the other night and came up with the following thoughts, mostly pertaining to E&amp;O:</p>
<p>How is the economy causing claims for our insureds?</p>
<p>Financial pressures, cost-cutting measures and layoffs can cause disruption in previously well-managed processes.  I can’t tell you how many times I’ve seen a reduction in staff where all the work just gets parsed out to the remaining employees.  Many of those employees have never done that work before, they don’t receive proper training, and the work is piled on top of an already-full desk with no incentive to put on the afterburners other than fear that their job is next if they don’t make themselves indispensible.    Is this conducive to quality output?  I think not.</p>
<p>For most businesses, the downturn in revenue occurs before the fall-off in demand, so it’s almost impossible to service an account throughout its lifecycle if payment is loaded up front and recognized immediately.  When I was on the retail side, one of our accountants asked why we didn’t earn our revenue over the 12 month policy period, versus recognizing it when bound.  The insurance folk guffawed at the accountant – “Why, that’s never done!” they said.  True, but why not?  Because policies rarely cancel mid-term?  Not so in many lines.  Because the work attendant upon that piece of business is completed at the time the account is invoiced?  Also not the case.  Because we assume nothing will ever go wrong, and we plan for constant growth?  Yeah, that’s the ticket.</p>
<p>The folly of this optimistic belief system hit me hard when one of my prior employers lost an underwriting program due to the carrier going into receivership.  Revenue ground to a complete halt in one month, but we had to service hundreds of policies for the remainder of the policy year.  We went from seven or eight people working on that program to one person pulling loss runs and trying to manage the endorsements and another trying to re-market and salvage what we could.  It was not a pretty picture on many levels, but it was particularly painful because it could easily have been avoided.  What if we had recognized the income on that program as it was earned and staffed accordingly?    We would have had a slow, predictable step-down in revenue corresponding with the step-down in servicing demands.</p>
<p>All that being attractive from a stress and humanitarian perspective, the E&amp;O-related question here is – what is the likelihood that errors were made during that run-off period with the staffing stresses that existed, versus if we had taken a more conservative approach to recognizing our income and kept a more suitable staffing level throughout run-off?</p>
<p>It also occurs to me that while our insureds may be suffering from financial stresses that could lead to claims, at least we can ferret that out by looking at financials and asking for information if any red flags are raised.  But what about the financial condition of their clients?  If your insured is providing services of an advisory nature, or services that roll up into a larger deliverable for the client’s customers, you can bet your bottom dollar that if something goes wrong, the client will be looking under every stone for someone to blame so he can recover money for the loss.  Either he’s trying to avoid being sued, or he already has been and figures he’s not going down alone. </p>
<p>Back in the day, circa 2005 and earlier, if there was any kind of relationship between your insured and his client, a mistake that damaged the client in some way would not necessarily result in a claim.  A lot of times the insured could make it good.  If not, the relationship tempered a client’s desire to make a claim against the insured.  But now…The insured doesn’t have the resources to fix a problem, and the client doesn’t have the resources to absorb the problem or honor the relationship and work through the issues.  It’s all about keeping your head above water, and a kinder, gentler response to a perceived wrong is not long considered, if at all.</p>
<p>How can you tell if the insured’s clients are under financial strain?  You can sort of assume that they are these days, but clearly that is not helpful, unless you choose to stop insuring anyone at all until the economy turns around.   It used to be that E&amp;O apps asked the insured if he ran a credit check and/or background check on prospective clients.  This was to ferret out payment/credit problems and any history of litigation.  I haven’t seen that question in a long time (except maybe on an LPL or APL app), but agents <strong>and</strong> their insureds would do well to resurrect that process.</p>
<p>And of course, a client’s financial stress will cause them to cut corners and have more errors in their own services – but they will still try to pin the causation on someone else so they can get reimbursed for their troubles.</p>
<p>Where does this leave us?  In a fine pickle.</p>
<p>We find ourselves with cost-cutting/cost-saving measures, requirements to be ever more productive with less staff and fewer resources, cutting corners on best practices because we’re doing the work of 2, 3, or 4 people.  We have unmotivated staff, untrained support people (or producers/underwriters), and are looking over our shoulders wondering what’s coming after us next, and how bad it is really going to get.</p>
<p>Our clients are in exactly the same place, unless they’re a debt collection company or something similar, with a contrarian prime time for maximum profitability.  Our clients’ customers have the same problems and are looking for the best value and scrutinizing everything they pay for.   If one cut corner or under-staffed error in the insurance program intersects with one mistake made by the client – you’ve got an uncovered claim with a very high likelihood that it will roll uphill to become your E&amp;O problem.</p>
<p>What can we do to address these issues?</p>
<p>As agents, we can and should take a closer look at who we bring on as clients.  I know it’s hard to second guess a potential account at any time, let alone when you’re scraping and clawing for every penny of revenue.  But failing to vet your potential clients can result in unpaid accounts receivable, an overabundance of servicing issues, an insured that doesn’t have time to provide sufficient and accurate information regarding their exposures, and in the end anything that goes wrong will be your fault and your commission income has been frittered down the drain with the handling costs of that account.</p>
<p>How can you evaluate potential clients?  It’s probably wise and reasonable to run a credit check, and research any Better Business Bureau  or similar complaints.  Knowing the potential client through the community or associations is always a good way to gather background information.  Requesting a copy of financials can be helpful, if the insured is willing to share them, and if the type of insurance you’re placing generally requires the financials.  The downside to the financials is that they are always  retrospective, and you are most likely to get ’09 year-end financials this early in the 2011 year.  A lot could have changed.  I’d say year-end financials and the most current interims would provide an adequate picture.</p>
<p>It may also be prudent to execute a contract with your client that defines the rights, duties and obligations of each party.  The insured must provide thorough and accurate answers to all questions in the information-gathering process, must notify you of any changes, and must pay premiums.  You would offer whatever services detail your level of engagement.  My philosophy here is that if the insured goes off the rails and doesn’t inform you of what’s going on, you can trot that contract out to reinforce your defense that you only had an obligation to respond to the needs of which you were informed.  If the insured engaged in shenanigans you didn&#8217;t know about and therefore didn&#8217;t insure or didn&#8217;t explain the exclusion applicable thereto, the contract will again bolster your defense.</p>
<p>The fact that we provide so many services for free and without contracts is a constant source of amazement to me, but that’s a topic for another day.</p>
<p>For the underwriters out there, I believe a return to some good old-fashioned questions would be helpful.  Perhaps the creation of an “Economic Conditions Impact Questionnaire” would be suitable.  Over the last many years, questions about financial condition and how the insured relates to its clients have slowly faded away. </p>
<p>Certainly, one of the growing drivers of claims is a client retaliating against our insured alleging unsatisfactory rendering of services in response to the insured attempting to collect monies owed.  This is a tried and true way to get the wolf to back away from the door, and the less liquid the insured’s client is, the more likely the response will be particularly venomous.</p>
<p>The following questions could help identify an insured that is sliding into a profile of higher potential for claims:</p>
<ol>
<li>Do you check the litigation history of your potential clients?</li>
<li>What is the average length of your relationship with your clients?</li>
<li>Are clients allowed to pay in arrears for your services?  If yes:
<ol>
<li>Do you run credit checks on your clients before extending terms?</li>
<li>Does your contract for services document billing rates and payment terms?</li>
<li>What percentage of your accounts are over 90 days past due?</li>
<li>What actions do you take to recover monies for aged receivables?</li>
<li>Do you turn past due accounts over to a collection service?</li>
<li>Have you filed or threatened suit against any clients in the last 24 months in order to collect monies owed to you?</li>
<li>Do you anticipate taking action against any clients in the next 12 months in order to collect monies owed to you?</li>
<li>Does your contract for services include a provision for you to return fees to the client, if the client is dissatisfied with your services?</li>
</ol>
</li>
</ol>
<p>I believe these questions, and similar ones you might cook up on your own, can be very helpful in identifying incipient problems.</p>
<p>I’ve also noticed in a few policies an exclusion for countersuits brought in response to a suit for fees brought against a client by the insured.  That approach would certainly insulate the carrier from these retaliatory claims by disgruntled (or broke) clients.   I’m not sure that any particular carrier would want to be the first to jump wholly into that pool, and the exclusion might be a deterrent to the purchase of that carrier’s policies, all other things being equal.   However, excluding these countersuits on an action-specific basis could be a brilliant solution.  This is similar to the “seek counsel” warranty exclusions in some older London EPL policies.</p>
<p>To implement this scenario, the carrier would add an endorsement to the policy that binds the insured to conferring with qualified counsel prior to filing a suit for fees.    Such counsel could be a risk management/mitigation person at the carrier, or it could be an approved panel counsel.  If the insured does not confer with qualified counsel there would be no coverage for any countersuit arising from their action against the client.  If the insured does confer with qualified counsel, there would be coverage.   Reasonable, wise, risk-management oriented, and tremendously helpful in getting the insured through the minefield of collecting debts without generating an attack on itself.</p>
<p> Bottom line, if the microcosm I’m observing does exist in a broader form, we are either experiencing an anomaly that will correct itself soon enough, or we are experiencing the beginning of a new “normal” which is not all that attractive.  Taking a more considered approach to accepting any given insured as a client, both at the agency level, and at the carrier level, could be the cure for many ills.  It&#8217;s time to look at more than the insured&#8217;s likelihood of a claim arising from their operations, and add the contemplation of the likelihood of a claim or other unpleasantness arising from their financial condition.</p>
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		<title>Your Insureds&#8217; Contractual Requirements &#8211; Part 2</title>
		<link>http://www.pltidbits.com/2011/02/your-insureds-contractual-requirements-part-2/</link>
		<comments>http://www.pltidbits.com/2011/02/your-insureds-contractual-requirements-part-2/#comments</comments>
		<pubDate>Fri, 18 Feb 2011 02:12:22 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[claims]]></category>
		<category><![CDATA[Coverage]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Misc E&O]]></category>

		<guid isPermaLink="false">http://www.pltidbits.com/?p=316</guid>
		<description><![CDATA[Some contractual requirements are nearly impossible to fulfill, and others are in conflict with each other.  What's an agent to do?]]></description>
			<content:encoded><![CDATA[<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">Here’s what got me thinking about contract requirements and whether the insurance we provide fulfills them, and more importantly, whether we have a duty to provide insurance that fulfills such requirements.</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">The insured is an architect firm, and the agent sent me the contract for a potential job to make sure our existing coverage met the limits requirements and there were no problems with the indemnification wording.  </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">However, the very first thing I noticed about the contract when I started to look it over is that it requires the following:  &#8220;The policy shall include without limitation contractual liability coverage to the maximum extent possible for the indemnification obligations&#8230;&#8221;</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">I feel like this is one of those pictures where you pick out how many things are wrong:</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">How many policies have you ever seen that included coverage &#8220;without limitation&#8221;?  How many policies cover contractual liability coverage (and contractual damages)?  </span><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">How can you have coverage &#8220;without limitation&#8221; and &#8220;to the maximum extent possible&#8221; at the same time? &#8220;Possible&#8221; meaning &#8211; as circumscribed by policy language?  Or &#8220;possible&#8221; meaning &#8212; that which is provided by the broadest coverage available in the world?</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">The indemnification wording combined with the requirement quoted above work to create sort of an Additional Insured situation where the client is looking for an agreement that the carrier will fund the insured&#8217;s defense and indemnification of them in the case of a loss arising from the insured&#8217;s negligence.  Yet they did not ask to be named as an Additional Insured (which I don&#8217;t encourage anyway).  </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">Interestingly, the drafter of this contract knows enough about claims-made coverage to require that if the policy is claims-made the retro date must pre-date work done under the contract.  But the contract does not require that coverage, or an Extended Reporting Period, be kept in place for a period of time after the work is done.</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">Last, but not least, and a tip of the hat to one of my loyal readers who shared a similar situation with me after last week&#8217;s Knugget, the contract requires a 2mm &#8220;per Occurrance&#8221; (sic) limit.  Notwithstanding the mis-spelling, have you ever seen a per-occurrence limit on a professional liability policy?  If it happens at all, I suspect it&#8217;s extremely rare.  Our policy limits are put up on a &#8220;per claim&#8221; basis, with the exception of some specialty lines which focus on line-specific language.   I don&#8217;t think I&#8217;ve ever seen the word &#8220;occurrence&#8221; on the dec.  So if one were to be exceedingly particular, virtually no policy would ever be able to meet that requirement.  Could there be a situation where this difference in terminology could result in an unexpected difference between what the client wanted and what the policy provided?</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">The important thing to deal with here is that the professional liability policy is not a contractual coverage.  It&#8217;s a negligence policy with exclusions, conditions and other limitations.  If a client is damaged by the insured&#8217;s errors or omissions, the policy will respond accordingly, and that&#8217;s what the client should be looking for when wanting proof of coverage.  If the insured does anything that triggers a contractual obligation, and the client seeks compensation under the contract &#8212; no dice.  So we generally cannot provide coverage that would meet a contractual liability requirement.</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">And I wonder if any client has ever withheld payment due to lack of an insurance policy that meets the contractual requirements.  Hmmmm.</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;">You could drive yourself (or your insured) crazy analyzing contract requirements to the nth degree, and advising when disconnects like the above occur so the insured can go back to the client and attempt to resolve the problems with the contract wording.  And it&#8217;s always problematic for an insured to be relying upon the advice of his agent to bring up contract wording problems while the client is relying upon the advice of his attorney &#8212; who may know a lot about transfer of risk and contracts, but not much at all about insurance.  I think it&#8217;s worth it in the long run to fight the good fight.  Eventually, the clients will get enough of the same feedback and mend their ways.</span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
<p style="margin: 0in 0in 0pt;"><span style="font-family: 'Verdana','sans-serif'; color: black; font-size: 10pt;"> </span></p>
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		<title>Your Insureds&#8217; Contractual Requirements</title>
		<link>http://www.pltidbits.com/2011/02/your-insureds-contractual-requirements/</link>
		<comments>http://www.pltidbits.com/2011/02/your-insureds-contractual-requirements/#comments</comments>
		<pubDate>Fri, 18 Feb 2011 01:58:13 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[claims]]></category>
		<category><![CDATA[Coverage]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Misc E&O]]></category>
		<category><![CDATA[accountant]]></category>
		<category><![CDATA[attorney]]></category>
		<category><![CDATA[breach of contract]]></category>
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		<category><![CDATA[wrong policy]]></category>

		<guid isPermaLink="false">http://www.pltidbits.com/?p=313</guid>
		<description><![CDATA[Agents are frequently provided insureds' contract requirements in order to determine insurance needed.  But contract requirements can go well beyond limits and Additional Insured status.  Does an agent owe a duty to their insured to provide the coverage required by the contract?  Or even more frightening -- does the agent owe a duty to the insured's client?]]></description>
			<content:encoded><![CDATA[<p>Knowledge Knuggets for 2/10 and 2/17 contemplate the issues surrounding insureds&#8217; contractual requirements.  The first installment addresses potential liability arising from placing insurance that may or may not meet the requirements.  The second addresses the reasonableness of various requirements.  I am posting these two Knuggets separately, as you may find them useful for different audiences.</p>
<p> * * * * * *</p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Some interesting things have come up lately regarding insureds&#8217; contractual requirements, and whether they&#8217;re attainable or whether they&#8217;re being covered by the insurance purchased.  I&#8217;m sure you&#8217;ve seen the same issue in GL as we have in PL where a contract requires something that just plain is not available, or doesn&#8217;t even exist.  </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Notwithstanding the potential breach of contract problem the insured is getting into by allowing such wording to stay in a contract and putting his head in the sand, the situation is pretty straightforward if the coverage sought doesn&#8217;t exist, or is so rare as to be nearly impossible to find or afford.</span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">But what if the insurance required is easily available and is priced to sell &#8212; but the insured still doesn&#8217;t comply with the contract because his agent provides the wrong policy?</span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">Sometimes jargon is the problem.  The insured&#8217;s client may be using language that is not what we&#8217;re used to.  Kind of like when lawyers say &#8220;personal injury&#8221; when they mean what we call &#8220;bodily injury&#8221;, or &#8220;public liability&#8221; when we use &#8220;general liability.&#8221;  </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">There is a relatively high-profile case from 2006 where a surplus lines broker was found to have a duty to a third party for not providing the insurance required by the third party.  This was a 9th circuit decision, and some believe it is bad law and will not be the precedent referenced in other jurisdictions. I believe that liability is ever-expanding with rare exception, but time will tell, either way.  In this case, the court found that the insured&#8217;s client was the &#8220;intended beneficiary&#8221; of the insurance, and so the placing broker had a duty to place coverage that would fulfill the needs as expressed.  This is similar to the theory that creates liability for an accountant when the audited financials he prepared are used to fraudulently secure a loan, and the lender is harmed.  The lender has a cause of action against the accountant, even in the absence of a contractual relationship because the accountant had reason to believe that his work product would be used by third parties, and those third parties have a right to rely upon the validity of that work product.  You can imagine how lack of confidence in audited financials would grind the machine to a complete halt.</span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">In this case, the insured had operations in India and was doing programming for a US client.  The US client wanted to be sure coverage would be in place in case the tech company did not deliver the product appropriately, so they required coverage be placed for the India company&#8217;s technology E&amp;O.  When the claim occurred, the client sued the insured, and lo and behold!  no coverage.  The policy that had been placed specifically excluded all work done in India.  And this was even in light of the specific request that coverage be provided for work done in India.</span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">I have long heard the theory that in the absence of a &#8220;special relationship&#8221; agents&#8217; duties (and to an even lesser extent wholesalers&#8217; duties) are to provide a policy generally in the same line of coverage as the insured requests.  i.e., &#8220;I want a general liability policy&#8221; so you place a general liability policy.  And if your insured is a roofer, and roofing is excluded, what the hay!  You got him a GL policy.  I know that NONE of my agents (especially the ones whose own E&amp;O I write) conduct business like this.  But there are agents who are just that slap-dash, or who will cut any corner to get the cheapest price, and these half-baked policies are often the result.  </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">I would propose that there is a growing trend to hold agents and brokers to a somewhat higher standard.  We are not required to be prescient and to figure out exposures the insured cannot even recognize.  But when an insured comes to us and says &#8220;I need coverage to fulfill this contract&#8217;s requirements&#8221;, gives us the contract, and then we provide 75% of what&#8217;s needed without ever addressing the shortfall, would that not be cause for the insured (or in some cases his client!) to come back against us for failing to perform in the manner in which all parties were relying upon us to do?  </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">I would hope that liability could only possibly occur if the placing agent were aware of the contractual requirement.  I&#8217;ve been shocked sometimes when I see a contract late in the game (or god forbid after binding) and just then discover what provisions the insured was needing to have in their policy.  Up until that point, I was unaware, and in many cases the retailer is not familiar enough with the policies or the terminology to know whether what is being requested is normal, unusual, available, included in a regular policy, or anything else.</span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt"> </span></p>
<p style="MARGIN: 0in 0in 0pt"><span style="FONT-FAMILY: 'Verdana','sans-serif'; COLOR: black; FONT-SIZE: 10pt">This has made me contemplate requiring the insureds&#8217; contracts prior to quoting, but at the end of the day, there could be dozens of them, and I couldn&#8217;t possibly have the time to go through them all and ensure that the policies meet them, or disclose when they don&#8217;t.  If you have a sophisticated insured, they might be able to determine if the coverage matches the contract requirements.  But most of the time, I would imagine the insureds rely upon you to figure out that very thing.  So the best we can do is be aware that this issue lurks, and help each other avoid it as much as time, energy, awareness and courtesy allow.  But don&#8217;t let it keep you up at night.  Yet.</span></p>
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		<title>Insureds Buying or Selling?  This is a D&amp;O opportunity! (7/15/10 Knowledge Knugget)</title>
		<link>http://www.pltidbits.com/2010/07/insureds-buying-or-selling-this-is-a-do-opportunity-71510-knowledge-knugget/</link>
		<comments>http://www.pltidbits.com/2010/07/insureds-buying-or-selling-this-is-a-do-opportunity-71510-knowledge-knugget/#comments</comments>
		<pubDate>Mon, 19 Jul 2010 00:52:56 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[Coverage]]></category>
		<category><![CDATA[D&O]]></category>
		<category><![CDATA[acquisition]]></category>
		<category><![CDATA[divestiture]]></category>
		<category><![CDATA[due diligence]]></category>
		<category><![CDATA[ERP]]></category>
		<category><![CDATA[mergers]]></category>
		<category><![CDATA[misrepresentation]]></category>
		<category><![CDATA[run-off]]></category>
		<category><![CDATA[tail]]></category>

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		<description><![CDATA[Insureds buying or selling businesses are beset with many exposures that can be dealt with very elegantly by a management liability (D&#038;O) policy.  This is especially important for privately-held businesses.]]></description>
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<td>If your insured is in acquisition, sale or merger mode, they have exposures that are suitable for framing &#8211; inside a D&amp;O policy. Here are a few of the larger exposures that warrant your attention, and bringing up a D&amp;O policy as a probable solution:</p>
<p> 1.  If your insured is in acquisition mode, during the due diligence process they will come into contact with sensitive information regarding the potential seller&#8217;s business processes, trade secrets, and key personnel.  If the deal does not go down, and the insured continues operations in the same industry as the potential seller &#8212; or starts such operations if they were not pre-existing &#8212; the seller can allege that the insured misused its sensitive data.  This misuse of data and violation of the confidentiality of the due diligence process is a classic scenario for D&amp;O coverage.  These days, some of the allegations regarding pure data could be covered under a privacy liability policy.  But most privacy liability policies will exclude claims involving Ds, Os, or senior management misusing data, so chances are no coverage would pertain.</p>
<p> 2.  If your insured does not obtain 100% shareholder support for the acquisition, minority shareholders who do not like the outcome can bring suit against the Ds &amp; Os for the management of the acquisition, or more likely the amount of money paid for the acquisition.</p>
<p> 3.  If the acquired company does not agree with the management of the acquisition, or the insured&#8217;s execution of all terms of the agreement, they can bring suit against the Ds &amp; Os.  Sometimes this would be a pure breach of contract action, but more frequently, there would be accompanying allegations of misrepresentation, possible fraud, inducement, etc., that would trigger a D&amp;O policy.</p>
<p> 4.  If your insured is the selling company, the representations made during due diligence can come under fire if the sold company does not perform as expected.</p>
<p> 5.  Many purchase agreements require the sellers to set aside a portion of the proceeds to secure future unknown contingencies.  A D&amp;O policy can be used to fund this obligation, with the buyer&#8217;s agreement.</p>
<p> All of the above pertain to either side of a merger, as well as a pure sale of shares, or sale of assets.</p>
<p> Two logistical things to note:</p>
<p> 1.  The breach of contract exclusion in a (privately-held) D&amp;O policy must be carefully analyzed to make sure it does not exclude claims for which we would be seeking coverage.  The more narrow the wording, the more likely there is to be coverage if a claim arises from an agreement integral to the purchase contract.</p>
<p> 2.  It is possible to secure a D&amp;O policy after the transaction takes place.  Generally, more possible if the insured is the seller, than the buyer.  There is a good handful of companies that will write standalone &#8220;run-off&#8221; policies. If they&#8217;re put in place at the time of acquisition, so much the better.  But there is a window of opportunity of a few months where it&#8217;s reasonable for the insured (and his agent) to realize that D&amp;O might be appropriate and to go looking for coverage.  This is especially the case when the D&amp;O is sought to secure contingency obligations.</p>
<p> Of course, it&#8217;s best if ALL your insureds have their D&amp;O in place at all times &#8212; but we know that isn&#8217;t always the case.  Keep trying, though!!  Remember &#8212; I can supply an indication based on five simple data points:  Name, location, nature of operations, number of employees, and asset size. </p>
<p> Although I did just learn in the school of hard knocks &#8212; please be sure to disclose if the prospect is in bankruptcy.   Lack of such disclosure will lead to frustration and disappointment for all.</td>
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<td>Chris Christian, CIC, RPLU<br />
Vice President/Senior Broker<br />
US Risk Brokers760-415-4213 or for TN agents 615-273-3451</p>
<p>Knowledge Knuggets do not constitute legal advice, nor are they the opinion of US Risk. </p>
<p>Please feel free to suggest future Knowledge Knugget topics.</p>
<p>Submissions:  chrisc [at] usrisk [dot]com</p>
<p>Consulting/Expert Witness requests: chris [at] pltidbits [dot] com</p>
<p><em>I am accepting new agent appointments, so please give me a call or send submissions if you feel I can be of assistance with your complex risks.  Or, if you just like working with propellerheads &#8211; let&#8217;s chat.</em></td>
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		<title>Kidnap &amp; Extortion &#8212; when the unthinkable happens (2/25 &#8211; 3/11 Knowledge Knuggets)</title>
		<link>http://www.pltidbits.com/2010/03/kidnap-extortion-when-the-unthinkable-happens-225-311-knowledge-knuggets/</link>
		<comments>http://www.pltidbits.com/2010/03/kidnap-extortion-when-the-unthinkable-happens-225-311-knowledge-knuggets/#comments</comments>
		<pubDate>Sun, 14 Mar 2010 16:47:04 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[Coverage]]></category>
		<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://www.pltidbits.com/?p=285</guid>
		<description><![CDATA[100,000 kidnappings are believed to occur worldwide on an annual basis -- and that does not include child custody battles or other child-related incidents.  Yet many insureds omit coverage for this important risk from their insurance portfolio.  It is easier to get and less expensive than most would assume.]]></description>
			<content:encoded><![CDATA[<p>I recently presented a webinar on Kidnap, Ransom &amp; Extortion for the Insurance Journal Academy, and since my mind was on the topic I also posted a 3-part Knugget about it.  The Knuggets are posted below in consolidated fashion.  If you&#8217;d like to hear and see the webinar, go to <a href="http://www.ijacademy.com">www.ijacademy.com</a> to register for the archived version.  Use the discount code &#8220;education&#8221; for a 25% savings.</p>
<p>Kidnap &amp; Ransom &#8212; the Real &#8220;Executive Protection&#8221; coverage &#8211;  consolidated re-post of 2/25 &#8211; 3/11 Knowledge Knuggets </p>
<p>A while back I posted on Twitter regarding my Executive Protection Checklist.  Interestingly, a couple days later I was being followed by an Executive Protection expert &#8212; a bodyguard firm.  I had never thought of &#8220;Executive Protection&#8221; that way, but certainly the purest form of Executive Protection is that of the Executive himself or herself against bodily harm.</p>
<p>One of the lines of business within any good Executive Protection program is Kidnap and Ransom coverage (sometimes also referred to as &#8220;Kidnap, Ransom &amp; Extortion&#8221; coverage).</p>
<p>First thing to know is that K&amp;R coverage is not nearly as mysterious as it initially appears.  It can be very cloak and dagger, but in its most straightforward incarnation, it is simply a reimbursement policy for ransom monies paid to kidnappers, or attempted to be delivered to kidnappers. </p>
<p>Now, assuming that anyone who has enough money to attract kidnappers would also have enough money to pay them, this becomes merely balance sheet protection, and that in and of itself has a great deal of value.  Typical insureds for this would be bank executives, CEOs of large companies, and especially wealthy executives that travel to foreign lands.</p>
<p>However, a policy does more than just pay ransom or extortion monies.  Once an insured has a policy in-hand, they also get the benefit of having someone to lean on if and when the unimaginable happens.  All the major K&amp;R carriers have contracts with companies that specialize in executive protection (bodily) and they have extensive experience in negotiations, extractions, repatriation, and delivery.</p>
<p>The four major coverage parts found in most policies include:  Kidnap, Extortion, Detention, and Hijack. </p>
<p>Extortion can pertain to threats to do bodily harm, threats to impair property, and threats to harm data.  The harm done can include not only damage to the property or data, but also reputational harm evolving from the publicity about same.</p>
<p>Detention refers to circumstances where the insured person is detained by the authorities (or sometimes others) in a country due to an actual or alleged violation of some kind.  If the insured person truly is in the country illegally or engaged in illegal activities, the policy tends to exclude coverage.  However, if the insured was not blatantly violating laws, the policy would generally respond.</p>
<p>Hijacking refers to insureds being nabbed in their vehicles for a quick return on the kidnapper&#8217;s investment of time.  Small demands, ATM withdrawals, or just the taking of whatever valuable possessions or money the victim has on his or her person at the time may satisfy the kidnappers.</p>
<p>The types of expenses covered by these policies can be mind-boggling.  A short list includes:  ransom, of course; crisis management expenses, negotiators&#8217; expenses, legal expenses, medical expenses, psychiatric aftercare, family travel expenses, the insured company&#8217;s travel expenses, salary of the victim, salary of a replacement worker for the victim, reward for informant, advertising costs, and legal liability should the insured company be sued by the victim or his or her estate.</p>
<p>Who can be insured under these policies?</p>
<p>The company, its executives, or even all employees, if desired.  Also included are family members, guests, domestic workers.  Some policies include all ancestors and all lineal descendants.  Others limit coverage to grandparents and grandchildren &#8212; no &#8220;greats&#8221; or &#8220;great-greats&#8221; included.  Coverage can be written on a scheduled basis, if desired, and some policies are purchased as individual or family policies without regard to any corporate entity.</p>
<p>One outlier of coverage is found in &#8220;child abduction&#8221; coverage.  This coverage is generally used for hospitals in case someone abducts an infant or toddler from the facility.  This is specialized coverage because these abductions frequently do not result in any ransom demand so otherwise would not trigger coverage.  Limits may be different from the main coverage part, so consider carefully what&#8217;s needed.  Ransom is not usually what will eat up the limit, but there are other expenses to contemplate.</p>
<p>So how do you identify who among your insureds should carry this coverage?  Think about:   </p>
<ul>
<li>Insureds with significant personal wealth</li>
<li>Insureds working for very large, high-profile or controversial companies (banks, oil/gas developers, chemical plants, etc.)</li>
<li>Insureds who travel abroad</li>
<li>Insureds who live or work near the southern border</li>
<li>Insureds with family that travels</li>
</ul>
<div> </div>
<div>It&#8217;s relatively simple to get a ballpark indication for your insureds for a whole year or for a particular trip.  All you need to know is how many people travel to where and for how long.</div>
<div> </div>
<div>So, for example, if you have a wholly domestic insured in a low-hazard location, but the principal&#8217;s family is going to go to China for two weeks for vacation, you could easily get an indication for that trip.  The policy could be purchased by the company, and the company could then reap some of the benefits of coverage.  Or, a less expensive policy could be purchased by the family. </div>
<div> </div>
<div>Alternatively, your insured might be located on the border and do business with points south.  You can get terms for the scheduled executives and the five managers that work outside the US.  Provide the underwriters with the headcount, locations, and they might want to know if there&#8217;s a lot of traveling back and forth, and then you can get some ballpark terms.</div>
<div> </div>
<div>
<div>Piece of cake.</div>
<div> </div>
<div>Last suggestion &#8212; don&#8217;t input these policies in your system under &#8220;Kidnap &amp; Ransom&#8221;.  Use something a bit more discreet, and store the list of covered persons away from the policy itself.  No sense in courting trouble, right?</div>
<div> </div>
</div>
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		<title>Caution! &#8212; Agents on Boards &#8211; 2/4/10 Knowledge Knugget</title>
		<link>http://www.pltidbits.com/2010/02/caution-agents-on-boards-2410-knowledge-knugget/</link>
		<comments>http://www.pltidbits.com/2010/02/caution-agents-on-boards-2410-knowledge-knugget/#comments</comments>
		<pubDate>Sat, 06 Feb 2010 00:27:22 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[claims]]></category>
		<category><![CDATA[Coverage]]></category>
		<category><![CDATA[D&O]]></category>
		<category><![CDATA[Misc E&O]]></category>
		<category><![CDATA[agents E&O]]></category>
		<category><![CDATA[board]]></category>
		<category><![CDATA[caution]]></category>
		<category><![CDATA[condo association]]></category>
		<category><![CDATA[conflict of interest]]></category>
		<category><![CDATA[D&O policy]]></category>
		<category><![CDATA[director]]></category>
		<category><![CDATA[duty of care]]></category>
		<category><![CDATA[duty of loyalty]]></category>
		<category><![CDATA[exclusion]]></category>
		<category><![CDATA[HOA]]></category>
		<category><![CDATA[homeowner association]]></category>
		<category><![CDATA[networking]]></category>
		<category><![CDATA[risk management]]></category>

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		<description><![CDATA[Agents frequently insure entities on whose boards they serve.  There are inherent conflicts and dangers in this business-building approach.  Exercise Caution!]]></description>
			<content:encoded><![CDATA[<p>This topic created a lot of discussion on LinkedIn, and I thank all the participants.  Great input!</p>
<p>Below you will find my recent Knowledge Knugget discussing the dangers of agents serving on boards.</p>
<p>I&#8217;m adding a new danger here, thanks to a discussion with one of my favorite agents in CA who noted a particular problem.</p>
<p>What happens if the agent has to make a claim against his insured, on whose board he sits?  There are not many circumstances under which this could happen, but it is a possibility.  How does he reconcile his duty of loyalty under those circumstances?  And I cannot imagine the befuddlement of the carrier that receives a claim on an insured where the agent who placed the business is the claimant.  And what if there&#8217;s no coverage, and the agent then gets sued by the client, yet he&#8217;s the claimant in the first place?  Theoretically, at that point, they would stop the insanity, consider the claims to be offsetting and dismiss the whole thing.  But maybe not.</p>
<p>The particular situation that brought this topic up had to do with a potential personal injury claim against an entity.   But I&#8217;ve also contemplated &#8212; what happens if an agent&#8217;s on the board of an entity, and the entity doesn&#8217;t pay its premium, and the agent needs to take action to recover the premium?  As you may know, defaults can be subject to a D&amp;O policy if the Ds &amp; Os knew they were misleading the creditor at the time credit was granted.</p>
<p>What if the agent director was kept in the dark and thus extended credit (ordering coverage bound, let&#8217;s say, on a policy with 25% minimum earned &#8212; like a non-standard condo HOA), and now is stuck with that 25% minimum earned because the insured&#8217;s check bounced.  How is he going to unravel that?  What if there&#8217;s an uncovered claim due to the policy being cancelled and they sue him, and he feels he must counter-claim against them to protect himself?  How do you explain that to the carriers you just bound the insured with, and your E&amp;O carrier?  Weee, What a Predicament! (as John Travolta exclaims in Face-Off, one of my all time favorite movies).</p>
<p>Imagine how complex it could get if an agent sat on the board of the HOA where he lived and wrote all their coverages and had a property or GL claim.  Covered or uncovered.  Wow.</p>
<p>Anyway, chew on all that (yes, I know &#8212; I worry too much) while you read the below Knugget, and let me know your thoughts&#8230;.</p>
<p>* * * * *</p>
<p><span style="font-family: Verdana,Geneva,Arial,Helvetica,sans-serif; color: #000000; font-size: x-small;">Twice last  week I had occasion to discuss the topic of agents writing insurance for  entities on whose boards they sit.  This is a common road to production for many  agents, but let me share with you why it might not be an course of conduct in  which you want to engage:</p>
<p>First problem &#8211;</p>
<p>If you&#8217;re sitting on a  board, it is your duty to put loyalty to that entity above any loyalty to  yourself.  If you are placing insurance for this entity, can you honestly say  that you are doing the very best for this entity that can be done?  Do you have  all the markets that are appropriate for its business?  Are you giving up your  commission so as to procure the lowest possible pricing?  Are you doing what it  takes to ensure the entity buys all needed insurance, even if you are not overly  familiar with some lines of business?</p>
<p>Can you possibly ever avoid the  inherent conflict of interest that comes with making money off of a service you  provide the entity?</p>
<p>To complicate matters, what happens if you&#8217;re also on  the board of your agency?  How can you reconcile those two entities&#8217; needs?  You  can&#8217;t.  You have to put loyalty to one above loyalty to the other, and therein  lies the rub.</p>
<p>If the question ever arises as to whom you placed first,  you will have very few defenses.</p>
<p>Solution?  Possibly, you could hand the  account to someone else in your agency and act only as a referral resource.   Your agency would still make the revenue, and if you don&#8217;t profit personally  from the placement, you will be at less risk.  Still, not completely free of  risk because at the end of the day, your agency, and the coverages and pricing  it can provide may not be deemed as the best possible for the  entity.</p>
<p>Second problem &#8211;</p>
<p>Check your insurance agents E&amp;O  policy, and you may find that claims arising from your services rendered to any  entity for which you are a director are excluded.  This is not an uncommon  exclusion.  There is usually some form of exclusion that eliminates coverage at  least for claims made by entities over which you exercise control (by ownership  or by directorship), and sometimes the exclusion extends to all services  rendered to, not just claims made by, those entities.  That means you may have  no coverage even if a third party makes a claim against you, rare though that  might be.</p>
<p>So if the worst case scenario occurs, and your entity has an  uncovered claim, there will be no coverage simply because you sat on the board.   No coverage for you, and most of the time, no coverage for the agency.  How,  then will you resolve that claim?  Out of your own pocket?  Scary stuff.  And  again, what if you&#8217;re on the board of the agency?  How could you have exposed it  to such financial harm?  Now you&#8217;ve violated your duty of loyalty and duty of  care to the agency.  Not good.</p>
<p>My recommendation both from an agents  E&amp;O risk management perspective and from a D&amp;O risk management  perspective is that you should not place coverage for any entity on whose board  you sit.</p>
<p>If sitting on boards is a large part of your networking and  business-building process, use it for networking, and write every other board  members&#8217; coverage, and that of all their friends.  But when it comes to the  entity&#8217;s coverage take the high road, and advise the board that you cannot write  the entity&#8217;s coverage yourself without creating an inherent conflict and  sacrificing the protection of your E&amp;O policy, and refer them to another  agent or three.  You&#8217;ll sleep better at night if you do.<br />
</span></p>
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		<title>Agents and Boards</title>
		<link>http://www.pltidbits.com/2010/01/agents-and-boards/</link>
		<comments>http://www.pltidbits.com/2010/01/agents-and-boards/#comments</comments>
		<pubDate>Sat, 30 Jan 2010 19:24:22 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[claims]]></category>
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		<category><![CDATA[agents E&O]]></category>
		<category><![CDATA[conflict of interest]]></category>
		<category><![CDATA[duty of care]]></category>
		<category><![CDATA[duty of loyalty]]></category>
		<category><![CDATA[Knowledge Knugget]]></category>
		<category><![CDATA[uncovered claim]]></category>

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		<description><![CDATA[Many agents serve on boards of directors, frequently non-profit, sometimes for-profit, and end up writing the entity&#8217;s insurance.  From a D&#38;O perspective, this creates an inherent conflict of interest, and from an Agents E&#38;O perspective, often creates an uncovered cause of loss, should a claim arise. I think most agents who write insurance under these [...]]]></description>
			<content:encoded><![CDATA[<p>Many agents serve on boards of directors, frequently non-profit, sometimes for-profit, and end up writing the entity&#8217;s insurance.  From a D&amp;O perspective, this creates an inherent conflict of interest, and from an Agents E&amp;O perspective, often creates an uncovered cause of loss, should a claim arise.</p>
<p>I think most agents who write insurance under these circumstances have not thought through the ramifications.  It all looks so simple on the surface.  But it&#8217;s not.</p>
<p>Next week&#8217;s Knowledge Knugget will discuss this topic in more depth.  Sign up prior to 2/4/10 to receive the KK in your mailbox bright and early.  I&#8217;ll post it here sometime after its distribution to my mailing list.</p>
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		<title>Quirks in the PL World &#8211; 1/7/10 Knowledge Knugget</title>
		<link>http://www.pltidbits.com/2010/01/quirks-in-the-pl-world-1710-knowledge-knugget/</link>
		<comments>http://www.pltidbits.com/2010/01/quirks-in-the-pl-world-1710-knowledge-knugget/#comments</comments>
		<pubDate>Wed, 13 Jan 2010 04:15:43 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[Coverage]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Additional insured]]></category>
		<category><![CDATA[AI]]></category>
		<category><![CDATA[allegation]]></category>
		<category><![CDATA[contract]]></category>
		<category><![CDATA[defense within the limits]]></category>
		<category><![CDATA[erode]]></category>
		<category><![CDATA[excess limits]]></category>
		<category><![CDATA[frequency]]></category>
		<category><![CDATA[GL]]></category>
		<category><![CDATA[insured v. insured]]></category>
		<category><![CDATA[liability]]></category>
		<category><![CDATA[limits]]></category>
		<category><![CDATA[pricing]]></category>
		<category><![CDATA[professional liability]]></category>
		<category><![CDATA[professional liability wholesale broker]]></category>
		<category><![CDATA[professional negligence]]></category>
		<category><![CDATA[protect]]></category>
		<category><![CDATA[severity]]></category>
		<category><![CDATA[trigger]]></category>

		<guid isPermaLink="false">http://www.pltidbits.com/?p=276</guid>
		<description><![CDATA[Agents are often befuddled when a professional liability carrier refuses to provide an additional insured endorsement or excess limits appear to be too expensive.]]></description>
			<content:encoded><![CDATA[<p>Happy New Year, and Welcome to 2010.  I hope it&#8217;s a better year for all of us.</p>
<p>We&#8217;ll kick off this year by discussing some quirks in PL placements, which become quickly apparent when an agent or insured expects the same responses from underwriters as they would enjoy from a GL carrier.</p>
<p>For this installment, we&#8217;ll review two specific quirks:  Additional Insureds and excess limits.</p>
<p>1.  Additional insureds</p>
<p>As you know, in the world of GL, if you want an Additional Insured added to coverage, you request it, identify the relationship, and you get an endorsement for x amount of money.  The carrier is then willing to notify the AI if coverage ceases and will defend claims against the AI.  Not so in the world of Professional Liability.</p>
<p>It&#8217;s rare for there to be Additional Insureds on a PL policy.  There are some exceptions, which I&#8217;ll save for a future Knugget.  Here are some reasons carriers will not provide Additional Insured status to Insureds&#8217; clients.</p>
<p>a.  The policy exists to protect the professional &#8212; not his clients.<br />
b.  An allegation of professional negligence is needed to trigger coverage, and the client is not the one rendering the covered professional service.  Therefore, tender of a claim against them would not trigger coverage under the insured&#8217;s policy.<br />
c.  Defense is within the limits (generally) so providing defense to a third party would erode the insured&#8217;s limits.<br />
d.  The Insured v. Insured exclusion in the policy will void coverage for any claim brought against the insured by the AI client.</p>
<p>An outgrowth of this overall reluctance to provide coverage to AIs is further demonstrated by the fact that even those carriers that will add an AI will absolutely decline to comply with an AI&#8217;s request to be notified of cancellation of a policy.</p>
<p>2.  Excess limits</p>
<p>In the world of GL, a 4mm xs 1mm limit is available broadly and for pennies on the dollar.  No one thinks twice about it, regardless of the size of the insured or why they want the higher limit.  It&#8217;s considered wise to always offer those additional limits to your insured.</p>
<p>In the PL world, carriers are more circumspect about putting up limits.  If you have an insured with, let&#8217;s say, 200k, or even 2mm in revenue, and you request a 5mm limit, you will not get it from most carriers.  If you place a 1mm limit, then seek a 4mm xs 1mm, you will likely not have much luck.  Here are some reasons carriers give for not putting up large limits:</p>
<p>a.  PL is a severity line, not a frequency line, so if a claim occurs, it may well exhaust the entire limit<br />
b.  The carrier will not put up limits higher than the insured&#8217;s revenue<br />
c.  The carrier will not put up limits higher than the insured&#8217;s assets<br />
d.  The carrier cannot get enough rate for the limit<br />
e.  The carrier does not want its policy to be the insured&#8217;s biggest asset<br />
f.  There appears to be some correlation between limit availability and loss incurred, so carriers do not want a high limit to be an attraction to plaintiffs.<br />
g.  The carrier will not provide an excess limit higher than the underlyer (i.e., if the primary is 1mm, the most they will put up is 1mm)</p>
<p>Pricing for PL excess limits is much heavier than that of GL.  For example, if a 1mm limit costs $10,000, a 5mm limit is likely to cost $24,000.  (5mm increased limit factors in PL often ranging from 2.30 to 2.45)  The 4mm xs 1mm costs an additional $14,400!   I&#8217;ve had agents fall out of their chairs with that kind of pricing because they were expecting a quote for a fraction of the 10k primary premium.  A 5mm xs 5mm limit will range from 40% &#8211; 70% of the underlying 5mm, depending on the line of business and the quality of the risk.</p>
<p>This pricing model, again, is largely driven by the fact that PL is a severity line.  In some lines with a tendency to more frequency and a lot of actuarial data, you might see the ratios come down a little.</p>
<p>There are some exceptions to the reluctance to provide higher limits, and in a future Knugget, I will touch on some tricks of the trade to persuading underwriters to put up the limits you need.<br />
<span style="color: #000000; font-family: Verdana,Geneva,Arial,Helvetica,sans-serif; font-size: x-small;">Chris Christian, CIC, RPLU<br />
Vice President/Senior Broker<br />
US Risk Brokers</span></p>
<p><span>760-415-4213 or for TN agents 615-273-3451</span></p>
<p>Knowledge Knuggets do not constitute legal advice, nor are they the opinion of US Risk.</p>
<p>Please feel free to suggest future Knowledge Knugget topics.</p>
<p>Visit www.pltidbits.com for archived Knowledge Knuggets and other Important Items regarding professional liability.</p>
<p>chrisc [at] usrisk [dot]com</p>
<p><span style="font-style: italic; color: #006633;">I am accepting new agent appointments, so please give me a call or send submissions if you feel I can be of assistance with your complex risks.  Or, if you just like working with propellerheads &#8211; let&#8217;s chat.</span></p>
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		<title>D&amp;O Policy for Professional Exposures?</title>
		<link>http://www.pltidbits.com/2009/10/do-policy-for-professional-exposures/</link>
		<comments>http://www.pltidbits.com/2009/10/do-policy-for-professional-exposures/#comments</comments>
		<pubDate>Mon, 12 Oct 2009 04:01:04 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[Coverage]]></category>
		<category><![CDATA[D&O]]></category>
		<category><![CDATA[Misc E&O]]></category>
		<category><![CDATA[contract]]></category>
		<category><![CDATA[E&O]]></category>
		<category><![CDATA[exclusion]]></category>
		<category><![CDATA[professional services]]></category>
		<category><![CDATA[Wrongful Acts]]></category>

		<guid isPermaLink="false">http://www.pltidbits.com/?p=269</guid>
		<description><![CDATA[D&#038;O policies are not intended to cover professional services, even though the entity and the employees are insured for their wrongful acts.]]></description>
			<content:encoded><![CDATA[<p>One of my new agents asked me why a consultant firm of hers would need E&amp;O, given that their D&amp;O policy covers the employees&#8217; wrongful acts.  Good question.</p>
<p>Click on Knowledge Knuggets Archives and check out the 10/8/09 Knugget for the inside scoop on why this is not a corner that can properly be cut.</p>
<p>***I am accepting new agency appointments, so if you have D&amp;O, E&amp;O, EPL or other professional business and would like to take advantage of my unique approach, please contact me at chrisc [at] usrisk [dot] com. *****</p>
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		<title>Missing your Tail?</title>
		<link>http://www.pltidbits.com/2009/08/missing-your-tail/</link>
		<comments>http://www.pltidbits.com/2009/08/missing-your-tail/#comments</comments>
		<pubDate>Tue, 18 Aug 2009 16:53:03 +0000</pubDate>
		<dc:creator>Chris Christian</dc:creator>
				<category><![CDATA[A&E]]></category>
		<category><![CDATA[claims]]></category>
		<category><![CDATA[Coverage]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[architects and engineers]]></category>
		<category><![CDATA[extended reporting period]]></category>
		<category><![CDATA[individual tail trigger]]></category>
		<category><![CDATA[lawyers professional]]></category>
		<category><![CDATA[lifetime tail]]></category>
		<category><![CDATA[limit]]></category>
		<category><![CDATA[loss development]]></category>
		<category><![CDATA[personal liability]]></category>
		<category><![CDATA[professional]]></category>
		<category><![CDATA[retire]]></category>
		<category><![CDATA[retirement]]></category>
		<category><![CDATA[soft market]]></category>
		<category><![CDATA[trigger]]></category>

		<guid isPermaLink="false">http://www.pltidbits.com/?p=266</guid>
		<description><![CDATA[Inability to trigger an extended reporting period can rob a retired professional of peace of mind.]]></description>
			<content:encoded><![CDATA[<p>Extended Reporting Periods are a critical feature of professional liability coverage whenever a professional reaches retirement.</p>
<p>I&#8217;ve noticed that most, if not all, standard physicians companies offer the doctor a lifetime tail upon retirement.  Sometimes the tail is free, if the doc has been with that insurer long enough.  Other times it&#8217;s at a relatively reasonable premium.</p>
<p>I&#8217;ve seen this provision in an accountants&#8217; policy or two.</p>
<p>However, I have not seen it extended on architects or engineers policies or in the handful of lawyers professional liability policies I have recently reviewed.</p>
<p>What&#8217;s up with that?</p>
<p>Notwithstanding the fact that many of these professionals work in a firm environment and don&#8217;t carry individual policies, they still have the issue of coming to retirement age with an incredibly long loss development horizon.  They frequently have no control over the ability to purchase tail on their own, having been just a cog in the wheel of the firm, yet they are personally liable for their professional errors in many jurisdictions.  If the firm does not maintain coverage, or somehow moves to a policy that does not include these hapless retirees, they are bare.</p>
<p>I would love to see the market respond to this issue by providing an individual tail trigger (and quite possibly limit) for professionals reaching retirement age.  Maybe in the next soft market, it will evolve.</p>
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