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Why Documentation Will Make Sure You Never Speak to an E&O Claims Handler

A well-documented agency file can mean the difference between outright vindication and a murky swearing contest that results in a lawsuit, settlement or both.
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why documentation will make sure you never speak to an e&o claims handler

The errors & omissions claims handler understands that you, the policyholder, are not altogether eager to speak with them. We get it.

Precious few people wake up in the morning and announce to the world, “What a fine day! I think I'll ring up my E&O claims handler!"

If you are this excited to speak with your claims handler, we are flattered. But under the assumption that the number of people with this inclination can be counted on one hand, let us assume that you—like most policyholders—are looking at the insurance agents E&O claims process through a more practical, less sentimental lens. Specifically: “How can I keep this from ever happening?"

This is a question we in claims hear quite often. And, with the caveat that you can never fully insulate your agency from E&O claims, the answer is simple: Document, document, document.

A well-documented agency file will not solve all problems and, again, it will not necessarily keep customers from alleging agency errors, but that well-documented agency file can certainly help. And it can sometimes mean the difference between outright vindication and a murky swearing contest that results in a lawsuit, settlement or both.

For example, an agent that occasionally manages a busy farm policy asked the customer to review the policy, coverage limits and a few other details. If everything looked in order, the agency had the customer sign a document stating as much. This document proved very helpful when the customer claimed the agency had failed to procure adequate limits for an outbuilding lost in a fire. The recent renewal document signed by the customer that included a list of the limits of all buildings, including the lost outbuilding, quickly put the claim to bed.

Requiring customers to sign off on coverages or otherwise state they have reviewed the coverages and limits procured is an effective way to head off the most-common E&O claim: You failed to get me the coverage I wanted or enough of the coverage I wanted.

Further, requiring customers to sign off when they don't want coverages can be equally important. In another instance, an insured held an annual renewal meeting with their customer where they recommended—not for the first time—that the customer should purchase cyber coverage. The customer declined, as usual, but signed nothing to that effect. Naturally, when a cyber event later caused significant damage to the customer's business, they claimed the agency had erred in failing to recommend or procure cyber coverage. Without any documentation, the claim became a dreaded swearing contest.

So, yes, documenting those coverage reviews, rejections and approvals can be very important in the E&O claims process. But these aren't the only contexts in which good documentation can make a big difference.

Agency notes—preferably in a management system—can tell their own story. They can show what the agency was told, what it did and when. They can also provide important information about calls or in-person conversations, which are often at the heart of E&O claims, that did or didn't happen.

Emails, too, are an important form of documentation. More obviously, they provide evidence of what documents, requests or information were exchanged between an agency and a customer. Less obviously, but no less important, an email follow-up to a phone call or in-person conversation can confirm what was discussed. These emails can be vital when faced with the common argument of, “I called the agency and told them what I wanted to be changed."

In particular, flood insurance can often be the coverage customers don't want … until they do. Or, it can also be the sort of coverage customers are happy to pay lower premiums on until they discover the practical consequences of those lower premiums in the form of lower limits, less coverage and so on. Documenting offers and refusals, reviews and renewals, questions and conversations can save you the headache and heartburn of a flood-related E&O claim and the call to your friendly neighborhood E&O claims handler.

Unless you're one of those precious few who just loves talking to us. Either way, we're happy to take your call.

Brendan McNeal is a claims specialist employed by Swiss Re Corporate Solutions America Holding Corporation. Insurance products are underwritten by members of the Swiss Re group of companies (“Swiss Re").

This article is intended to be used for general informational purposes only and is not to be relied upon or used for any particular purpose. Swiss Re shall not be held responsible in any way for, and specifically disclaims any liability arising out of or in any way connected to, reliance on or use of any of the information contained or referenced in this article. The information contained or referenced in this article is not intended to constitute and should not be considered legal, accounting or professional advice, nor shall it serve as a substitute for the recipient obtaining such advice. The views expressed in this article do not necessarily represent the views of Swiss Re and/or its subsidiaries and/or management and/or shareholders.

Friday, April 19, 2024
E&O Loss Control