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Claims Examples

Real-life case studies provide the good, the bad, and the ugly of E&O claims made against agents. They provide an excellent way to learn what agents should and should not be doing to reduce their E&O exposure. With the names changed to protect the innocent, or guility in some cases, these case studies can be shared with agency staff as learning tools and to keep E&O claims prevention at the forefront of their minds.

A Fresh Set of Eyes

Barry Businessman entered ABC Insurance looking to change both his agent and carrier. Barry’s business had recently suffered a small fire loss. That was when Barry learned his policy contained a 100% coinsurance clause and the business was underinsu...

All or Nothing

John was an experienced agent at a medium sized agency. John placed CGL, Commercial Auto and Work Comp for his longtime client Hannah. John also sold Hannah her homeowners policy. In addition to her business interests, Hannah owned a very large hous...

Check Marks the Spot

Betty is a CSR for an agency specializing in commercial insurance. She primarily works with Bob, one of the agency’s top producers. Bob’s practice is to meet with the clients ...

Communication is Key

Olivia, a CSR for Joust Insurance Agency, has been placing coverage for P&G Construction for a number of years with Heritage Insurance. Joust has a membership with Ambest.com and receives regular updates on the rating of its carriers. Joust’s prod...

Dig A Little Deeper

Penny was contacted by another agent who was acting as an insurance consultant for a jewelry store and was seeking quotes through several agencies. The insurance consultant provided a list of insurance coverages and limits, including business interr...

Don’t Take it Personally

Donna was employed as a CSR for a large, well run agency in a major U.S. city. Unfortunately, she was having some very serious personal problems that required her to be absent from work on a fairly regular basis. About 90 days prior to the renewal...

Don't Take Their Word For It

Dan was contacted by his wife’s uncle who was purchasing a business and wanted Dan to handle getting insurance coverages for him. The main activity of the business involved installation...

Going the Extra Mile

Anne was an experienced agent at a small agency. A new client came to the agency. Anne met with him to discuss his insurance needs. The client owned a large home in an area that was prone to flooding. Anne recommended and placed Homeowners cov...

He Said She Said

Midtown Emergency Medical Transport has been placing its CGL coverage through Teresa’s agency for ten years. Teresa and Frank, MEMT’s owner, have a friendship predating their business relationship. Frank has gone to Teresa for all personal and comm...

In Over Your Head

Andrew was an experienced agent at a large insurance agency. Andrew placed Commercial Property coverage for his client who was a real estate developer. Among the properties he owned, the real estate developer owned a shopping center. The agent an...

Open the Lines of Carrier Communication

Fred, a CSR with the TNT Agency, placed a minimum-limit personal auto policy for Oliver. The policy had effective dates of 11/1/04 – 5/1/05. The carrier billed Oliver directly...

Raising the Bar: Placing Bonds in Difficult Times

ABC Bond Agency is a non-exclusive agent for Mega Surety, meaning it can write surety bonds with other carriers as well as Mega Surety. ABC Bond Agency writes bonds for customers all over the United States. Tim, the agent at ABC Bond, was contacted...

System Failure

Fred, a CSR with the TNT Agency, placed a minimum-limit personal auto policy for Oliver. The policy had effective dates of 11/1/04 – 5/1/05. The carrier billed Oliver directly and had no practice of copying TNT on any correspondence sent directly t...

The Good Samaritan

Osgood Builders was a large residential contractor. They had purchased their liability insurance through the Towers agency for many years, and although they were an excellent account for the agency in many respects, they also had developed an advers...

What’s In a Name?

The TLC Agency specializes in providing insurance coverage for owners and operators of senior living centers, including nursing homes, assisted living facilities, and cooperative apartments. All lines of property and casualty coverage were provided ...

A Surplus Lines Blow-Up

Joe Smith Insurance Agency’s office is in Pecos, Texas, as is Smith’s long-time client, Pyrotechnics, Inc. Pyrotechnics designs and performs fireworks shows throughout the southwest region. Smith has procured Pyrotechnics’...

Check and Then Double Check

Martha is a CSR with a rather large agency that writes business in four states. She’d been in the insurance business for about five years and was starting to think of herself as a more seasoned professional. Marth...

Clear Communication

George was an experienced agent at a small agency. He had a small manufacturing client for whom he had placed a number of coverages, including CGL, equipment, and workers’ compensation. At a routine meeting, the client told George that it had decid...

Cover your Bases

Clark Carlson left Big Time Accounting, to open his own business Clark Carlson, CPA. Clark met with his independent insurance agent, Anne Albright to discuss what coverage he would need for his new venture. Anne and Clark settled on a BOP and fille...

Document, Document, Document!

Dan was contacted by his wife’s uncle who was purchasing a business and wanted Dan to handle getting insurance coverages for him. The main activity of the business involved installation, repair, and testing of petroleum storage equipment, including ...

Don't Admit Liability

A&B Insurance Agency placed commercial property coverage for its client Commercial Real Estate Developers, Inc. (CRED). A fire destroyed one of CRED’s properties. The carrier, Wepai Insurance Company, adjusted...

Get a Life

The Jones Agency prides itself on being a full-service agency, and even states in its brochures and form letters that they provide “any and all types of insurance.” Doug Jones, the agency’s owner, has enjoyed many years of sales success and has exc...

Got Checklists?

Charlie, a busy partner in a growing law firm (currently 30 employees) and David, an experienced producer of a large agency, meet to discuss procuring coverage for the firm since the...

I'll Take Your Word For It

Ben is a producer for an agency that writes about $6 M in gross annual premiums a year. One day he was contacted by a jewelry store owner that was dissatisfied with their current agent...

No Problem or Big Problem

Simonson Paint Company was a customer of the Merriweather Agency for over 25 years. In fact, Jacob Simonson’s and Frank Merriweather’s sons, who were now running their respective businesses, attended high school together. Simonson Paint owned seve...

Professional Services Exclusion and CGL

An agency’s client purchased a CGL insurance policy with a $1 million limit. Notably, the client indicated on his CGL insurance application that he operated a small trucking company that hauled exclusively fresh water to various local construction sites. In reliance upon the client’s response on the noted application, the CGL carrier issued the aforementioned policy containing a “professional services “exclusion that precluded coverage for any claim arising from the transportation of waste and flammable materials. Unbeknownst to the insurance agent...

Shakin' In Your Shoes

An insurance agency’s client purchases homeowner’s coverage to protect his $1 million home with an HO2 from a major carrier. During the sales process, the agent discusses every other possible option with the client...

The Bumps and Bruises of Policy Delivery

Tumble Out Bar is a customer of the Wesell Insurance Agency. Tumble Out has requested a liquor liability policy to replace its previous policy. The previous policy included assualt and battery...

Two Blind Mice

Lizzie moved from out of state and took a CSR position at a large agency. She had been in the insurance business for about one year. The agency had recently hired a new producer, Tom, who was writing a significant amount of new business and needed ...

Whose Truck Is It?

A1 Insurance Agency had built a solid reputation it the community. A1 did this by hiring good employees and compensating them well through pay and benefits. One such benefit A1 offered its employees was auto coverage at cost. A1 would waive its commission on auto policies written for employees of the agency. Cindy the CSR decided to take full advantage of this benefit and she started adding extended family members' autos to her auto policy. All went well until one of Cindy's cousins had his truck stolen. Cindy reported a claim to the auto carrier, who denied the claim as Cindy did not have an insurable interest in her cousin's truck. Cindy's cousin filed suit against A1 Insurance alleging he had paid a premium and received a certificate of insurance from AI showing that his truck was insured....