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How to Report A Claim

Reporting A Claim

The Swiss Re insurance agents E&O policy requires that insureds report “claims” and/or “potential claims”.  A normal agency reaction is that the mere reporting of a claim or potential claim could result in an adverse underwriting action taken toward the agency. However, reporting a potential claim to the Swiss Re claims department does not automatically result in any underwriting action by the Swiss Re underwriters. Each claim/potential claim is reviewed on an individual basis by the underwriter to determine the facts and circumstances.  In fact, since the Swiss Re policy is a claims made policy, it is to the insured’s benefit to report any and all claims/potential claims to insure that they are timely reported within the policy period.


If no reserves or payments are applied to a claim, as a general rule no underwriting action will be taken. For the purposes of both the Loss Control Credit and the Claim-free Experience Credit, a claim is defined as an Errors and Omissions incident or situation for which any expense payment, any loss payment, or any loss reserve is made or established by or on behalf of the insured in excess of the following values (plus any applicable deductible) based on GAP size.

 

 

Food for Thought

Below are some things to think about should your agency be involved in a potential E&O claim:
 
  • Do not admit liability—to the insured or the insured’s insurance company
  • Be empathetic, but be careful what you say
  • Do not discuss the existence of an E&O policy with anyone—and don’t provide copies
  • Complete a claim reporting form and forward it to your E&O carrier or producing state association along with details of any conversation or correspondence you have received making a demand for damages
  • Do not offer to pay the claim yourself
  • Involve your E&O Improvement Specialist, or other appropriate agency personnel, and appoint a person who will be the agency’s sole point of contact for all matters related to the claim
  • Interview every person involved in the claim—and remember it’s not about the “who”, it’s about the what, when, where, and how
  • Have each person involved in the situation write a narrative describing the incident and check the customer’s file to determine the chronology of events
  • Forward all documentation to your E&O carrier
  • Cooperate fully with your E&O carrier