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Overview of Liability of Producers. Presented by Joseph D. Hampton May 21, 2013. Common allegations: • “I thought I had coverage but it appears that I don’t” • “I have coverage but it’s not enough”. Where coverage is the issue: • Insurer is sued • Producer is sued - PowerPoint PPT Presentation
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Presented byJoseph D. Hampton
May 21, 2013
Overview of Liability of Producers
Common allegations:• “I thought I had coverage but it appears that I don’t” • “I have coverage but it’s not
enough”
Where coverage is the issue:• Insurer is sued• Producer is sued“If there is no coverage then Producer messed up.”
Where the amount of coverage is the issue:• Producer is the focus of the suit• Insurer often named as vicariously liable entity
Side trip: procedural context of lawsuits• 1st resolution method: summary judgment• 2nd resolution method: trial• 3rd resolution method: settlement
Why is this important?• Facts and disputes over them are
determinative of outcomes• Simple rule statements subject to
exceptions (“yeah, but...”)
General rule:Absent a “special
relationship,” a producer owes no to duty to obtain a sufficient amount of coverage, or particular types of coverage.
Corrollaries:• Insured must advise the producer of the coverages and limits he wants• Insured is in the best position to know his needs
When does a “special relationship” exist? 1. Representation by producer
of specialization, and additional compensation, OR
2. Longstanding relationship, interaction on coverage, and reliance by insured
Specialist scenario:• more common with brokers than agents• more common with specialized commercial products (i.e., marine)• often involves consultation fees
Longstanding relationship scenario:• 7-plus years (in caselaw)• repeat business, multiple products, meetings• historical reliance by insured on agent’s advice
Cost calcuators:• explain them and imperfections• explain how they are used• GIGO – use correct data
Mortgaged properties: • find out lender’s minimums• consult with insured thereafter• explain lender’s requirement for ACV, not necessarily RCV
Contents coverage: • explain limitation to percent of structure value• explain availability of riders for particular properties (i.e. jewelry)
Protect yourself!• explain coverage nature and limits• follow through on commitments (“I will run the estimation program,” “I will see if underwriting will up the RCV”)• DOCUMENT AND CONFIRM YOUR COMMUNICATIONS
Questions?