Tuesday, December 4, 2012

Valuation - Thinking Outside of the Box

By Robb Greenspan, SPPA When a loss occurs to commercial property,the losses don’t end when the flames or shaking stop or when things dry out.

* This is a great article by Robb Greenspan, discussing the process of the commercial property loss, and what steps your client would need to take should they have to file a claim. For more information on commercial policies, or becoming an Independent Insurance Agent in commercial lines, please contact Tague Alliance at (760) 729 - 1143, or info@taguealliance.com *
In commercial enterprises, the ramification of losses extends out to employees, their families and customers as well. The Insureds first duty is to maintain the welfare of the business and its employees. The next concern is the continuance of the business. Their last concern should be the insurance claim itself but unfortunately,this can’t be!

The Policy of Insurance demands many steps be taken immediately after the loss occurs. The first step is to notify the broker/agent and carrier. The undamaged property must then be protected from further destruction, separating damaged from undamaged goods in preparation of taking an inventory. This inventory is then followed by pricing the goods, accounting work-ups and documentation of claims through the books and records. After it is all compiled, it must be submitted to the insurance company’s adjuster and accountants for review and the negotiations will then start. If a building loss is involved, protecting it from further damage is the first step prior to determining loss, after that, a Scope of Repairs is developed and then the bidding process starts. The Policy of Insurance demands many steps be taken immediately after the loss occurs. While the Insured is fulfilling the duties and obligations of the contract of insurance, his/her business is usually being ignored. Many businesses fail after a loss because the policyholders neglect to immediately focus on the business continuity rather than dealing with the insurance companies needs. What a claimant really should be doing is to deal with their customers and vendors, their employees and staff to insure the continuity of the business.
• Who Does The Insured Call?

After the fire department, the broker usually receives the first call. The Insured may look to the agent/broker for help. Usually in small losses, the broker’s office can assist in reviewing the policy and give some claims advice. In larger losses this may present a problem. The E&O exposure to the gent/broker is ever present in normal situations, and in a claims situation the ramifications can be financially disastrous. The least of the problem is the unhappy client who questions the broker’s ability to properly write insurance after having to deal with a plague riddled claim. When something goes wrong in the settlement, it can manifest itself in an E&O suit. When a large or problematic claim arises, the broker, many times, will be best advised to stay out of the claims process completely and allow the insurance company to assume the burdens of advising the client in the claims process. However, this has problems too.

• Why Not Rely On The Insurance Adjuster?

The Insurer has strong incentives to keep claims costs down. The heavy claims backlog that plagues most companies restricts the amount of time the adjuster can spend with the claimant. If the adjuster is not available to answer the claimant’s questions, who is? Asking an insurance company adjuster for help or advice is analogous to going to the IRS Auditor for tax advice. One hires an expert to represent them in tax preparation rather than rely on the Internal Revenue Service whose motivation is to collect taxes. The same can be said about the insurance company whose motivation is profit. They, the carrier, are going to do “what’s fair” to them, however, “what’s fair” to an insurance company many not be fair to the Insured, as is the case many times.

• What Help Can An Insured Get?

There is an industry known as Public Adjusters or Claims Consultants for the Policyholder who can help. As claims experts who handle hundreds of claims a year, Claims Consultants know the ins and outs of the claims process. We understand the mentality of the insurance company and how to prepare a claim that they will readily accept. We can give specific advice to claimants based upon our experience with their specific industry and their individual needs. Claims Consultants for the policyholder handle all of the required tasks of claims submission keeping the insured best interest in the forefront of the process, thus allowing the Insured to concentrate on re-establishing their business and their lives. We also reduce the time spent in the adjustment of the claim by the Insured as well as the broker. Our goal is to produce a better recovery for the Insured and quicker than they can on their own with less time spent on the claim and more time spent keeping their business viable. Not all losses require the help of a public adjuster. We usually do not get involved in small cases and most times you can be of help to them in this type of loss. If the claims are over 75K or have problems manifesting themselves at the onset on smaller ones then we are needed.

• What Help To The Broker Is The Claims Consultant?

The Claims Consultant and broker can work as a team, thus making the broker/agent part of the claims process, yet reducing or eliminating, completely, any liability associated with advising clients in claims situations. By assuring the successful settlement of claims, the broker is credited with this success and can expect the continued business from his or her Insured.

Without the professional help of a Public Adjuster/claims consultant, claims can go wrong! If due to circumstances an Insured receives what they perceive as an unsatisfactory answer (over expectation of what their claim is worth), the agent/broker can be blamed for writing bad insurance and will probably lose the account. The professional Claims Consultant can help to assure that this does not happen by accepting the burden and responsibility of the claims process. We steer the client in the right direction and focus the client’s vision as to what their losses truly are (real expectations). Of course if there are real issues such as underinsurance penalties (co-Insurance) we can many times reduce the effects of this by using techniques developed over the many years of experience we have. Most times your client will never know there was a problem if handled properly.

• What Services Can A Claims Consultant Provide That An Agent/Broker Cannot?

The better claims consulting offices are staffed with licensed Adjusters; Inventory Specialists; Accountants and CPA’s; Building Experts and Estimators who are all available to advise the Insured and to help document the claim. Once the claims are properly prepared and submitted, the Claims Consultant will follow through with negotiations so the claims are paid and the property is re-built or replaced quickly. As mentioned above, the Claims Consultant’s task is to fulfill all of the requirements stated in the contract of Insurance after a claim arises. The Claims Consultant can also find the extensions of coverage’s within a policy, thus taking fair advantage of the insurance bought and paid for by the claimant.

• How Is The Claim Prepared?

The first step in a typical claim would be a review of the insurance policy. If problems are noticed at this initial review, a meeting is held privately with the Agent/Broker to discuss any insurance problems that we foresee arising and work out a methodology to avoid or reduce these problems so as not to become issues in the future. Next, a detailed inventory of stock and equipment is undertaken by our Inventory Specialist. At the same time, if Real Property is involved, Building Estimators and Construction Experts are brought in to prepare a detailed Scope of Loss and Damage, detailing all of the necessary costs to rebuild or repair that structure. Once these steps have been completed, the Accountants are called in to prepare any accounting schedules necessary to support values of inventory, stock, etc., as well as to determine the extent of income loss suffered by the Insured. After all of this is completed, it is packaged and reviewed with the client and then submitted to the insurance company. This is where the experienced Professional Adjusters begins the negotiation process. We work until a mutually satisfactory answer is arrived at, thus, closing the claim and leaving both Insured and Insurer satisfied with the outcome. While this tedious process is going on, your client is free to re-establish his business or her customer base and deal with their employees, thus insuring the continuity of the business.

• What Other Services Are Provided?

Although the service provided by each company vary, the better firms will work with you to establish insurance needs and make recommendations on Forms & Endorsements for future insurance purchases with your client . We also can;

 Help establish the value of personal property, real property and business income needs for underwriting purposes.

 Claims Consultants are available to the Agent/Broker for consultation for underwriting questions.

 Provide qualified courses on claims and property insurance for state CE credit.

Of the above list, not all Claims Consulting firms can fulfill all of these duties. One should look for a firm that has the full staff of in-house adjusters, accountants and inventory specialists and other expertise to perform all of the duties above.
• How Does One Choose A Professional Claims Consultant?

Many policyholders feel the need to retain the services of a Claims Consultant mainly because of the time constraints they feel after a loss occurs. A second reason is because they realize that a professional, with experience, can do better than a novice handling their own claim, thus avoiding the learning curve. You can help your client choose the proper Public Adjuster by looking at the criteria listed below:

 First and most important, check references of past clients. Not just by looking at the name but by making the phone call. All reputable firms should provide a list of past clients including names and phone numbers for contact.

 Check current licensing status of the Claims Consultant. Look at the DOI’s web site to insure that the consultant or Public adjuster is current in their licensing.

 Does the firm have membership in both professional organizations such as the National Association of Public Adjusters (NAPIA) or the California Association of Public Insurance Adjusters (CAPIA) Are they affiliated with any other insurance groups such as IIABA, PIA, IBA-West.

 Is the professional staff accredited through the National Association of Public Insurance Adjusters? NAPIA issues two accredations. One is the S.P.P.A. (Senior Professional Public Adjuster) and the other is the C.P.P.A. (Certified Professional Public Adjuster). In order to earn a designation, one must go through lengthy education courses and real-time experience in the practice and then pass rigorous tests, similar to the CPCU designation

 Does the firm have full support personnel?

 Do they have Inventory Specialists on staff? (not contracted out)

 Do they have Accountants and CPAs on staff? (not contracted out)
 Do they have Claims Adjusters, Building Experts and Estimators to fulfill your client’s needs? Do they have the expertise on equipment and machinery analysis? These are important tools that the public adjuster uses!

 Checking with the Better Business Bureau, the local Chamber of Commerce can also lead you to the right Professional Claims Consultant.

In conclusion, by calling in the Claims Consultant at the onset of a claim, Public Adjusters can advise and assist your client on your behalf to steer them in the right direction, thus avoiding the many traps and pitfalls that the Insureds usually find themselves in when handling large claims. If and when problems of value and loss, coinsurance or missing or inadequate endorsements arise, we are there to minimize or avoid completely the effects of these problems thus reducing the exposure to the agent for E&O suits. When the handling of the claim produces an acceptable answer to your client and one that the insurance company finds acceptable as well, the Insured is left with a positive perception of the claims experience and your carriers are happy. The net effect of this is that the client feels the agent/broker did a good job on his or her behalf in placing the insurance with the carrier and this can lead to a long relationship between you and your client.
About the Author: Robb Greenspan, SPPA is a senior partner and second generation owner of The Greenspan Company/ Adjusters International, a public adjusting firm was established in Los Angeles 1946. Greenspan is dedicated to representing the policyholders interest in property claims only. He has written numerous articles and papers on insurance and teaches continuing education for agents and brokers as well as other professionals for over 20 years. Greenspan is currently a member of the Curriculum Board for the California Department of Insurance and past member of the Insurance Commissioners Consumer Complaint and Unfair Claims Practices task force. He holds the Senior Professional Public Adjusters accreditation issued by the National Association of Public Adjusters.

Wednesday, November 7, 2012

Frozen Turkey Thrown by Teenager Causes Severe Damage to Passenger and Vehicle

Thanksgiving is just around the corner! Although this isn't a happy holiday type story, it definately ties insurance and Thanksgiving together. Check out this article by Laurie Infantino about property damage and bodily injury caused by a Thankgiving turkey.
Written By:

Laurie Infantino, AFIS, CISC, CIC, ACSR, CISR, CRIS

President of Insurance Community Center

I saw the story on TV recently and my first thought was thank goodness this was not my son who threw the turkey. It is only because he had other mischievous plots in mind. The incident occurred on Long Island in Lake Ronkonkoma on November 13, 2004. The injured woman has just published a book on the accident titled, No Room for Vengeance, and has been featured on several talk shows. FOX News said the release of Ruvolo’s book comes just after a similar shocking story made news around the country, in which Manhattan mother Marion Hedges was severely injured after kids pushed a shopping cart off of a fourth floor walkway onto the ground below. It landed on Hedges.
The accident that injured Victoria Ruvolo occurred when a 20 pound turkey was thrown out of a moving car and smashed into her windshield. The driver was struck and immediately lost consciousness. Were it not for her friend, in the passenger seat, leaning over and grabbing the steering wheel, who knows how many people might have been killed. Ruvolo sustained serious injuries and required hospitalization for three months.

Police say they had pictures of the assailants, five teenagers caught on store surveillance tape buying the turkey at a supermarket. They bought the turkey with a stolen credit card. This was a somewhat unique set of circumstances. The driver was 19 years old. Too often these crimes go un-solved as people throw items from freeway overpasses, shot paint bombs or spray paint from guns blinding passengers and other such mischief.

This case was different, the five teenagers were arrested. The driver was arrested on charges of first-degree assault, reckless endangerment, forgery, criminal mischief and criminal possession of stolen property. The four other teenagers were charged with criminal possession of stolen property. A wonderful side note to this story is that Victoria received the Most Inspiring Person of 2005 from BeliefNet because of her appealing to the judge to NOT send the assailant away to serve a 20 year sentence. She insisted on offering him a plea deal. Cushing could serve six months in the county jail and be on probation for five years if he pleaded guilty to second-degree assault.
Now to the question of the hour—is this covered by insurance. We might try looking at the Homeowners Policy first but will not find coverage there for a loss that occurs from the ownership of usage of a vehicle. So now we look at the Personal Auto Policy and surprise—surprise. The policy states:

We do not provide Liability Coverage for any "insured":

1. Who intentionally causes "bodily injury" or "property damage".

The question will be did they “intend” to hurt someone by throwing the turkey or did they just throw the turkey as a prank. Courts will look very strongly at the “intent” of the act and in most cases will determine that it was not an “intentional” bodily injury. Clearly if the PAP responds in the manner we will look to our umbrella for excess limits. What is interesting is that the PAP appears to have a much broader response then the most current edition dates on the Homeowners Policy. Here is an example of the language the ISO 2000 edition contains:

E.1. Expected or Intended Injury “Bodily injury” or “property damage” which is expected or intended by an “insured” even if the resulting “bodily injury” or “property damage”:

a. Is of a different kind, quality or degree than initially expected or intended; or

b. Is sustained by a different person, entity, real or personal property, than initially expected or intended.

Questions about points discussed in this article? Tague Alliance can help answer any questions you may have, about this article, or about becoming an Independent Agent with SIAA.  Call the office at (760) 729-1143, or email at info@taguealliance.com

Tuesday, October 30, 2012

Workers’ Compensation Five Simple but Critical Tips

Some agents may find Work Comp a difficult line of business to write, but this article written by Diana B Henderson gives you some helpful tips to make writing this line of business easier.

Laurie InfantinoCreated by:
Diana B. Henderson The founder and president of The Henderson Group, a workers’ compensation and disability management consulting and training firm in Newport Beach, California.  With more than twenty-five years of hands-on experience, she has worked in both the corporate and service provider communities.  She has worked at Aon Risk Services in a consulting role and Hunt-Wesson Foods as their National Workers’ Compensation Manager responsible for their in-house California workers’ compensation claims handling operation. 
Diana consults to both public and private sector employers on a wide range of issues.  She assists in developing cost-effective approaches consistent with the client’s overall operating philosophy and employee relations objectives.  Diana is often utilized as a litigation consultant and expert.  She also develops and conducts highly interactive and comprehensive workshops.

As a business owner and employer, do you want to know how five simple but critical tips can help you impact your workers’ compensation costs?  

Impacting your workers’ compensation bottom line.

1. Timely reporting.  Whether compensable or questionable, timely reporting mitigates total claim cost.  Providing adequate and accurate information assists the claims handler in adjusting the claim and providing appropriate benefits.  Questionable claims need immediate attention so that the investigation activities are completed within the 90-day window for making a compensability decision.  The trigger for the 90-day clock to begin is the date you knew about the claim, not the day you report it to your insurance carrier. 

2. Take control.  Reforms included in SB899 provided an alternative mechanism for managing medical utilization and costs through the use of Medical Provider Networks (MPNs).  Consult with your carrier regarding the MPN implementation process.  Ensure that you display the requisite informational posters and distribute required notices and pamphlets.  Your insurance carrier or claims administrator should be able to provide these documents to you.  Just remember, absent the requisite poster and pamphlet, even the most basic form of medical control is lost. 

3. Return to work.  Incentives are available for providing permanent return to work opportunities.  Additionally, productivity, morale and the overall cost can be positively impacted.  Effective with injuries on or after January 1, 2005, if you employ more than 50 full time employees, the cost of a claim can be impacted either negatively or positively depending upon the ability to offer a return-to-work opportunity for an injured worker.  This is done via a 15% reduction or a 15% increase for each payment of permanent disability indemnity.  The reduction is applied if return to work is offered even if the injured employee does not accept the offer.  Conversely, the increase is applied if return to work is unavailable and/or NOT offered.

4. Stay engaged and connected.  Maintain and insist on high levels of communication with your injured worker and claims handler.  Continually monitor and review the status of every open claim.  Provide requested information expeditiously.

5. Use experts.  If you lack the expertise, do not hesitate to consult with experts to assist in managing this bottom line expense.  It is well worth the investment.

Diana B. Henderson The founder and president of The Henderson Group, a workers’ compensation and disability management consulting and training firm in Newport Beach, California.  With more than twenty-five years of hands-on experience, she has worked in both the corporate and service provider communities.  She has worked at Aon Risk Services in a consulting role and Hunt-Wesson Foods as their National Workers’ Compensation Manager responsible for their in-house California workers’ compensation claims handling operation. 
Diana consults to both public and private sector employers on a wide range of issues.  She assists in developing cost-effective approaches consistent with the client’s overall operating philosophy and employee relations objectives.  Diana is often utilized as a litigation consultant and expert.  She also develops and conducts highly interactive and comprehensive workshops.

Created by:
Diana B. Henderson The founder and president of The Henderson Group, a workers’ compensation and disability management consulting and training firm in Newport Beach, California.  With more than twenty-five years of hands-on experience, she has worked in both the corporate and service provider communities.  She has worked at Aon Risk Services in a consulting role and Hunt-Wesson Foods as their National Workers’ Compensation Manager responsible for their in-house California workers’ compensation claims handling operation. 
If you have any questions regarding this article or would like to contact Diana, she can be reached at The Henderson Group, 4590 MacArthur Blvd., Suite 500, Newport Beach, CA 92660.  The phone number is 949-417-5722.  Her e-mail address is Diana@TheHendersonGroup.net

Questions about joining SIAA? Contact Tague Alliance at (760) 729 - 1143, or info@taguealliance.com. Website: http://www.Taguealliance.com

Tuesday, March 27, 2012

Tague Alliance - New Office

Hello Everyone....

We have moved our Tague Alliance office to a more functional space and are very excited about the new digs. Our physical address is now: 380 S Melrose Drive, Suite 414 in Vista, CA 92081.

The Tague Team

Tuesday, January 17, 2012

Tague Alliance - Focus on Retention

This was a great post from MetLife Auto and Home and Tague Alliance felt that it was worth sharing:

Focus on Retention
As you enter the New Year, take some time to reflect on ways to improve your business model in the coming year. This may include expecting more than others think possible. One area of critical importance is customer satisfaction. Ask yourself, “Is your client the most important person on the premises?” A few simple steps can start you down the road to improved customer service.

5 Simple steps that can make a difference in your retention (by Larry Moffett)

Review your agency's 3-year retention numbers
This simple act will give insight on how your customers view your agency. Is your retention level in the 90 percent range or in the 70’s? The lower the retention percentage, the more probable customer satisfaction is an issue. Often, when we think about customer satisfaction, we think in terms of “over the top” service. That’s great, and a worthy goal to strive for. But, “over the top” service probably won’t happen in most agencies on a consistent basis. What is possible and attainable is for the agency to render service that will resonate with their clients. Generally, this can be achieved with little or no investment. Customer satisfaction is achieved not through programs, but by changing behaviors and attitudes. Customer satisfaction increases when agencies intentionally focus on areas that truly resonate with clients. Educating front-line staff—training and coaching them to adopt skill sets that resonate with customers—pays big dividends.

Determine how your agency measures up

Reliability - if the level of service dependable? Are the clients' concerns addressed and questions answered in a reasonable timeframe?
Assurance - does the service build confidence?
Empathy - do the people giving the service communicate they care?
Responsiveness - are customers needs uncovered and addressed?
Tangibles - pay attention to the things your customers see and feel. Do staff and surroundings appear professional and inviting?

Take control of factors that can influence customer satisfaction
Multi-policy: Customers who have more than one policy with the same agency/company, such as auto and homeowners insurance, are more likely than clients with mono-line policies to be satisfied with their policy offerings. “Bundled clients” renew policies at an 11 percent higher rate than “single policy” clients.
Get it right the first time: Customers are more satisfied when they only have to contact their agent once to resolve an issue. Satisfaction declines significantly with each additional client-initiated contact.
Return calls: When call backs to clients are required, agents who call back as promised get consistent high satisfaction ratings.
Time is critical: Clients who file physical damage claims expect prompt service. Same-day response to the first notice of an accident, followed by a settlement within a week and repairs completed within two weeks, characterize best practice. Some data suggests satisfaction with claims handling drives 44 percent of the overall impression of the insurer.

Policy reviews
Clients who have their policy needs reviewed each year report satisfaction levels that are significantly higher than those who do not. Customer surveys reveal that nearly half of those surveyed report that they have not been offered an annual policy review by their agent. Unless a customer files a claim, offering the client a “risk review” is one of only a few opportunities an agent has to build trust with the customer. Otherwise, the sum of their interaction is limited to paying their bills and reviewing periodic policy changes.

Stay focused and enjoy the benefits
High levels of customer service mitigate price; good service helps shift the focus away from price. Our friends in retail learned long ago that the better the service, the higher the prices they can charge for their products. The bottom line is that happy customers directly equate with agency financial performance. Every customer lost has an impact on the bottom line

Tague Alliance is focused intently on R.P.G. - Retention, Profit, Growth! Growing is made much more difficult when your agency retention is lagging. For every client and policy that you keep, it is one less that has to be found, quoted, and sold.

Tuesday, January 10, 2012

Snowmobile Safety

Do you have any clients that take winter trips to the snow? If you clients have snowmobiles, here is a good article to share with them. It's a great lead in to get the opportunity to quote the business!

Bounding over trails through woods, over fields and across frozen ponds or lakes with cold blasts of air whipping around are all part of the fun that thousands and thousands of people enjoy during winter in their snowmobiles. Snowmobiling’s fun should not mask the fact that it still involves the use of fast, heavy vehicles that, in collisions, can cause severe injuries and damage to property. Some models of snowmobiles and all-terrain vehicles operate at speeds that rival automobiles. Unlike autos, they are open vehicles, lacking the structural protection of even the smallest auto; therefore the danger to snowmobile users is far higher.

The danger of being injured while operating snowmobiles is compounded by some important factors. Snowmobiles are operated over rough terrain with obstacles that are often hidden by snow. They are operated in areas where the drivers are not familiar with paths or trails. Novices and older operators with poorer reflexes are attracted to recreational snowmobiling and these vehicles are often used very late at night, in remote areas. Another consideration regarding use of snowmobiles is that operators also combine driving with drinking and alcohol intensifies the other dangers.
Naturally there are practices that can help lower the chances of being in a serious accident. Snowmobile operators should:

Avoid solo snowmobiling - having another person around in case of an accident is probably the greatest safety practice.

Properly maintain the snowmobile to insure safer operation

Dress in appropriate safety gear and clothing, including water-repellant apparel

Operate snowmobile at speeds that are appropriate for conditions and terrain

Do not drink alcohol while operating a snowmobile

Use marked trails and don’t stray off of them

Carry a first aid kit, as well as other emergency equipment, especially tools, flashlights, compass, matches, etc.

Avoid crossing bodies of water as breaking through ice is a major peril (drowning is a chief source of snowmobile accident fatalities).

If you've got your own snowmobile, make sure it's insured! We can provide you with the best snowmobile policy available. And our companies don't require that you have a homeowners or renters policy.

Contact Tague Alliance with any questions about placing stand alone snowmobile business!

COPYRIGHT: Insurance Publishing Plus, Inc. 2010