FYI Express - February 2013 by FYI Express

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EXPRESS “What You Don’t Know Can’t Help You!” … Eddie K. Emmett, Editor / Publisher

8 Ways to Make Your Website Compelling In this edition 8 W AYS TO M AKE YOUR WEBSITE COMPELLING.................................. 1 GET A COMPLIMENTARY WEBSITE & M ARKETING ASSESSMENT .............. 2 YOUR COMPETITIVE ADVANTAGE: BE NICE .............................................. 4 THE TOP FIVE SALES MYTHS .......... 8 LIMRA: AMERICANS HAVE RUDIMENTARY KNOWLEDGE ABOUT LIFE INSURANCE........................... 12 7 W AYS TO KILL YOUR LOCAL SEARCH RANKINGS WITHOUT TOUCHING A COMPUTER ............... 14 WAYNE HOOPER REPORTS: QUESTIONS ON HOMEOWNERS COVERAGE .................................. 17 VALUATION FORMULAS FOR AGENCY PURCHASES AND START UPS ............................... 25 BE READY FOR NEW REGULATIONS IN 2013 ........................................ 27 WE INSURE GA ............................ 29 SPECIALTY AUTO CARRIER SEEKS TSM FOR GEORGIA TERRITORY. ... 30 ATI INSURANCE ACQUIRES ALLSAFE SERVICES .................................... 30 VALENTINE CROSSWORD PUZZLE . 40

by Steve Anderson

Your insurance organization's website is your electronic “storefront.” It is an important foundation for maximizing your Internet presence. As you develop your online marketing presence, you will likely send prospects to your website. Your website needs to be designed to provide prospects and customers with the information they want so you can keep them coming back for more. So take a look at your existing website and ask yourself a few questions:

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1) Where do your eyes go first? You only have a few seconds to capture the attention of people who come to your site. Make sure they're seeing something relevant and important to them. 2) Can they tell what your website is about? If you are using various marketing methods (Google Places, Facebook Pages and Ads, emails, updated content) to bring people to your site, you need to make your site is very clear on what you want them to do there. Continued on page 2 February, 2013

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8 Ways to make your Website compelling

Providing links to different social platforms where the agency has a presence gives your potential new customer another glimpse into your agency. And hopefully you have included some testimonials from satisfied customers.

Continued from page 1 Again, you only have a few seconds to communicate what makes you different than anyone else, so be clear and compelling.

Ask different people their opinion. Ask staff for their input as well as clients and friends and family. You may not be able to see flaws in your agency website that others will highlight.

3) Is important information above the fold? “Above the fold” is an old newspaper term that references information that is on the top half of the page. Use the same principle on your agency website. Make the important information that will grab your visitors attention is viewable without needing to scroll down the page. And make sure you are using this space wisely. Do you really want to waste this valuable space with a big picture?

Once you determine a few areas where you can improve, develop a plan to start implementing changes. You don't have to do them all at once—just do a few at a time until you have a website that really works. Steve Anderson is the leading authority on insurance agency technology. He is a prolific writer known for his knack for translating “geek speak” into easily understood concepts. Check out his free weekly newsletter “TechTips” and other resources for the insurance industry on his website.

4) Are the benefits highlighted? Your website visitors want to quickly learn “what's in it for them.” Spell out the benefits of the products and services you offer clearly on the website homepage. 5) Does the prospect know what to do next? In direct response marketing terms this is a “call to action.” If you have piqued the visitor's interest and they want more information, or if they want a quote, or maybe they want to sign-up for your newsletter -- is it crystal clear what they should do next? It could be to fill out a simple form to subscribe to the agency newsletter, or simply download your special report on "5 Ways to Save Money on Your Insurance". 6) Are the colors and font distracting?

Get a Complimentary Assessment

Jarring colors, quick animation, and gaudy fonts can really be distracting. And if your visitors are distracted, they'll quickly click away. Be especially careful of audio or video content that automatically starts playing when they come to the site. This is the fastest way to get them to leave.

Website

Your website affects your social media, email marketing, lead generation, brand awareness and sales strategies. Find out how to turn your online presence into a full-fledged inbound marketing in a complimentary website & marketing assessment. Your assessment will cover:

7) Do they feel personally connected? People buy from people they like, not machines or websites. Connect with your prospects by being honest, straightforward, and using a conversational style. Show some personality and that insurance doesn’t have to be boring.

• A full diagnostic opportunities to improve

your

website

and

• How your marketing compares against your competitors

8) Are there links to social platforms?

Send an email to eddie@fyiexpress.com

Many prospects will want to do more research about you and your agency before taking the next step.

FYI EXPRESS

Marketing

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February, 2013

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If you can’t send a document for signature by email, there is another agent who can. If the price is similar, the customer will go with the agent who makes it easier to buy! Agents using InsureSign are currently signing over 1700 new applications and renewals per month using our service. That number is growing rapidly month by month. Get signed up with InsureSign now and erase the advantage of direct writers and other competition.

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You don’t have to be over-the-top amazing. No, you just have to be a little better than average. The key is to be better than average, all of the time. That’s what amazement is about. It is consistency that makes being above average, even just a little above average, amazing.

The Shepard Letter Your Competitive Advantage: Be Nice A Common Sense Customer Service Tactic The other night I did a speech that was more about motivation than it was about business and customer service. The audience included college students in their teens and 20’s, people in the prime of their business careers and retired people. The client asked me to deliver a simple message about going from being average to being amazing.

So, I shared five amazement tactics, and it was the fifth and final tactic that created a surprising response, and the subject of this article. And, it was simple: Be nice. The reaction from the audience was surprising. They unexpectedly applauded. I wondered why they would applaud at something so simple – something that seemed like just common sense. More on that in just a moment. Continued on page 6

If you’ve been reading my customer service articles or watching my weekly videos on YouTube, then you know my definition of being amazing is about consistently being better than average. And above average means exactly that. FYI EXPRESS

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February, 2013

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Your Competitive Advantage: Be Nice Continued from page 4

After the speech I asked my wife, who was in the audience, why she thought the audience applauded. She said that so many people aren’t nice. It’s not that they are rude or mean, although sometimes they are. No, they just don’t smile and say thank you. And, when you encounter someone who is nice, you feel so much better about doing business with them.

I went on to explain what it took to be nice. I’ve written about this type of thing before, but here is the spin. Nice people do a number of things: They are respectful of others. They do what they say they are going to do. You can count on them.

In business, being nice is part of delivering customer service. It’s the positive attitude, the respect you show to the customer, and the way you make them feel appreciated. It’s an essential part of any customer service strategy. The best system isn’t complete without the positive feelings the customer experiences from doing business with you.

They show up on time, respecting the time of others. They are polite. They say, please and thank you. And, speaking of thank you, they write thank you

Shep Hyken is a customer service expert, professional speaker and New York Times bestselling business author. For information contact (314) 692-2200 or http://www.hyken.com. For information on The Customer Focus™ customer service training programs go to http://www.thecustomerfocus.com/. Follow on Twitter: @Hyken (Copyright © MMXII, Shep Hyken)

notes. That last point, writing thank you notes, was a callback to the beginning of the speech when I talked about how my parents taught me to do the right thing. That started when my mom made me write thank you notes to anyone that gave me a gift. That was a great lesson, taught at a very young age, about doing the right thing; being nice and showing appreciation to people who are nice to you. FYI EXPRESS

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The Top Five Sales Myths

Sales Myth #2: Cold calling is a waste of time and doesn’t work.

by John Chapin

In over 24+ years I’ve built four different businesses primarily through cold calling. Cold calling is simply the fastest, most pro-active way to get leads. The reality is: if you are new in business or struggling, it’s more than likely you don’t have enough leads and you’re not getting enough through networking, referrals, and other sources... Time to cold call. Yes, cold calling is the most difficult, most time consuming task you can do, yet unless you have millions of dollars to spend on marketing campaigns, cold calling yields results like no other prospecting method.

As someone who has been in sales for over 24 years, and now as a sales trainer, speaker and coach, I continually hear debate over the following five sales myths. In this article I will expose and throw light on these top sales fairy tales. The Top Five Sales Myths Debunked Sales Myth #1: Sales is NOT a numbers game. The more people you talk to, the more business you will do, even a blind squirrel finds a nut if it keeps looking. Granted, you want quality behind the numbers and, depending upon your business, it may be helpful to do some research on the person you’re calling before you call. That said, in order to be successful in sales you need lots of good solid relationships and the only way to get those relationships is to go out and talk to lots of people. The bottom line is: if you talk to enough people during the day, you will eventually run into someone who says, “I need what you have” or “I know someone who needs what you have.” Know the number of people you need to talk to during the day in order to be successful and then go out and talk to that many people and more. FYI EXPRESS

Also, cold calling builds character and keeps you grounded. The reality is: if you can cold call effectively and with confidence, nothing will stop you, you will be able to do any other sales task you need to do in order to be successful. That is why I recommend you never stop cold calling even when you are extremely successful. Granted, you may only make one or two cold calls a week at that point, but this will keep you sharp and on your toes.

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February, 2013

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The Top Five Sales Myths Sales Myth #3: Friday afternoon is a bad time to call on prospects and clients. Most salespeople believe that prospects either take Friday afternoons off or, if they do work, that they don’t want to be bothered by salespeople at this time. This is simply not true. Not only do most prospects work on Friday afternoons, they are also in a better mood at this time than at any other time during the week. As a result, Friday afternoon is a great time to prospect and close business. In addition, because most salespeople don’t make calls at this time, you will stand out as someone who is dedicated and hard-working. The bottom line is: Friday afternoon is one of the best times to prospect and close business.

For access to John's free monthly newsletter and white paper on what it takes to be successful in sales, visit John's website at http://www.completeselling.com Have a sales question? E-mail John at johnchapin@completeselling.com John Chapin’s specialty is helping salespeople and sales teams double sales in 12 months. He is an award-winning sales speaker, trainer and coach, a number one sales rep in three industries, and the primary author of the goldmedal winning "Sales Encyclopedia". In his 24+ years of sales, customer service and management experience, he has thrived in some of the toughest markets and economies. For permission to reprint, or to reach John, email him at johnchapin@completeselling.com.

Sales Myth #4: A good salesperson can sell ice to Eskimos.

John Chapin

The premise here is that a good salesperson could sell someone on something that is so obviously not needed. Nothing could be further from the truth. Top salespeople, over the long haul, don’t take advantage of people by selling them something they don’t need. Top salespeople make it all about the other person and they always do what is best for them, even to the point of sending someone to the competition on rare occasions.

Helping you find and get all the business you want

That said, are their some “temporary” sales successes who take advantage of people and make lots of sales by selling them items they don’t need? Yes. But in the long-term those people get caught, burn out, find that their personal lives in shambles, or a combination of all of these. The bottom line is: you can’t take advantage of people for long and live a happy, fulfilling, successful life. The top salespeople are honest, have integrity, and focus completely on the other person. They only make the sale if it is a win-win. Sales Myth #5: The customer ISN’T always right. Salespeople I’ve seen with this attitude seem to have a chip on their shoulder. It’s an attitude of arrogance in which they seem to believe the customer should be privileged to be doing business with them as opposed to the other way around. If you have a mindset that the customer isn’t always right, chances are great that you will not go above and beyond, you will not do more than expected, and you will not deliver top-notch, second-tonone follow-up and service after the sale. If you do not do everything within your power to ensure the customer has a great experience, odds are they will have a mediocre experience at best and you will never stand out. That said, is the customer always right? No, but you’d better walk into that conversation convinced they are, or they will pick up on your suspicion and indifference quickly and as opposed to running into that 1% of unreasonable people, you’ll find the number closer to 50%. FYI EXPRESS

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N-Surance Outlets (NSO) has released an upgrade to its online rater, SNAPPY. NSO pioneered Snappy in 1994 and with this new release approved agents can now login and quote over 500 ISO casualty classes (and growing!). Some examples include artisan contractors, GC’s, restaurants, daycares, and special events. The quotes comparatively rate across up to 6 A Rated E&S carriers showing all policy forms, terms and conditions. Approved and trained agents can now generate up to 6 quotes for their clients in under 2 minutes. Selective new appointments are being considered, so please contact Ken Fort (kfort@nsoins.com // 404.226.9843) or Bill Murrey (bmurrey@nsoins.com // 678.987.4904) to discuss further.

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“One of the top reasons consumers give about why they don’t buy life insurance is because it is ‘too confusing,’” noted Douglas. “The study shows that consumers with a better understanding of life insurance have a higher level of confidence in insurance companies than those less knowledgeable about life insurance. The study offers companies an in-depth view on what consumers know and the factors that contribute to better understanding of life insurance, helping them take the right steps to increase Americans’ comfort level with the industry and its products.”

LIMRA: Americans Have Rudimentary Knowledge About Life Insurance LIMRA Researchers Test Americans’ Life Insurance IQ – 70 Percent Fail WINDSOR, Conn., Jan. 17, 2012—Recently, LIMRA provided a life insurance IQ test to 4,000 Americans to gauge their knowledge and understanding of life insurance. Less than a third (1,200) passed the 10question exam and the majority (55 percent) answered fewer than five questions correctly.

Please feel free to share the link to our quiz with your readers: www.limra.com/NewsCenter/LIIQ.

“In addition to identifying the aspects of life insurance that consumers understand and where consumers admit to being in the dark, the study also shed light on some widespread misperceptions,” said Jennifer Douglas, LIMRA associate research director for strategic and developmental research. “With life insurance ownership at an all-time low, it is important that the industry not only overcome consumers’ lack of knowledge about life insurance but address the misinformation that is out there confusing them and possibly having a negative impact on their image of the industry.”

LIMRA, a worldwide research, consulting and professional development organization, is the trusted source of industry knowledge, helping more than 850 insurance and financial services companies in 73 countries increase their marketing and distribution effectiveness. Visit LIMRA at www.limra.com. Catherine Theroux | Director | Public Relations | LIMRA | 300 Day Hill Road | Windsor, CT 06095 | Office: 860-285-7787| Cell: 703-447-3257

LIMRA researchers identified a number of factors that were associated with higher life insurance IQs among the survey respondents: • If the person cited multiple sources of information attributing to their understanding of life insurance •

If the person owns individual life coverage

• If the person’s primary source of information is through their occupation, some sort of seminar, or a financial planner •

If the person is older

• If the person has a higher degree of confidence in the life insurance industry HOW MANY YEARS DO YOU HAVE LEFT?!

•

If the person has a higher level of education

• assets

If the person has higher household investible

Watch your age in the upper right corner as you progress through the questions!

•

If the person is male

•

If the person views life insurance as important

It’s kinda fun to watch your age go up and down as you answer the questions.

Less than one percent of those surveyed answered all ten questions correctly. (Take the quiz and compare your knowledge). What does this mean for the industry?

Now this is interesting, give it a try.... How long will you live? This is a calculator that estimates your life expectancy. It was developed by Northwestern Mutual Life. It's interesting that there are only 13 questions. Yet, they can predict how long you're likely to live. http://media.nmfn.com/tnetwork/lifespan

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Facts from LIMRA Americans Know they Need Life Insurance – the Trick Is Getting Them to Buy According to LIMRA’s research, almost 9 in 10 Americans view life insurance as a necessity. In addition, life insurance beat out all other sources of financial assets or income that Americans expect to use to help pay bills, and to maintain their lifestyle if the primary wage earner dies. Yet, in 2011 only 59 percent of individuals LIMRA surveyed said they actually own some sort of life insurance and half of American households said they needed more life insurance. How does the industry bridge this gap and help people protect their loved ones? Over the past two years, only 22 percent of U.S. households seriously shopped for life insurance. Of those, 41 percent said life triggers — getting married, buying a home, having or adopting a baby, receiving substantial assets, or experiencing the death of a relative or close friend — were the reasons they began to shop for life insurance. But even life events only propelled a little more than half of those who shopped to buy. Why aren’t these people buying life insurance they feel they need? Many don’t know how much life insurance or what kind to buy. LIMRA has found that this indecision leads consumers to procrastination. LIMRA research has revealed four things producers can do to help shoppers become buyers: 

  

Conduct a needs analysis with clients and prospects. Consumers who get one are “considerably more likely to buy” than consumers who don’t. What’s more, producers who recommend an amount of insurance to buy ultimately sell more policies, at a 60 percent higher coverage level. Meet directly with clients. Clients who meet with producers face-to-face buy policies70 percent of the time. Raise the issue. One-quarter of life insurance shoppers consider life insurance only after an agent or advisor initiated the discussion. Be persistent with follow-up. More than one-third of shoppers said the producer should have followed up with them while they were still deciding whether to buy.

Buying life insurance is an act of love. Make sure your clients protect the ones they love by ensuring they have the appropriate amount of life insurance. All facts are from LIMRA’s life insurance consumer studies.

More “News, Satire & Opinions for Independent Agents from Independent Agents” at www.fyigeorgiaviews.com

7 Ways to Kill Your Local Search Rankings without Touching a Computer There are a million online misadventures that can snuff out your business’s rankings in local search – in the Google+Local (AKA Google Places) search results and everywhere else. Attempts to spam or deceive Google usually backfire. You can also destroy your rankings through sheer laziness – like if you never update any of your business information or never bother to understand Google’s quality guidelines. You may be aware of what online actions can hurt your local rankings. Maybe you’ve learned the hard way. But there also are offline ways you can kill your local rankings. Simply not doing anything stupid or naughty in your local SEO campaign isn’t enough. You can lose local visibility and local customers without ever touching your computer (or smartphone or iPad). To be more precise, I can think of 7 ways:

Offline Way to Die Online #1: Relocate, rename, or use a new phone number without updating your Google+Local page or other business listings to reflect the change(s). By “update” I mean you must do two things: (1) update all your business listings with the new info, and (2) scour the web for listings (AKA citations) that list your old info. (By the way, doing a free GetListed.org scan can be a huge help when you get to this step.) If you fail to do the above, you may be OK…for a little while. After some months a major third-party data source (most likely InfoGroup) will catch wind of the change and create new listings for your business with the new info. This will cause your business to have inconsistent info spread all over the web – which itself is a rankingskiller – and may cause Google to create unwanted and inaccurate Google+Local pages for your business (another rankings killer).

Offline Way to Die Online #2: Get a phony address, like a PO box, UPS box, or virtual office. Eventually your fake-o address will enter the localsearch “ecosystem” (in the way I described above) and you’ll end up with inconsistent business info all over the web, penalties from Google, or both. (It’s likely that the only reason you’d want a phony address in the first place is so you can try to game Google – so it’s likely your rankings won’t die with you unplugged. More likely, you’ll try to update your listing(s)

FYI EXPRESS

with the fake address and end up getting flagged by a competitor or “good citizen.”)

Offline Way to Die Online #3: Mistreat your customers and get slammed with bad reviews. This probably won’t have a direct effect on your rankings unless you have dozens or hundreds of scathing reviews, BUT it may affect your rankings indirectly. For instance, nobody knows for sure whether clickthrough rate (i.e. the percentage of people who see your business listed in Google and click on it) is a factor that Google takes into account when sorting out the local rankings. But Google does “know” a bunch of userengagement stats. If people simply don’t click on your listing because they see a 10/30 average Google rating, or if nobody clicks your link from (say) your Yelp listing because you have a 1-star average, Google may very well take your rankings down a peg. Also, although “social signals” like Facebook shares, tweets, and Google +1s don’t seem to affect your local ranking much or at all as of this writing, they most likely will become a stronger ranking factor in the future. If potential customers are scared off by bad reviews, you’ve got fewer opportunities to get social shares. Most of all, at the end of the day, it’s about getting people to pick up the phone. You can’t do that very easily if nobody clicks on your Google+Local page or website because your reviews/ratings are so dismal. By the way, you get bonus idiot points if you get hammered with bad reviews but don’t write thoughtful “replies from the owner” because you never check up on the sites where you’re listed or simply don’t care.

Offline Way to Die Online #4: Hire and fire an unethical SEO. He or she has access to your Google+Local page or other listings (and maybe even your website), and may do something nefarious or simply not hand over your command codes. Offline Way to Die Online #5: Let your domain name or hosting expire (thanks to Chris Silver Smith for this one). True, technically you don’t need a website to rank in the Google+Local or other search results. But if you don’t have one, you’re shooting yourself in the foot, because many local-search ranking factors depend on your website. If you’re in a competitive local market, forget it: without a site you’ll fare about as well as Lance Armstrong in a polygraph test.

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February, 2013

Insurance Professionals of Atlanta Please join us for Dinner, Networking and a Program on â&#x20AC;&#x153;What Small & Intermediate Businesses Need to Know About Cyber Insuranceâ&#x20AC;?by Allen Cross of INSURETrust Date: February, 12 2013 Time: 6:00 PM Location: Brio Tuscan Grille,Perimeter 700 Ashwood Pkwy, Atlanta, GA 30338

Cost: $25.00 RSVP by 2/7/13 by contacting Deidre Scheidler, 1st Vice President at info@ipanaiw.org Acceptable forms of payment are cash, check, or credit card. Credit card payments must be processed prior to the meeting by going to www.ipanaiw.org. Note: A small credit card service fee will apply. Reservations are guaranteed. If you make a reservation and cannot attend, you will still be responsible for the cost.

More “News, Satire & Opinions for Independent Agents from Independent Agents” at www.fyigeorgiaviews.com

7 Ways to Kill Your Local Search Rankings Continued from page 14

Offline Way to Die Online #6: Never grow your site. No, I’m not talking about updating the copyright at the bottom of your website so that it no longer reads “© 2002.” I’m talking about keeping a “static” website to which you rarely or never add useful, non-promotional info that might cause a potential customer to think “Hey, that was handy.”

Things will happen to your online local presence, whether you know it or not – and probably not all of those things will be good. Sometimes you’ll need to fix or remove inaccurate info on your listings, respond to reviews, or double-check your Google+Local page or website is compliant with the Google update du jour. But you can’t fix any problems if you never know about them.

Not only does Google know when a website is an online paperweight and reflect that fact in your rankings, but if your site is devoid of fresh, helpful info, nobody will link to you, share your site, or give you a juicy unstructured citation or review.

By the way, there’s no offline way to fix most of the above problems, if they become problems for you. The solutions involve getting with the times, getting on the computer (or tablet), learning a little bit of local SEO (as you’re doing now!), and getting your hands a little dirty. That will help you get or stay visible to local customers and to keep the phone ringing.

If you’re going to rank well, your site needs to show signs of life.

Any other offline “ways to die” you can think of? Any questions or general suggestions?

Offline Way to Die Online #7: Never check your Google+Local page and other listings. They say a watched pot never boils. The corollary is that an unwatched pot can eventually boil over or boil until there’s no water left.

Phil www.localvisibilitysystem.com

Check out the demo link at: www.insuresign.com/demo FYI EXPRESS

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February, 2013

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Wayne Hooper Reports: Questions on Homeowners Coverage By Wayne Hooper

What reason in the Georgia laws could a carrier use to nonrenew a Homeowner policy if they did not have the auto coverage? Wayne Hooper - Editor for the FYI EXPRESS ANSWERED BY Don Cameron

20257 5

Jan 4 2013 9:48AM

No, there is no such directive. It is illegal for an insurance company to non-renew the policy merely and only because the insured will not carry companion business. The reasons for non-renewal are contained to OCGA 33-24-46. This month I looked into some Homeowner questions based on a conversation with a personal Lines agent in the metro Atlanta area. She complained about how difficult it is to find a “Mono-line” homeowners carrier. The major writers of Homeowners are requiring supporting coverage of an automobile policy. If a renewing Homeowner policy does not have a supporting auto policy, then at least one carrier is ordering inspection reports inside and outside the home. If the customer balks at allowing the inspectors into their home the policy is non-renewed for failure to cooperate or increase in hazard, both grounds for a non-renewal. I thought there had been a directive from the Ga. Department of Insurance, prohibiting the requirement of a supporting line, so I asked the department about it. Question and Reply from the Georgia Insurance Department about requiring supporting coverage to write a Homeowners policy

I have a Property Insurance question concerning my home

20257 4

Jan 4 2013 9:45AM

Many Homeowner carriers are now requiring the insured's to write their auto with that carrier in order to get the Homeowner policy or they will nonrenew if the customer does not add the auto to support the Homeowners.. Did not the insurance department issue a directive many years ago against requiring one line of insurance to support another?

When shown the official DOI reply, the agent replied: "Oh, I know they can't do it that way, that is the reason for all of the inspections, inside and out! That way, if they fail to comply with the inspection, then they will have a "right" to cancel, or if they find something they don't like, then that also gives them a way to cancel....getting around the commissioner!!!"

If you read OCGA 33-24-46 then you have an outline of the reasons a carrier can legally get off a homeowners policy at renewal. I can tell you from my experience as an underwriter very few homeowners can stand up to an "inspection” if the carrier wants to get out of that market. I have seen non-renewals and new business terminations for: shrubbery needs trimming, toys in the yard, grass needs mowing, junk cars parked in the yard, dogs not fenced, gates not self-closing, pools not fenced, dog appears vicious, gutters need cleaning, roof is old, house has metal siding, roof is metal, 2 or more losses in three years and last but not least the insured refused to answer my questions. I don't even want to get into questions of redlining, which everyone knows is done either by agency appointment, rates, underwriting, and value of the dwelling or age of the dwelling. It's one of those dirty little secrets of the P&C business as to how the rules and rates are structured to avoid the laws against discrimination.

Questions about vacant or unoccupied Homeowner Dwellings Continued on page 20

FYI EXPRESS

Page 18

February, 2013

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Wayne Hooper Reports … Continued from page 18 The "Independent Insurance Agents and Broker of America" virtual online University put out a 29 page white paper on the Homeowner 3's wording where the policy use of the words "you" and "residence" are explored in detail, with court case references. This paragraph from that paper best defines that article. "According to some interpretations and courts, if ‘you’ no longer reside in the dwelling, coverage on that structure immediately terminates. If you never resided in the dwelling, coverage may never have attached. This gives rise to a number of circumstances that, if this school of thought is correct, may lead to a catastrophic coverage gap for such homeowners. This is evidenced by both court decisions and real life insurance claim denials." I referred this article to the underwriting department of at least three major Homeowner carriers, specifically asking if a named insured (You) was suddenly hospitalized and unable to return home did they retain their coverage. All of the carriers declined to go on record or put their comments in writing but all said the coverage would be "determined by the claims adjustor" who would look into the circumstances before determining coverage. . I did get a reply from David Helms, CPCU, CLU, a longtime friend and former colleague whom I thought was worth sharing on this subject. . "As an individual not speaking for the organization, I find this question to be interesting and it raises a number of issues in terms of the contractual language and potential adverse impact on unwary policyholders. If we examine the ISO HO-3 2000 edition as a sample, you are correct in that “residence premises” can be interpreted to mean the one family dwelling shown in the declarations where you reside. The term “you” refers to the named insured shown in the declarations or resident spouse. Since this is a dwelling coverage issue we then look to the following: Section I – Property Coverages A. Coverage A – Dwelling 1. We cover: a. The dwelling on the “residence premises” shown in the declarations, including structures attached to the dwelling. As you can see, it appears that coverage for the dwelling is contingent upon it being located on a parcel of land meeting the definition of “residence premises.”

FYI EXPRESS

If neither the named insured shown in the declarations or resident spouse reside there, I do not see that the dwelling can be located on the “residence premises.” Although the ISO HO eligibility guidelines intend for owner-occupancy of such dwellings in question, we both know that eligibility guidelines are not incorporated into the insurance contract. In a contract of adhesion, we construe any ambiguities in favor of the insured (contra proferentem.) As such, how we define the term reside would also have to be considered. In addition, how a “you” not residing in the dwelling affects the risk should be measured. Does this present a material increase in the risk or is it just incidental? Tenant occupancy will generally increase the hazard, but what about a responsible house sitter occupying the dwelling over an extended period of time? Finally, in some states the courts recognize the Doctrine of Reasonable Expectations which can reform insurance contracts to provide coverage although the literal language of the form provides none. “Just some random thoughts of an insurance guy." David's comments track the points made in the white paper, which argues both sides of the question without a definitive answer citing court cases going each way. I found the problem on reading the referenced court cases' which stretched from 1894 to present, is the definitions changed over the years. The wording of who is the NAMED INSURED has changed to YOU in recent years, that simple change cut out family members who counted for occupancy in the past. To avoid coverage questions, make sure the Named Insured (YOU) understands that any change in his or her residency may void the coverage unless agreed to “In Writing" by the carrier, otherwise it becomes a questionable coverage situation which is best avoided. I feel the more agents bring the questionable underwriting procedures to light in the Homeowner's and Auto market the better our industry will be served. Many underwriters think that because it is "our company's procedure", it's OK; there will not be legal issues. Carriers often make panicky market decisions based on faulty information. I worked with a direct writing carrier in the 70's who terminated all customers with At Fault or Not At Fault accidents within three years because of a down turn in the stock market wiped out their investment income. (25% of their total book was terminated) They fired all of their sales staff with less than 5 years’ service. A year later we accepted those same risks with At Fault accidents trying to build market share again once the stock market recovered. Continued on page 22 Page 20

February, 2013

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Wayne Hooper Reports …

This gives rise to a number of circumstances that, if this school of thought is correct, may lead to a catastrophic coverage gap for such homeowners. This is evidenced by both court decisions and real life insurance claim denials.

Continued from page 20 I learned then it's all about profit. If the carrier is profitable, all is right with the world! If that profitability slips then the blame game begins. It must be the insured's or the agent's fault is the simple solution to a complex problem.

For example, an elderly widow was admitted to a convalescence home to recuperate from some health problems in order to be able to return home and to selfsufficiency. Her home remained her legal address and her nonresident children cared for the home, though no one lived there during her presumably temporary stay at the health care facility. After a few months, her home was totally destroyed by fire. The insurance company denied the claim on the house on the basis that she did not reside there at the time of loss.

I think agency underwriting is the most bogus form of redlining a carrier can do! If a risk fits the carriers guidelines, reports are ordered and approved, then it cannot be the agent's fault if that line of business is unprofitable. The "Law of large numbers" requires the carrier to measure results at a statistic relevant level. It cannot be done at the agency level, the numbers are simply too small to be valid.

As another example, a home was damaged by Hurricane Gustav. The homeowners had temporarily vacated the premises during remodeling though they visited the premises daily. The insurer denied the claim because the insureds were not residing there at the time of loss.

That's my opinion and I'm sticking to it! Wayne Hooper - Industry Editor Questions, comments or suggestions for future topics? Send them to wayne@fyiexpress.com

In one other example, the purchaser of a home renovated it before moving in. During the renovations, the house suffered a six-figure fire loss. The insurance company denied the claim because the insured had never resided in the house prior to the loss.

Where You Reside Catastrophic Homeowners Policy ‘Exclusion’ You may wish to read the entire white paper at http://www.independentagent.com/Education/VU/Pages/f eatured-resources/reside/where-you-reside.aspx We encourage the use of this information to inform agents, insurers, regulators, media, and consumers, and, as warranted, to seek resolution of this potential problem. Most homeowners policies provide coverage for the dwelling on the “residence premises.” The term “residence premises” is typically defined to include the dwelling “where you reside.” The question is, what happens if you no longer (or never) reside(d) there? The cost to rebuild the average home in the United States is somewhere in the neighborhood of $250,000. For most Americans, this is by far their most valuable asset. In order to protect that asset from loss, most consumers insure the replacement cost of their homes with a homeowners policy. Most homeowners policies cover the dwelling “where ‘you’ reside.” According to some interpretations and courts, if ‘you’ no longer reside in the dwelling, coverage on that structure immediately terminates. If you never resided in the dwelling, coverage may never have attached. FYI EXPRESS

Each of these is a real-life claim where losses to homes were denied based on a lack of residency, to the complete surprise to the insured and the agent. There is no specific exclusion for damage to a home in most homeowners policies due to a lack of residency, yet there have been court cases where such denials were upheld. Our research has uncovered nine court cases that have concurred with similar claim denials (along with an equal number of judicial decisions overturning claim denials). A nonresidency situation can arise unexpectedly due to illness or death, military deployment, foreclosures, relocations, etc. Even when it arises due to a routine sale, temporary rental, occupancy by a family member, divorce or separation, or transfer of ownership to a trust, given that there is no clear exclusion for most losses in most homeowners policies, most agents and virtually all insureds presume there is no coverage problem. The purpose of the full white paper is to explore sixteen (16) very common “nonresidency” situations, the rationale for/against coverage, and potential solutions in jurisdictions where a coverage gap is presented. It is up to the reader to decide the best course of action in remedying these types of situations. We encourage the use of this information to inform agents, insurers, regulators, media, and consumers, and, as warranted, to seek resolution of this potential problem.

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February, 2013

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What is the difference between a seasoned insurance agent and mortgage broker? The agent works and the mortgage broker thinks he does! There's a lot to be said for this stupid joke because it holds a bit of truth and exposes the true value of you as a seasoned insurance professional. I'm assuming you consider yourself one heeeehee. Clients come to you not only to offer good pricing but have to know about numerous coverages, exclusions and the true needs to your client. Understanding policy forms, client coverage needs and the applicable policies is part of our everyday life in the office. Quite a few formers agents and brokers who didn't cut in our business migrated there because they thought it would be easy money and it can be but how much training do you really need to tell clients what the current interest rate is? In my opinion, the insurance agent provides much, much more of a service than mortgage brokers and realtors and this is the reason why clients will stick with an agency for decades. They know they can get solid advice and pricing from an independent agency who employees licensed, bonded and well trained insurance pros. Recently, I have had some clients refinance their homes with a company called Cash Call and I updated their homeowners’ policies accordingly. The one thing that these customers had in common with Cash Call was their complaints on how bad the service was. I suppose you get what you pay for. Mortgages are a necessity but it's not an industry that requires a whole lot of business savvy. Basically, a cheap rate is teased for the best credit scoring clients and this entices customers to call. I wish insurance was that easy but it's not. If you are representing viable and long term clients who have assets, your expertise is required and you have to know what you're doing or somebody will be representing your clients instead of you. So many people came into our industry when the broker fees were easy to collect and now that trend has faded. Many of those same people realized the party was over and were looking for other easy, get-paid-quick occupations and they either end up being mortgage brokers or realtors. I take a lot of pride in the industry we all call our occupations. Commercial producers have a particularly difficult task when they insure a client. You can have 2 cabinet shops with the same gross income per year and their premiums could be thousands of dollars different.

FYI EXPRESS

Some shops assemble and manufacture on the premises in additional to milling the wood and they may have other operations within the business that presents another risk factor which changes the premium dramatically. These are the real professionals of our industry and those who handle clients with numerous real estate holdings and assets. It's your job to continuously monitor their needs. Slamming a loan together is a wham bam thank you mam one shot and after it closes, the client is often forgotten unless they need another loan. I'm trying to find some value in that line of work but it is very similar to selling used cars. The relationship often ends after the loan is funded and the broker makes his commission. Health and life agents and brokers have even more difficult tasks in keeping up with all the current rules and regulations within their field of expertise; as a matter of fact, noncompliance in some situations can lead to huge fines! How do you like that incentive to be current? Your P&C and Life/Health licenses allow you to explore many avenues and when you do it right, you're rewarded with not only that business but inevitably they ask you to help them with other policies. After writing thousands of policies in the preferred tier, at this point I have well over 2300 clients and most of them have multiple policies. It's like having a pot of gold in a filing cabinet and these clients religiously renew every year. But then again, I am easy to find especially by email. You'll find that today's technological level of communication has changed purchasing habits tremendously. Being quick, thorough and reachable is the key. Are you waiting till tomorrow to check that voice mail? WRONG! Waiting to call that client back to give them a quote in a day or two? WRONG. The faster you email them a formatted and complete quote with stylish fonts and easy to read explanations, the faster you will see that book grow. Perspective clients are very much impressed with speed service. We hear it all the time how great a company’s service is and then you test them only to find them falling short of your expectations. We are living in a world of nanoseconds and getting things done yesterday. That's what it takes these days. Many of us get it but there are still those who stare at the phone expecting their lame yellow page ad to pay for itself. Hah....wake up. We're passing you by Mr. Oldschool -I'll always have a double truck ad" dinosaur. Yep...there are still a few of these hanging by their teeth and the slow, financially painful regression continues until I eventually hear about them being for sale. It's a story much like Groundhog Day...Groundhog Day....Groundhog Day.

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February, 2013

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VALUATION FORMULAS FOR AGENCY PURCHASES AND START UPS Inevitably, some producers decide to quite their job at the agency and decide that they can open their own. They think it’s just about renting a space and getting a catchy agency name and phone numbers and the money will start rolling in. I would have to agree..........if it was 1993!! For you marketing representatives or producers who think this is the time to spin off and open your open business, I would like to give you a bit of a reality check and this is coming from somebody who did it but also sees and hears what is happening now with new business startups. If you have business knowledge or education, some money socked away and fiercely driven, I encourage you to go for it. I will assume you are personally good at sales and not planning on hiring anybody initially except for a part-time CSR. I will also assume you have previous experience in obtaining new business in something other than nonstandard auto insurance. So why all the assumptions? This market is NOT for the inexperienced dreamers at all. It is a completed waste of their money and time and the insurance companies and general agencies that are considering appointments. The success stories that I have heard of and there are very few come from producers who have been in the business for at least 5 years or so and write multiple lines of insurance and they have a niche or a healthy marketing plan to attract new clients. They either buy leads, market specific affinity groups or advertise in key markets that they specialize in. Their success is almost a guarantee because they are opening a new business as a continuation of something they have already started. In a few cases, the agent owned her own book of business and was tired of working under the tight corporate umbrella of rules, expectations and production requirements. In another case, the producer worked with Golden 1 Credit Union members directly and had a healthy referral base. There aren't too many individuals out there that are this lucky but they are out there and coming into the market.

In a very short period of time, things have changed and a few of those aggregators have, in turn, sold off what they purchased. Brokers’ fees are minimal in most cases and the general public is much more aware of getting the best deal with many agencies charging NO fees at all. The cash flow chart went from a money maker to a break even scenario and the attraction was gone. Why else would anybody purchase large books of low-retention policies? It' all about the cash flow and growth. The product could be anything and all these investing groups care about is that they are making money - not breaking even or losing money. So what is the current valuation of a nonstandard auto agency? It's whatever somebody is willing to pay but when it comes down to it, an owner is lucky to get 1X the commissions for 1 year. Broker fees are not normally included in the formula since they can't be depended on to remain level - they have been shrinking. I know...I hear you. There are still some agencies that are collecting broker and service fees regularly but it is not something that can be relied on. Eventually, customers get tired of paying the fees and move over to more reputable and non-fee charging agencies. This has been the trend and will continue to be. I wish it was like it was in the old days. All you had to do was place a yellow page ad and the phones would ring and ring. This is now a market for the strong willed, computer savvy and clever producers and principals. We utilize email the way we used to use the phone. We respond in a matter of minutes instead of hours to our clients’ needs and their quote requests and we rarely use a fax anymore. We use PDF files and scanners. Paper checks are rarely needed anymore because most insurers offer E-checks and credit card options. The better clients don't want to pay high billing fees and have much better retention. EFT clients are much better as well. As a matter of fact, when somebody offers to pay with a check, I'm leery especially when I tell them that we will use an E-Check program that will sweep the money out of their account and they tell me they will call back. There are still a few people who like to use paper checks but that's quickly disappearing. The best way to sum this up is that your future customers want their insurance needs taken care of with precision and with little or no issues. Those who deliver this with efficiency, professionalism and speed will own the market in 2013. If your agency is still hanging on to old methods, your future is much more uncertain than the rest of us who have morphed into TECHNOSTUDS. You gotta get on board or it’s all gonna pass you buy......in the fast lane.

Lately, there has been a rash of 2-4 year old agency owners who want to sell off their relatively small book of nonstandard auto business and are surprised when they Make plans to attend “How to Evaluate, Buy hear about the current valuations for their agency & Sell Insurance Agencies” seminar at this business. Several years ago when a few large broker fee year’s conventions. bandit bucket shops sold their locations and books, they made a very good profit. The valuations and marketing Info at www.AccuAgents.com, outlook were much more positive then now and they www.PIATX.org and were snapped up by a few aggregator companies who www.FYIGeorgiaViews.com. were building up their premium levels into the 10s of millions of dollars. FYI EXPRESS Page 26 February, 2013

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To promote the Plan / Prevent / Protect strategy, the DOL is expected to propose new regulations under the Fair Labor Standards Act (FLSA) that would require employers not only to explain their employees' general rights under the FLSA (as currently required under notice posting laws), but also would require you to explain how pay is computed and what their employment status is (i.e., exempt or nonexempt). The DOL also may require employers to provide information justifying independent contractor classifications to workers not categorized as employees.

Be Ready for New Regulations in 2013 The elections are over, and nothing has changed on the surface. But, while predictions of legislative gridlock likely are accurate, one of the biggest problems businesses, and HR, may face will be new regulations. Find out what the DOL and EEOC have on their agendas for the coming four years. It's 2013, but status quo is again the rule in Washington. After a contentious election season, we are back where we started with a divided Congress and President Barack Obama at the helm.

In addition, the DOL is expected to issue new Occupational Safety and Health Administration (OSHA) regulations to support the Plan/Prevent/Protect strategy. One likely rule will require employers to implement an injury and illness prevention program which would involve planning, implementing, evaluating, and improving processes and activities that protect employee safety and health. Also, OSHA is expected to make changes to its reporting system for occupational injuries and illnesses "to enable a more efficient and timely collection of data that is intended to improve the accuracy and availability of the relevant records and statistics."

What exactly does that mean for businesses and human resources for the next four years? Early indications are that not much new legislation will be passed since the House of Representatives still is controlled by the Republicans and the Democrats maintain a majority in the Senate. However, because President Obama retains the executive authority, the regulatory agencies under his control are free to pursue their agendas by issuing new regulations and enforcing existing ones more aggressively. Here are our predictions for the New Year, as well as actions your organization should take to limit the impact of potential new regulations and enforcement activities.

The DOL also is overdue to issue new Family and Medical Leave Act (FMLA) regulations to implement the 2008 changes to the FMLA creating new leave rights for employees to care for injured military family members and to deal with qualifying exigencies arising from military service. Those regulations should be implemented within the next few months.

More Regulations at DOL and EEOC Likely Although no new regulations have been issued yet, you can find clues to likely regulations and actions from the Department of Labor (DOL) and the Equal Employment Opportunity Commission (EEOC) in the strategic plans the agencies posted on their Web sites last year. Specifically, the DOL's regulatory agenda for the next four years will be centered on its "Plan/Prevent/Protect" strategy. According to the DOL's strategic plan document for 2011 to 2016, the Plan/Prevent/Protect regulatory agenda is based on the principle that "employers and others must find and fix violations - that is, assure compliance - before a DOL investigator arrives at the workplace." Employers, therefore, "must understand that the burden is on them to obey the law, not on the DOL to catch them violating the law." According to the DOL, "plan" means that the DOL will propose rules requiring employers to create a plan to find and fix any violations of the laws or risks to employees, "prevent" means that the DOL will propose rules requiring employers to implement their plans to prevent violations and risks, and "protect" means the DOL will propose rules requiring employers to assure that their plans actually do protect employees.

The EEOC's 2012 to 2016 Strategic Enforcement Plan focuses on combating employment discrimination through "strategic law enforcement" and indicates that the majority of the EEOC's financial and human resources will be dedicated to this mission. The plan does not specifically address new regulations, but you likely can expect stepped up enforcement of discrimination laws by the agency. In particular, as we saw last year, the agency most likely will continue to issue guidance on the applicant screening process, such as background checks, the exclusion of unemployed applicants, and high school diploma requirements. In addition, the ADA is expected to generate a lot of activity at the EEOC thanks to the expanded definition of disability created by the ADA Amendments Act of 2008. And, the agency has pledged to focus on enforcing equal pay laws as well. Continued on page 30

(Download free Hours of Work model policy including analysis of DOL regulations.)

FYI EXPRESS

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February, 2013

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2013 Employment Regulations Continued from page 28 (Download free Equal Employment Opportunity model policy including an analysis of EEO regulations.) Actions to take: Keep up-to-date on DOL and EEOC proposed and final rules and guidance and be prepared to implement new policies and procedures to comply with new requirements. HR Matters Tools and Resource Center will be reporting on any new enforcement activities that affect employers. Increased Scrutiny of Independent Contractor Classifications Thanks to the nation's ballooning deficits, you can expect that the Internal Revenue Service (IRS) will continue to try to increase its tax collections by targeting employers who misclassify employees as independent contractors. The IRS has collected hundreds of millions in back taxes and penalties from employers who improperly classified employees as independent contractors. And, the agency will look to the DOL for help. Since 2011, the IRS and DOL have had a Memorandum of Understanding (MOU) to "improve coordination on employee misclassification compliance and education" through "enhanced information sharing and other collaboration." The IRS duties under the MOU appear to be directed toward evaluating and following up on employment tax referrals provided by the DOL as the result of the DOL's investigation into independent contractor issues. The DOL stated its intent in its strategic plan to work with the IRS to identify and remedy employee misclassifications. Note, too, that state labor, revenue, and unemployment compensation agencies have their own definitions of independent contractor and are stepping up their review of the independent contractor label as well. In fact, several states have signed MOUs with the IRS and DOL to coordinate independent contractor enforcement activities. Actions to take: If you are considering adding more independent contractors to provide services normally performed by employees to cut costs, make sure you understand what the criteria are for independent contractors. There are three different standards commonly used by the federal courts and agencies to determine independent contractor status:

One of the key issues common to all of the tests is whether your organization exercises control over how the worker performs the job. In addition, be sure you can support the classification with documentation showing that the worker meets the IRS and other independent contractor criteria. HR Matters Tools and Resource Center will keep you up-to-date on independent contractor issues. Reprinted with permission from HR Matters, copyright Personnel Policy Service, Inc., Louisville, KY, all rights reserved, the HR Policy and Employment Law Compliance Experts for 40 years, 1-800-437-3735. Personnel Policy Service markets group legal service benefits and publishes HR information products, including the free weekly electronic newsletter, HR Matters E-Tips (http://www.ppspublishers.com/hrmetips.htm). This article is not intended as legal advice. Readers are encouraged to seek appropriate legal or other professional advice.

What’s Happening Specialty Auto Carrier seeks TSM for Georgia territory. Individual must be self-starter with focus on creating mutually beneficial relationship with insurance agencies. Contact Eddie Emmett at eddie@fyiexpress.com for more details.

(1) the IRS 20-factor analysis, for coverage under federal withholding requirements; (2) the "economic reality" test, used to determine compliance with requirements of the Fair Labor Standards Act (FLSA); and (3) the common law "right to control" test, used by many courts to administer discrimination and benefits statutes.

FYI EXPRESS

ATI Insurance Acquires AllSafe Services http://www.atiinsurance.com/news/newsdetail.php?A TI-Insurance-Acquires-AllSafe-Services-17

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February, 2013

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RALPH T. HUDGENS

NEWS

COMMISSIONER OF INSURANCE SAFETY FIRE COMMISSIONER INDUSTRIAL LOAN COMMISSIONER

R E L E A S E For Immediate Release January 24, 2013

Seventh Floor, West Tower 2 Martin Luther King Jr. Dr. Atlanta, Georgia 30334

www.oci.ga.gov

Contact: Glenn Allen 404-463-0729 gallen@oci.ga.gov @GA_DOI

HUDGENS KICKS OFF

FIRE SAFETY CALENDAR GIVEAWAY Atlanta – Georgia Insurance and Safety Fire Commissioner Ralph Hudgens today kicked off a statewide fire safety campaign aimed at school-age children. Calendars featuring fire safety tips for children and illustrated by children are being distributed to thousands of classrooms around the state. Commissioner Hudgens kicked off the calendar distribution at C.L. Gideons Elementary School in Atlanta, Ga. The calendars feature colorful fire safety posters that were award winners in contests hosted by Hudgens’ office and the Georgia Fire Sprinkler Association during National Fire Prevention Week last October. C.L. Gideons Elementary student Jarriah Cockhren created one of the posters featured in the calendar. Entitled “Splash’s Fire Safety Tips,” the calendars include 12 fire safety tips created specifically for this project. “The students did an outstanding job on the posters that appear in these calendars,” Hudgens said. “I hope the calendars will be displayed in classrooms across the state, and help to remind students of the importance of fire safety in their daily lives.” Thanks to a joint project sponsored by Commissioner Hudgens and the Sprinkler Association, the calendars will be given away free to third-grade classrooms throughout the state. The Georgia Firefighters Burn Foundation, Inc., also helped sponsor the project.

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FYI EXPRESS

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February, 2013

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TTIPS Insurance Regulation Committee Newsletter Submissions

claims of bad faith against AGCO and estoppel against AGCO’s contractual defense.

Brian T. Casey

AGCO Corp. manufactured and sold an agricultural spray applicator, the RoGator. AGCO purchased extended protection plans (EPP) from Warranty Specialists d/b/a Glynn General Corporation and offered them to customers who purchased RoGators. The EPP provided coverage required due to a mechanical breakdown or failure that is the result of a true defect in material or workmanship. Glynn General Purchasing Group (GGPG) obtained a master policy of liability insurance for AGCO from Cassidy Davis to provide coverage to AGCO for its liability to AGCO’s customers pursuant to the EPPs.

Trey Sivley Locke Lord, LLP Bell v. Liberty Mut. Fire Ins. Co., A12A1094, Georgia Court of Appeals (December 11, 2012) On December 11, 2012, the Georgia Court of Appeals upheld the grant of summary judgment to Liberty Mutual concerning a disputed claim arising from a house fire. The Bells, the insured homeowners, and Liberty Mutual submitted the disputed claim to two appraisers and to an umpire to determine the actual value and amount of loss. The umpire issued awards for the loss of the dwelling and loss of personal property in amounts less than the policy limits and the Bells filed a motion to set aside the awards. The Bells argued the umpire’s failure to include a list of damage or loss to any specific articles of personal property or components of the house was an irregularity, palpable mistake of law, or fraud, as the state standard fire insurance policy requires such itemization. The court held the standard insurance policy in Georgia places a duty to make such an itemization on the insured, but not on the umpire, and it was not erroneous for the court to refuse to require the umpire to perform the itemized listing in the absence of an explicit provision requiring such in the policy. The trial court did not rule on the issues of whether the house was wholly destroyed and whether Liberty Mutual denied the claim in bad faith by omitting the itemization provision from the contract and thus were not decided on review. Brian T. Casey – LOCKE LORD, LLP, (404) 8704638, bcasey@lockelord.com. Trey Sivley – LOCKE LORD, LLP, (404) 870-4657, tsivley@lockelord.com. __________________________________________ Lloyd’s Syndicate No. 5820 d/b/a Cassidy Davis v. AGCO Corp.; AGCO Corp. v. Lloyd’s Syndicate No. 5820 d/b/a Cassidy Davis; Glynn Gen. Purchasing Grp. Inc. v. AGCO Corp., A12A1125, A12,A1126, A12A1281, Georgia Court of Appeals (December 11, 2012). On December 11, 2012, the Georgia Court of Appeals affirmed the grant of partial summary judgment to AGCO Corp. and denial of summary judgment to Lloyd’s Syndicate No. 5820 d/b/a Cassidy Davis (“Cassidy Davis”) on the issue of whether there was insurance coverage for obligations of AGCO arising from its liability to customers pursuant an extended warranty plan, and denying summary judgment to AGCO for its FYI EXPRESS

The RoGator at issue was powered by four wheel motors and the failure of one wheel motor stopped the machine. Initially, the ACGO dealer repaired the machine, submitted a claim for reimbursement for the repair cost to Warranty Specialists, who paid premiums to Cassidy Davis, and Cassidy Davis paid Warranty Specialists for claims deemed valid. After paying approximately 25 wheel motor claims, Warranty Specialists stopped paying the claims because Cassidy Davis had invoked the Epidemic Failure Clause (EFC). AGCO then paid the claims and filed this action. The Court affirmed that the master policy provided coverage for the wheel motor claims; it was unambiguous and contained no exclusion for mechanical breakdowns or failures resulting from design or engineering defects and only a causal connection is required to show a loss arose out of a specified act set forth in a contract. Whether Cassidy Davis acted in bad faith denying the warranty claims is question for the trier of fact, the Court determined, as it could not find that the insurer’s defense to coverage was reasonable as a matter of law under the circumstances presented in the case in order to grant summary judgment. The Court denied Cassidy’s argument that there was no bad faith because payment was not yet due as AGCO did not have a judgment rendered against it, finding no judgment had to be rendered against AGCO before it could demand payment from Cassidy or before Cassidy was obligated to reimburse AGCO. The Court held that Cassidy, Warranty Specialists, and GGPG were not estopped from asserting other grounds to deny coverage because they initially denied the claims based on the EFC. Brian T. Casey – LOCKE LORD, LLP, (404) 8704638, bcasey@lockelord.com Trey Sivley – LOCKE LORD, LLP, (404) 870-4657, tsivley@lockelord.com

Continued on page 36

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February, 2013

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TTIPS Insurance Regulation Committee Newsletter Submissions America’s Health Insurance Plans v. Ralph T. Hudgens, in his official capacity as Georgia Insurance and Safety Fire Commissioner, 1:12-cv2978-WSD, United State District Court, Northern District of Georgia, Atlanta Division (December 31, 2012) On December 31, 2012, the United States District Court, Northern District of Georgia, Atlanta Division (“District Court”) denied the Commissioner’s motion to dismiss America’s Health Insurance Plans’ (“AHIP”) complaint challenging the Georgia’s amended prompt payment law as preempted by ERISA and granting AHIP’s motion for a preliminary injunction against the enforcement of the amended prompt pay law. The prompt pay law came into existence in Georgia in 1999 with the passage of Ga. L. 1999, Act No. 263, § 2, 1999, codified at O.C.G.A § 33-24-59.5. In substance, the prompt pay law requires all health benefit plans to pay claims within 15 working days or face an 18% per annum interest charge on the outstanding the claim balance. Importantly, the 1999 prompt pay law specifically excluded health benefit plans that were subject to the exclusive jurisdiction of ERISA. In 2011, this exclusion for ERISA welfare plans was removed from the prompt pay statute through the Georgia General Assembly’s enactment of the Insurance Delivery Enhancement Act of 2011, No. 196, 2011 Ga. Laws 595, codified in relevant part as amended O.C.G.A. § 33-2459.5 and newly created O.C.G.A. § 33-24-59.14 (note that these laws are virtually the same insofar as both apply same prompt pay requirements to ERISA plans). The Commissioner argued that the prompt pay law only regulated third party administrators, which are not ERISA fiduciaries, and that alternatively the prompt pay law regulated insurance and was therefore not preempted by ERISA by virtue of its insurance savings clause. The Court rejected the Commissioner’s argument, concluding that the plain terms of the amended prompt pay statute clearly “related to” an employee benefit plan and that, while the prompt pay law did regulate insurance in accordance with the requirements of the ERISA savings clause, the ERISA deemer clause also applied and preempted the new prompt pay law insofar as it deemed a self-funded employer benefit plan to be insurance. Consequently, the District Court dismissed the Commissioner’s motion to dismiss AHIP’s preemption challenge to the amended prompt pay law and granted AHIP’s motion for preliminary injunction prohibiting the enforcement of the amended prompt pay law against self-funded employer benefit plans and administrators thereof.

Brian T. Casey – LOCKE LORD, LLP, (404) 870-4638, bcasey@lockelord.com

Trey Sivley – LOCKE LORD, LLP, (404) 870-4657, tsivley@lockelord.com

FYI EXPRESS

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February, 2013

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Paraprosdokians

12. You do not need a parachute to skydive. You only need a parachute to skydive twice.

Paraprosdokians (Winston Churchill loved them) are figures of speech in which the latter part of a sentence or phrase is surprising or unexpected; frequently humorous.

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February, 2013

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