Serving New York, New Jersey, Connec cut, Eastern Pennsylvania and Washington, DC
“Yates” Grates D&O Value Implica ons Are Far Reaching Vol. 127 No. 16 | October 17, 2016
And… What Trump and Clinton Branding Teach Us page 18
[ FOREWORD ]
STEVE ACUNTO
In Focus
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VOLUME 127, NUMBER 16 OCTOBER 17, 2016
uThe St. Regis Hotel in New York was the site of the Insurance Division of Development Corporation for the Israel/Israel Bonds annual luncheon. Dave S. Hattem, senior executive director and general counsel of AXA Equitable Life Insurance Co., Douglas J. Hayden, president of Wright Public Entity, and Martin Minkowitz, Stroock & Stroock & Lavan LLP and co-chair of the Israel Bonds Insurance Division, were honored for their lifetime contributions to the organization and to Israel. Over $10 million in indications to invest in Israel bonds were announced.… Enhanced access to new
services to consumers and is committed to utilizing modern technology to meet customer needs. LICONY is working hard to ensure that the business climate in this state will allow companies to do this, grow their businesses, and grow the state’s economy. Our new legislative agenda reflects these priorities and we are eager to work with lawmakers and regulators to ensure that this industry can continue to thrive in the state where it was founded 250 years ago.” LICONY’s 2017 legislative agenda includes advocating for New York to join the Interstate Insurance Product Regulation Compact (IIPRC), which
EDITOR & PUBLISHER Steve Acunto 914-966-3180, x110 sa@cinn.com CONTRIBUTORS Peter H. Bickford Jamie Deapo Kelly Donahue-Piro Michael Loguercio Christopher Paradiso Lawrence N. Rogak N. Stephen Ruchman Jerome Trupin, CPCU Barry Zalma PRODUCTION & DESIGN ADVERTISING COORDINATOR Director of Operations and Creative Services Gina Marie Balog 914-966-3180, x113 g@cinn.com EDITORIAL ASSISTANT COPYEDITOR & PROOFREADER Maria Vano mariavano9@gmail.com SUBSCRIPTIONS P.O. Box 9001, Mt. Vernon, NY 10552 914-966-3180, x111 circulation@cinn.com
L-R: INSURANCE DIVISION CO-CHAIR NAT PERLMUTTER; HONOREES DAVE S. HATTEM, DOUG HAYDEN AND MARTIN MINKOWITZ; AND ISRAEL BONDS VICE PRESIDENT FOR SALES STUART GARAWITZ. (PHOTO: SHAHAR AZRAN)
insurance products and the provision of greater value to policyholders were adopted as legislative priorities by the Life Insurance Council of New York (LICONY) at its annual Legislative and Regulatory Conference in Cooperstown, NY. LICONY’s 72 life insurance company members issue the vast majority of the life insurance products sold to customers in New York. LICONY President and Chief Executive Officer Mary A. Griffin said, “The life insurance industry in New York is focused on providing new products and 4 October 17, 2016 / INSURANCE ADVOCATE
would modernize and streamline the way insurance products are reviewed and would allow new products to be offered to New York consumers more quickly. To date, 45 jurisdictions have joined the compact which offers a single point of filing for life insurance policy forms, so that policies approved by the Commission may be sold in every state that is a member. LICONY will also make the case that New York companies should be allowed to proCONTINUED ON PAGE 34
PUBLISHED BY CINN Media, Inc. P.O. Box 9001, Mt. Vernon, NY 10552 (914) 966-3180 | Fax: (914) 613-1595 www.cinn.com | info@cinn.com President and CEO Steve Acunto
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Contents
14 4
Foreword: Headline Steve Acunto, Publisher
8
Exposures and Coverages: Precious Metals Exclusion; Per Claim Deductible; Adjuster Has the Right to See the Damage; Fixing Federal Flood Insurance Jerome Trupin, CPCU
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24
The Social Notebook: 10 Wake Up Calls on Social Media Marketing for Your Agency Chris Paradiso
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On My Radar: Rescission of PIP Policy Available for Fraud Barry Zalma
28
On the Level: Lemonde–A Fairy Tale with an Unhappy Ending? Jamie Deapo
30
Looking Back: September, 1991
32
Courtside: EUO No-Show Denial Upheld: Sufficient Basis Existed for Demand
33
Classifieds
“YATES” GRATES D&O VALUE
[FEATURES]
18
October 17, 2016 | Volume 127 Number 16
Guest Opinion: Six Personal Branding Lessons Professionals Can Learn from Trump and Clinton Karen LeLand Guest Article: The Rise of Chatbots: Pypestream Brings Secure Mobile Messaging to Insurance Industry Donna Peeples
6 October 17, 2016 / INSURANCE ADVOCATE
[A D F E ATUR E S ] 9
PIA: METRO RAP 2017
13
MSO: Concealed Spaces
23
Insurance Industry Charitable Foundation: 10th Anniversary Benefit Dinner
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[ EXPOSURES & COVERAGES ]
JEROM E TRUPIN, CPCU
Precious Metals Exclusion; Per Claim Deductible; Adjuster Has the Right to See the Damage; Fixing Federal Flood Insurance Precious Metals Exclusion Thieves pried open seven air conditioning units at Celebration Church and stole seven condenser coils. Stolen coils can sell for more than $1,000 each because of their copper content. Copper theft is big business. It’s estimated at almost a billion dollars a year, with theft from a/c units accounting for three-fourths of it.1 ISO Special Form coverage includes theft, so you’ve probably seen some of these claims. However, Celebration Church’s claim was denied. The reason: precious metal exclusion. Special Form coverage limits theft of precious metals coverage to $2,500, but let’s look at the actual wording: $2,500 for jewelry, watches, watch movements, jewels, pearls, precious and semiprecious stones, bullion, gold, silver, platinum and other precious alloys or metals. This limit does not apply to jewelry and watches worth $100 or less per item. I don’t think that copper, even at its present price levels, is a “precious metal.” But even if it is, I’d argue that the doctrine of ejusdem generis would result in full coverage for the insured. Ejusdem generis is the “birds of a feather” doctrine—that is, when interpreting an item in a series, only those meanings that are similar to the other are used. Thus, a policy condition applying to “automobiles, trucks, tractors, motorcycles, and other motor-powered vehicles” might not apply to an airplane even though it’s a vehicle, because the other items are all land-based vehicles. I was about to call the attorney who posted the information, but I decided that
I don’t think that copper, even at its present price levels, is a “precious metal.” But even if it is, I’d argue that the doctrine of ejusdem generis would result in full coverage for the insured.
I’d better first read the case. It turns out that the church’s policy was not an ISO form. It contained a different exclusion, which read: ...Theft or attempted theft, and any vandalism caused by or resulting from such theft or attempted theft, of any copper, aluminum or any other precious or semi-precious alloys or metals that are attached or connected to buildings or structures, or are part of any machinery or equipment attached or connected to buildings or structures.”2 That pretty much rules out any coverage for Celebration Church. PRACTICE POINTERS: There are several lessons here: 1. (For me) Get your brain in gear before you open your mouth. 2. Watch out for non-standard policy terms when you’re dealing with forms you don’t know.
Jerome “Jerry” Trupin, CPCU, is a partner in Trupin Insurance Services located in Sleepy Hollow, NY. He provides property/casualty insurance consulting advice to commercial, nonprofit and governmental entities. He is, in effect, an outsourced risk manager. Jerry has been an expert witness in numerous cases involving insurance policy coverage disputes and has taught many CPCU and IIA courses. Jerry has spoken across the country on insurance topics and is the co-author of over ten insurance texts used in CPCU and IIA programs including Commercial Property Risk Management and Insurance and Commercial Liability Management and Insurance. He regularly contributes articles to CPCU Society publication, the Insurance Advocate®, and others. He can be reached at jtrupin@aol.com. Thanks to Jerry Trupin for this article and to the CPCU Society for letting us reprint it.
CONTINUED ON PAGE 10
1 “Copper Theft Is A Billion Dollar Industry With Air Conditioning Theft Accounting For 75% Of The Total.” Copper Watcher Store http://www.copperwatcher.com/ 2 Celebration Church v. United Nat’l Ins. Co., 2016 U.S. App. LEXIS 16061 (5th Cir., Aug. 30, 2016).
8 October 17, 2016 / INSURANCE ADVOCATE
Jan. 26, 2017
T H E R O O S E V EL T H O T EL s N E W YORK CIT Y
Schedule Wednesday y, Jan. 25, 2017 6:30-8:30 p.m.
Metr e oRAP welcome reception Y-YIP hossted by NY Coonnolly’s Times Square
@PIIAEd ducCoonf | #MeetroRAP
For registration n information, contac ct ‌
PIANY ’s Education and Conference Department. t QJB PSH
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Thursday y, Jan. 26, 2017 8-10 a.m.
Education session: The New e “Social� Insuran nce Industry– How Do Yo ou Manage Thaat? Panel Discussion Submitted for NY and NJ CE C crredits. e
9-11 a.m.
Continental breakfast
9 a.m.-12:30 p.m.
Trade r show open - Cash door-prize drawingss - Exhibitor and major doorr prize drawings
1-2:30 p.m.
n Keeynote/awar y ds luncheon - Keynote e speaker - Awar w d presentation - Bernard I. Koz o el and Arthu ur I. Moll Memorial scholarship preseentations
2:45-5:45 p.m.
Education session: E&O–The Next e Generatio on Cathy Trrischan, CPCU, CIIC, CRM, AU, ARM, AAI, CRIS, MLIS Submitted u for NY and NJ C CE crredits. e
[ EXPOSURES & COVERAGES ] CONTINUED FROM PAGE 8
3. Remember “ejusdem generis” when interpreting a policy. Or remember to refer coverage declinations to experts. They may see interpretations that are not immediately obvious to us.
Per Claim Deductible Deductibles make eminent sense economically, but not emotionally. From the insured’s point of view, retaining as much of the exposure as possible is the best way to lower insurance premiums. But the satisfaction of lower premium at policy inception is no match for the pain of not collecting in full when the loss occurs, no matter how clear the arithmetic; it’s the way we’re programmed. Economists call it “loss aversion.” Loss causes more pain than gain generates satisfaction. Furthermore, some deductibles can really be painful, as Rensselaer County discovered. The county had a practice of strip-searching every suspect who was jailed for any offense. Federal courts ruled that was unconstitutional if the alleged crime was only a misdemeanor and there was no reasonable suspicion that the suspect was concealing weapons or contraband. A class action ensued claiming damages for all the people arrested in the county and charged with misdemeanors between 1999 and 2002. The county was insured for public officials and police liability by Selective Insurance Company. Selective agreed to defend the county up to the limits of coverage and subject to the deductible. And there’s the rub. The county’s policies in 1999 and 2000 had a $10,000 per claim deductible; the 2001 policy had a $15,000 per claim deductible. The case eventually settled for just a nominal award to the claimants: $5,000 to the lead plaintiff and $1,000 to each of the others. There were 800 plaintiffs—that’s about $800,000 plus attorneys’ fees of $442,700. The $10,000 deductible should be no problem for a large county, right? Wrong. Selective said the deductible applied per claim. Since there were 800 claims, in its opinion each of the claims was below the applicable deductible—the entire
$1,242,700 was the county’s obligation. The county argued that it was all one claim and only one deductible should apply. Selective also asserted that because the injuries to the class members did not constitute one occurrence, the attorneys’ fees likewise should be allocated among the various “occurrences.” The County responded that the attorneys’ fees should be attributed entirely to the lead plaintiff because there was only one set of lawyers for all class members. In a truly Solomonic decision, the court held that the individual damage awards were subject to one deductible each, meaning the insurer would make no payments for the damage awards. However, because the policies were silent as to how fees should be allocated in class actions, the court held that the policy was ambiguous as to the attorneys’ fees, ruling that all the defense costs should be allocated to the lead plaintiff. That meant that only the remaining $5,000 of the $10,000 deductible applying to the lead plaintiff ’s claim would be paid by the insured; the insurer would pay almost all the attorneys’ fees. The lesson here is that liability deductibles can be dangerous. Liability deductibles come in two versions: per claim or per occurrence. Per occurrence is preferable. If a fire caused by the insured’s negligence damages the property of 10 claimants, that’s one occurrence and therefore one deductible, but if the deductible applies per claim, there are 10 claims and therefore 10 deductibles. Further, both types apply per occurrence; multiple occurrences mean multiple deductibles. Rensselaer County had the less desirable per claim deductible, but even the per occurrence wouldn’t have helped them in this case. The court would most likely have ruled that the strip-searches were separate occurrences just as they held they were separate claims. Make sure you look at worst-case scenarios when evaluating deductibles.
The Adjuster Has the Right to See the Damage “The insured, as often as may be reasonably required, shall exhibit to any person designated by this company all that remains of any property herein described”
is how the 1943 NY Standard Fire Insurance policy put it. A similar requirement was in most earlier property insurance policies and is in every current one. ISO’s commercial property puts it this way: “As often as may be reasonably required, permit us (the insurer) to inspect the property proving the loss or damage... ”It’s Insurance 101, but somehow one insured, TV Realty, LLC and, more surprisingly, its public adjuster didn’t get the message. TV Realty claimed that its building was damaged by high winds and rain during a storm on December 26-27, 2012. On December 27, TV Realty’s CEO called a public adjuster to handle the claim on its behalf. The public adjuster reported the claim to Tower Insurance on January 10, 2013. An appointment for the adjuster to inspect the loss was set for January 18, 2013, but, at the insured’s or the public adjuster’s request, was postponed to January 24. When the adjuster arrived at the building on January 24, he found that the roof had been completely repaired and all the debris disposed of. Tower denied the claim, stating that the insured had breached two policy requirements. It had failed to promptly report the loss and it failed to make the damaged property available for inspection. The insured argued that the delay was caused by the public adjuster’s busy schedule of year-end obligations and other winter losses. The court was not impressed. It ruled: “...the public adjuster and his schedule are irrelevant to plaintiff ’s obligations to provide prompt notice to Tower of a potential covered loss. There is not a single valid excuse for plaintiff ’s failure to notify Tower of the damages just before or just after notifying plaintiff ’s public adjuster of the damages. The notice to Tower was required under the policy, notice to plaintiff ’s public adjuster was merely at the plaintiff ’s discretion.”3 The court noted that Tower did not have to show that it was prejudiced by the late notice. Although the court didn’t point CONTINUED ON PAGE 12
3 TV Realty LLC v Tower Insurance Company Of New York, 306589/2013. Supreme Court, Bronx County June 28, 2016. 2016 NY Slip Op 31720(U)
10 October 17, 2016 / INSURANCE ADVOCATE
Strength. Honor. Stability.
New Yo ork Insurance Associa i tion ti
KNOW BE T TER NE W YORK CONN O EC TIONS w w w.nyia.org
[ EXPOSURES & COVERAGES ] CONTINUED FROM PAGE 10
it out, the requirement to show prejudice only applies to liability claims in New York.
Fixing Federal Flood Insurance August’s flooding in Louisiana is projected to have caused $8.5 to $11 billion in damages. The loss estimates do not reflect: • Losses to land and infrastructure • Business interruption losses • Losses to Marine Hull, or Marine Cargo lines of business • Loss adjustment expenses • “Demand surge” (the increase in costs of materials, services, and labor due to increased demand following a catastrophic event).4 Much of this damage occurred to property not located in FEMA’s special flood hazard zones. Whether you believe in global warming or Santa Claus or not, flood is a serious exposure for all insureds. The ruling that mortgagees must require evidence of flood insurance from borrowers when the property is located in a special flood hazard zone has resulted in those who are not in those zones feeling that they don’t need flood insurance. Nothing could be further from the truth. You don’t have to be a special flood hazard zone to be at risk. Louisiana, Katrina, Sandy, and other storms have proven that. There is a private flood insurance market for mid-size and larger commercial properties as well as some high-end homeowners. But for smaller risks, private insur-
National flood insurance is not working. Flood insurance is purchased primarily by those at high risk. To overcome the adverse selection that it faces, NFIP tried to increase premium rates, but the outcry from those facing huge premium increases doomed that solution.
ers have not been able to find a way around adverse selection. (Adverse selection is insurance-speak for the tendency of those at greater risk of loss to be most likely to purchase coverage.5) National flood insurance is not working. Flood insurance is purchased primarily by those at high risk. To overcome the adverse selection that it faces, NFIP tried to increase premium rates, but the outcry from those facing huge premium increases doomed that solution. There are several suggestions floating around to cope with the problem. An interesting one is to include flood insurance in all homeowners’ policies. Advocates of that approach cite several reasons to support that technique:
• Bundling flood coverage with other homeowners’ coverage spreads the risk very effectively. • Accumulation problems for insurers would be mitigated. (“Accumulation” refers to the total of risks that could be involved in a single loss event.6) The biggest losses for the NFIP have been the accumulation nightmares from Sandy and Katrina. • Bundling flood with the other covered perils would reduce the flood premium by spreading the risk across uncorrelated perils. It would make flood insurance viable and closing the protection gap would make it attractive.7 Legislation permitting bundling coverage has been introduced in congress and passed on bipartisan vote, but is stalled in the Senate.8 My take: The added cost to all homeowners, whether in flood-prone areas or not, will make it a very hard sell. I haven’t seen any good estimates of how much it would add to current homeowners’ premiums, but I think it will be meaningful. Further, given the roadblocks we call legislatures, it’s hard to see the needed legislation being enacted. There are other proposals to cope with the problem. I’ll discuss some of them next month. In the meantime, stay dry.[IA]
4 “AIR Estimates Insured Losses for Louisiana Floods to Range Between USD 8.5 Billion and USD 11 Billion” Globe Newswire Sept. 19, 2016 https://globenewswire.com/news-release/2016/09/19/872886/10165183/en/AIR-Estimates-Insured-Losses-for-Louisiana-Floods-to-Range-Between-USD-85-Billion-and-USD-11-Billion.html 5 Economists and financial markets call “adverse selection” asymmetric information. “Asymmetric information...is present whenever one party to an economic transaction possesses greater material knowledge than the other party. This normally manifests itself when the seller of a good or service has greater knowledge than the buyer (or vice versa)...” http://www.investopedia.com/terms/a/asymmetricinformation.asp 6 “IRMI Online” https://www.irmi.com/online/insurance-glossary/terms/a/accumulation.aspx 7 Adapted from Ivan Madox “Not Just Private Flood—Universal Flood” http://www.intermap.com/risks-of-hazard-blog/2016/09/not-just-private-flood-universalflood 8 John Romano “Either Fix Flood Insurance Problems or be Prepared for Disaster” Tampa Bay Times 8/20/16 http://www.tampabay.com/news/business/banking/romano-either-fix-flood-insurance-system-or-be-prepared-for-disaster/2290280
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Concealed Spaces WHAT YOU CAN’T SEE CAN hurt you. Concealed spaces represent a unique concern in underwriting due to their very nature. Helping clients understand the potential hazards of concealed spaces is another sign of the true insurance professional. What is concealed space? Not everyone knows. Concealed spaces or voids are non-occupied spaces created by building construction. Areas that are occupied or used for storage would not be considered concealed space. A concealed space is not visible, with limited or no access to it. Attics, cocklofts, joist or truss spaces that are part of floor-ceiling assemblies are all examples of concealed spaces. Other areas could be the spaces above suspended ceilings, stud spaces inside framed walls or crawl spaces under buildings. Common areas of concealed space are the vertical chases between floors for pipes, ducts and mechanical systems. These would often be in larger buildings. Concealed spaces are not restricted to the interior of a building. Exterior areas of concealed space on a building include soffits, eaves and overhangs, as well as decorative frame elements. Think of the quaint downtown shopfeel created by the addition of decorative motifs. All of these outside elements cannot have openings or unprotected openings into the building. Perhaps the greatest hazard of concealed spaces is fire. If a fire were to start, or somehow spread to one of these concealed spaces, there can be extremely serious consequences. The fire can burn for a significant amount of time before detection. Manual fighting of concealed space fires can be difficult because of limited access and inherent venting problems. Such fires are very dangerous to firefighters. Vertical concealed spaces can also act as flues to spread fire and hot gases. Fire can spread rapidly through the voids and cause structural collapse before the firefighters can react to the new danger. Building construction and the construction of the concealed space are important factors when determining a possible fire loss. Fire resistive buildings
and some noncombustible buildings face a lesser threat, as long as the concealed spaces are also of noncombustible construction and contain noncombustible elements. Frame and heavy timber buildings would of course add a significant amount of fuel to a fire. Buildings protected by an automatic sprinkler system designed and maintained to NFPA 13 (Installation of Sprinkler Systems) and NFPA 25 (Inspection, Testing & Maintenance of Water-Based Fire Protection Systems) Standards are at a much lower risk for fire damage. NFPA 13 requires all areas of a building be protected by the automatic sprinkler system, with the exception of certain areas. NFPA 13 directly addresses concealed space sprinkler requirements, including areas where sprinkler heads may be omitted. These areas may contain piping or wiring for various building systems. As of 2016, NFPA 13 includes 18 types of concealed spaces that do not require sprinklers. Reasons include lack of adequate space for the required piping, or low hazard due to construction (www.nfsa.org). Examples of areas where sprinklers could be omitted include the joist space of less than six inches between studs. Other areas would be joist space greater than six inches of separation if it were filled with noncombustible insulation. Concealed space that is constructed of noncombustible or limited combustible material is not required to be protected with automatic sprinklers, provided there is minimal combustible loading and no access to the spaces (NFPA 13).
The best way to reduce the fire hazard in concealed spaces is to use noncombustible materials (www.paroc.com). Most modern building codes will require fire stopping to be installed to separate areas of concealed space in new buildings. Fire stopping is designed to prevent spread of fire in noncombustible buildings by sealing joints and other openings through which fire could pass. However, older buildings or those that have had remodeling may have had the fire stopping removed (www.fire engineering.com). Renovations will often cover an older ceiling or wall with a new one, actually creating a concealed space as well as making a higher fire load (cfbt-us.com). Insurance pricing is also impacted by the presence of concealed spaces. Insurance rating bureaus address concealed spaces in their rating schedule. For example, if there is a combustible concealed space of over 20% of a building’s area, a significant charge is added to the rate. Concealed spaces represent unique challenges to insurers. Helping clients navigate the issues is another valueadded service of the professional insurance agent.
139 Harristown Road Glen Rock, NJ 07452 | Suite 100 (800) 935-6900 | www.msonet.com INSURANCE ADVOCATE / October 19, 2016 13
“Yates” Grates D&O Value
David E. Wood is a partner in the Los Angeles office of Barnes & Thornburg LLP, where he is a member of the Insurance Recovery and Counseling Practice Group. With more than 30 years of experience in the insurance field, Mr. Wood devotes his practice to advising and representing publicly and privately owned corporations in insurance recovery matters.
Can D&O Insurance Protect Officers and Directors Against an Increasingly Aggressive Department of Justice?
Implications Are Far Reaching B Y D AV I D W O O D
14 October 17, 2016 / INSURANCE ADVOCATE
uOn September 9, 2015, the U.S. Department of Justice published a memorandum entitled “Individual Accountability for Corporate Wrongdoing,” authored by Assistant Attorney General Sally Quillian Yates, the product of a working group of prosecutors convened to assess “how the Department approaches corporate investigations” and to identify “areas in which it can amend its policies and practices in order to most effectively pursue the individuals responsible for corporate wrongs.” (Emphasis added.) What became known as the Yates Memo put the corporate community on notice that the DOJ intends to re-focus investigations in criminal and civil matters to target “high-level executives, who may be insulated from the day-to-day activity in which the misconduct occurs.” The message of the Yates Memo is loud and clear: Criminal prosecutions and civil recovery litigation henceforth will look past the corporate veil and target corporate executives and employees wherever possible. This means more aggressive investigations and claims by the government, and higher attorneys’ and experts’ fees incurred to defend against them. The Yates Memo contains six measures taken in every investigation of improper corporate conduct: 1. To qualify for cooperation credit in a DOJ prosecution, a corporation must fully disclose “all relevant facts relating to the individuals responsible for the misconduct” (meaning the corporation risks more severe criminal penalties if it shelters executive wrongdoers). 2. Criminal and civil investigations of corporations “should focus on the individuals from the inception of the investigation.” 3. Criminal prosecutors and civil attorneys handling corporate investigations should communicate with one another “to effectively pursue individuals.” 4. Except in rare instances, civil attorneys and criminal prosecutors should not release or grant immunity to individual corporate officers and employees. 5. No investigation of a corporation should be resolved without a clear plan to proceed against individuals. 6. Civil attorneys should focus recovery efforts on individuals, evaluating “whether to bring suit against an individual based on considerations beyond that individual’s ability to pay.” Corporate executives and boards will want to stand together with the company in responding to government investigations. Good directors and officers (D&O) liability insurance can help promote this strategy. As the cost of responding to investigations and claims increases, companies and the executives who lead them have been asking for quite some time whether these costs are covered by D&O policies. Until relatively recently, the answer was yes and no. Yes, these costs are covered as long as an individual is targeted in a formal investigation initiated by a complaint, indictment or subpoena. No, these costs are
not covered where the investigation is informal or preliminary. The rationale was that in the absence of a demand for monetary relief or redress of a tangible wrong, the D&O policy didn’t provide coverage. In the past decade, however, the soft market for this kind of policy has spawned a number of new D&O products and endorsements extending coverage from costs of responding only to formal investigations, to include the costs of responding to a preliminary investigation or informal request for cooperation.
Targeting Coverage D&O policies generally are triggered by a “claim” made first against the insured and reported to the insurance company during the policy period. The wording of D&O policies varies significantly from carrier to carrier. With the advent of coverage for the costs of responding to an informal investigation, many definitions of “claim” now encompass civil, criminal, administrative or regulatory investigations once an individual insured is identified, in writing, by the investigating agency as a person against whom a formal proceeding “may be commenced.” While the requirement that the investigation be “formal” generally is gone, an informal request by the government for information and documents may not identify by name any particular individual insured as the target. D&O carriers have proven reluctant to pay attorneys’ fees and costs incurred to facilitate early cooperation with a government agency where no person has been specifically named in the government request. The costs of responding to an informal request for cooperation can be substantial, and there are ways to trigger D&O coverage for them. First, even if such a request does not name an individual, the subject matter of the request may describe a person with sufficient detail to constitute a de facto identification. For instance, suppose the government writes to a company and asks for: (1) all documents relating to the sale of a particular product to a foreign nation; (2) documents, including general ledger entries, reflecting all consideration booked by the company for the sale; (3) documents reflecting value of any kind provided by the company to any person or company other than its employees to induce or facilitate the sale; (4) the name of the senior vice president in charge of the division that made the sale; (5) all documents, including the senior vice president’s employment contract, stating how his year-end bonus is calculated; and (6) the amount of the senior vice president’s bonus in the years the sale was pending and closed, and how much of the bonus was attributable to the particular sale. A reasonable argument can be made that this request is the opening salvo of an investigation of this senior vice president for possible violations of the Foreign Corrupt Practices Act, and that the identity of the targeted individual is obvious and can be no one else.
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INSURANCE ADVOCATE / October 17, 2016 15
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Second, even if a request is vague as to an individual target, extrinsic evidence may identify the person sufficiently to trigger coverage. Suppose in the previous example the government requests the names of all employees involved in the sale of the product who had decision-making authority and interacted in person or in writing with decisionmakers at the foreign nation. If evidence extrinsic to the request shows that the SVP is the only employee who fits this description, there is a reasonable argument that D&O coverage has been triggered. (See e.g., Jemmco v. Executive Risk Indemnity, Docket No. L-486-07 (N.J. Superior Ct., filed March 22, 2007) [court found sufficient affidavit from insured’s counsel stating that he had seen the formal investigate orders, which were not public, when he met with lawyers from the Securities and Exchange Commission and others]; Ace American Ins. Co. v. Ascend One Corp., Docket No. 1:06-cv-0337-CCB (D. Md. August 7, 2008) [allowing evidence extrinsic to a subpoena to prove “wrongful acts” were being asserted against insured].) The third and most obvious way to ensure coverage under this example is to have the broker ask the underwriter on inception of the policy or at renewal to endorse the policy to make clear that the identification requirement is satisfied where the individual is named or can reasonably be identified in the writing that initiates the covered civil, criminal, administrative or regulatory investigation.
Wedge Issues The Yates Memo also advises that—absent extraordinary circumstances or departmental policy interests—resolution of an investigation against a company should not result in a release of or immunity for individual directors or officers accused of wrongdoing. By incentivizing companies to make a speedy and complete disclosure of information about its directors or officers’ potential wrongdoing, the Yates Memo exacerbates a simmering conflict of interest in most D&O insurance programs. D&O insurance policies are commonly written on an aggregate limits basis, which means the limits of the D&O insurance program are available for any and all claims. Thus, any claim will erode the limits of the policies available to pay other claims that are being made or allocated to the particular policy period. This can create conflicts of interest between a company and its directors and officers when their respective interests are not aligned. Where companies may be quick to cooperate with a government investigation, individual directors and officers may lack the same incentive. Sharing limits between the corporation and the individual insureds may exacerbate this conflict. The best way to avoid this is to buy one set of limits covering the corporation, and a set of separate or excess limits for the individuals. Other wedge issues concern self-insured retentions and 16 October 17, 2016 / INSURANCE ADVOCATE
application issues. Generally, D&O policies have three insuring agreements—known as Side A, Side B and Side C— which define the carrier’s promises to its policyholders. Side A covers the personal liability of the individual directors and officers when the corporation is not permitted or is financially unable to indemnify them for a claim against them arising from execution of their duties. Where the corporation is permitted and able to indemnify its directors and officers, Side B covers the losses sustained by them (defense expenses, settlements and judgments) to the extent that the company indemnifies them. Side B does not cover the direct liabilities of the corporation—Side C does. Side C coverage often is limited to the company’s liability associated with its own securities, and is intended primarily to respond to Rule 10b-5 actions and other shareholder litigation. For corporate officers and directors, the most important piece of a D&O policy is Side A, representing the final bulwark against claims of liability against them personally. When their company can’t indemnify them, Side A is their only source of protection for their personal assets. Most corporations purchase Side A coverage that is not subject to any self-insured retention to ensure that their directors and officers need not pay a retention as a condition to coverage, unlike the corporation must do under Sides B and C. Also, corporations regularly purchase Side A coverage that is non-rescindable. In most states, if an application for insurance includes an intentional misrepresentation of a material fact, on which the carrier relies in selling the policy, the insurer can rescind the policy by giving back the premium and acting as if the insurance contract had never been made. In some states, such as California, the misrepresentation doesn’t have to be intentional—a merely mistaken representation, if it’s material and the insurer relies on it, is enough to rescind coverage. A D&O policy that has non-rescindable Side A coverage—meaning that rescission of Side A applies only to individual insureds who knew of the misrepresentation—protects good directors and officers by preventing an insurer from walking away from the insurance contract because of a single director or officer’s misrepresentation. A year out from issuance of the Yates Memo, it’s too soon to tell whether and to what extent a government campaign to more aggressively target individuals has happened yet. But the DOJ has said what’s coming, and there is no reason to doubt its resolve. To adjust to this threat, directors and officers not only need to adhere to a higher standard of care, they also need to review their D&O policies to see if they are carefully tailored to meet the costs of defending and resolving claims of breach of this higher standard. Desirable policies will cover the cost of answering preliminary requests for documents and information even where no target is named, and will have Side A coverage that is subject to separate limits, is non-rescindable and subject to a zero-cost retention.[IA]
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KAREN LEL AND
Six Personal Branding Lessons Professionals Can Learn from Trump and Clinton uDespite having the two highest unfavorable ratings of any major presidential candidates in history, Donald Trump and Hillary Clinton have outlasted their competitors—and one of them is going to become the leader of the free world. What does success in the face of such highly unfavorable ratings teach us about personal branding? And what can working professionals at every level learn from it? Internationally-regarded brand strategist and revered media expert source Karen Leland, author of the newly released title, “The Brand Mapping Strategy: Design, Build, and Accelerate Your Brand,” examines both candidates’ personal branding successes, challenges and resulting lessons for us all in six specific areas. According to Leland’s predictive Brand Mapping Matrix, the success of any brand—in business, politics or otherwise—boils down to how the brand performs across these six key dimensions. Leland details each dimension below, including exactly how each candidate fared therein as well as the correlated business brand takeaways, to help other enterprising professionals achieve in kind. 1. Develop Your Brand by Design, Not Default. Know precisely where you are so you can discern where you need to go. Trump: “The Donald” has clearly defined himself as the Billionaire Maverick, owing no one anything. Trump has carefully crafted his image as the antiestablishment candidate proudly going against the grain. As a general strategy, it has allowed him to get away with more than the typical business leader or politician normally would. Clinton: Despite her best efforts to promote herself as “the qualified candidate,” many Americans have by default stamped Clinton with the brand of Matron—part of the old guard of Washington politics. Recently she has 18 October 17, 2016 / INSURANCE ADVOCATE
begun to pivot and is trying to find her way to a brand by design based on straight-talking thoughtfulness. **Personal Brand Takeaway: Every business person, from secretary to CEO, needs to start by assessing the personal brand they currently have and be truthful about the degree to which it exists by design—or default. Then they need to take stock of the impact that current brand is having. Is your brand producing the reputation you desire? Is it creating the environment and responses you are looking for? If not, a pivot to a more powerful personal brand may be needed. 2. Anchor Statement. What is the goto description of who you are and what you do? This is sometimes referred to as an elevator pitch. Clinton: To date, Mrs. Clinton has made her marketing bottom line “I’m the woman candidate,” but that has not played well with Sanders supporters and younger voters in general. While Clinton’s status as the first woman Presidential nominee is certainly history-making and a proud moment, as an elevator pitch it’s flawed. She would be better served by focusing on another message (consider Obama’s focus on messages of hope and change, as opposed to his race) that resonates with a wider slice of democrats and the population at large. Trump: Four words—“Make America Great Again.” This single sentence has become Trump’s signature call to arms, his reason why voters should check the box next to his name come November. The issue Trump will face as the election gets closer is how he will translate this general idea into specific policies. **Personal Brand Takeaway: All business people need to be able to present their brand in less than a minute. For example: When at a cocktail party you are asked the standard, “What do you do?” can you
Karen Leland is CEO of Sterling Marketing Group, a branding and marketing strategy and implementation firm helping CEOs, businesses and teams develop stronger personal and business brands. Clients include AT&T, American Express, Marriott Hotels, Apple Computer, LinkedIn and Twitter. She is the best-selling author of nine books, including her most recent title, “The Brand Mapping Strategy: Design, Build, and Accelerate Your Brand,” which details proven strategies, best practices and anecdotes from real life brand-building successes to help readers design, build and accelerate a successful brand. Learn more online at www.KarenLeland.com.
answer in a few short sentences that pique the listener’s interest? If not, your anchor statement needs some work. In addition, it’s important to pay attention to how your anchor statement is resonating and landing with your desired audience. 3. Unique Branding Proposition. What is it about what you do, or how you do it, that makes you unique, distinct and special? What sets you apart? Trump: Trump has taken a twopronged approach to differentiating himself. First off, he is keen to point out (at every possible opportunity) that he is a businessman, as opposed to a career politician. Secondly, his message of “I’m willing to go it alone,” whether it relates to raising money to fund his campaign or being supported by the Republican party, is at the heart of his “why I’m unique” message. Clinton: Hillary’s strongest point of differentiation to date has been “I’m the woman candidate.” The problem is that too much of her messaging has focused on this, and the voters don’t really seem to care. **Personal Brand Takeaway: Positioning yourself by specifically articulating how your brand speaks to the needs of your audience, and the unique way you address those needs, is critical to
creating an effective personal brand. And the more specific you can be, the better. 4. Brand Tone and Temperament. What is the consistent mood, tenor, quality, character and manner you bring to all your interactions? Clinton: Clinton’s tone has consistently been one of a serious Implementer. The tonal subtexts to her speeches ring with “I’m experienced, I know what I’m doing and I can get the job done.” Her demeanor, while dignified, is missing an accessibility (and even friendliness) that voters need to see in order to wholeheartedly embrace her as their Presidential candidate. However, given the alternative, it may be enough to win her the highest office in the land. Trump: Trump is always Trump. To some, his brash pronouncements play with a tone of rugged individualism. For others (even some members of his own party), his demeanor shows up as angry, and even childish in cases. So much so that the question of his temperamental suitability to be President has become a Democratic rallying cry. Likewise, Trump’s tone has some Republicans begrudgingly supporting him for the sole “anyone but Hillary” reason. Not exactly the inspiring message you would want your personal brand to create. **Personal Brand Takeaway: What you say has power, but the way you say it—your tone—has just as much impact. Every businessperson needs to be aware of how their brand tone is coming across (online and off) and adjust where necessary. In addition, taking any tone to an extreme will always backfire: Both too serious or too snarky harm a brand in the long run. 5. Signature Story. Why do you do what you do? What’s the essential story that brought you to this place? Trump: Rather than focus on a narrative based on how his past has informed his bid for the Presidency, Trump is pointing to the present problems America faces as his reason for seeking office. But by doing so, he is missing the opportunity to tie his brand to a bigger, more historical reason for running.
Know exactly what your brand brings to the table and how it stacks up against your competitors, and craft a powerful way to talk about it that inspires confidence in others.
Clinton: After her win in California on Super Tuesday, Clinton spoke about her mother, the influence she had on her life and how the way she grew up set her on a path to public service. She has skillfully integrated her history into her narrative and connected the dots of how what she learned there has brought her to here. **Personal Brand Takeaway: Never underestimate the power of a good story. A strong (and truthful) narrative about where you came from and what has influenced you to do the work you now do can connect you with your customers, employees and colleagues at a deeper level. Your brand needs to be more than a single sound bite or pithy elevator pitch. Otherwise, you run the risk of damaging your brand when
things don’t go exactly as you planned. The best brands feature multiple, complementary messages that weave together to form an accessibly complex and in-depth communication. 6. Signature Ser vices. What are your core competencies? Clinton: At the heart of Hillary Clinton’s brand is her varied and deep experience in government—and her proven ability to get things done in a political system that makes this challenging at best. Her particular expertise in foreign relations—especially at this time in America’s history—gives her a powerful place to stand as the candidate of choice. She is able and willing to talk about the “how” of the why. Trump: In almost direct opposition to Clinton, Donald Trump’s brand is rooted in being “not” a government insider—but a business one. Continually providing tough talk about his corporate success, negotiation expertise and business acumen, Trump is presenting voters with the idea of a president who would function more like the CEO of a company than the head of state. While this “non-establishment” message is resonating with many people, the downside is Trump’s lack of specifics and seemingly naïve understanding of how things actually work in Washington and the protocols that keep the wheels turning—thus causing a questioning of his suitability for the job. **Personal Brand Takeaway: Know exactly what your brand brings to the table and how it stacks up against your competitors, and craft a powerful way to talk about it that inspires confidence in others. The fulcrum of your brand needs to rest on the material ingredients of your values and commitments. A standout style (be it a brash Trump or competent Clinton) is a plus, but it will only take you so far. At some point, going beyond taking a stand for what you believe in and specifically letting people know how you plan to get there will become a central issue. Think about one area where your personal brand is being expressed more in talk than displayed in action and focus on aligning the two.[IA] INSURANCE ADVOCATE / October 17, 2016 19
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D ONNA PEEPLES
The Rise of Chatbots: Pypestream Brings Secure Mobile Messaging to Insurance Industry uIntelligent automation, or chatbots, is transforming customer service in the insurance industry. These bots offer customers new ways to ask questions, make purchases, and more within a messaging app on their smartphone or mobile device. Recently Pypestream, a leading business-to-consumer messaging platform, announced a partnership with Insurance Thought Leadership (ITL), a global network of companies across the insurance and risk management marketplace. As a part of the partnership, Pypestream will advise ITL members on opportunities with mobile messaging and chatbots to improve realtime customer service and communication. Among the first customers in the insurance industry to adopt Pypestream is LYNX Services, a wholly-owned subsidiary of Solera Holdings, Inc., a leading provider of software and services to the automobile insurance claims industry. As part of the agreement, Pypestream will initially develop automated chat capabilities specialized for auto glass repair/replacement servicing companies to initiate and complete transactions in a more streamlined and efficient manner—expediting auto glass repairs for customers in real-time. Mobile Messaging and Chatbots a Win for the Insurance Industry Pypestream’s development of a custom-built chatbot for LYNX Services and others in the insurance space is just the beginning of the trend we’re seeing industry-wide to adopt mobile messaging in a bigger way. Key benefits of mobile messaging and chatbots for insurance companies include: • Improved Customer Experience: Quote requests, appraisals, claims and updates on the status of claims can be handled easily and securely through the message stream, and further automated through the use of chatbots. 20 October 17, 2016 / INSURANCE ADVOCATE
Among the first customers in the insurance industry to adopt Pypestream is LYNX Services, a wholly-owned subsidiary of Solera Holdings, Inc., a leading provider of software and services to the automobile insurance claims industry. • Real-Time, 24/7 Customer Service: No more waiting on hold or toggling between apps or websites to find what you need. With Pypestream, simple requests such as making an addition to a policy, requesting an insurance certificate, filing a claim or asking questions related to current coverage can quickly be answered though the message stream, or automated using a chatbot. • Secure In-Message Billing and Payments: Billing inquiries and reminders, and soon in-message transactions, can also be securely handled through the Pypestream platform, allowing customers to pay on the go. In short, mobile messaging needs to be at the forefront of every insurance brand’s agenda today. Customer service and other interactions you have with customers shouldn’t require constant searching online, waiting on hold with call centers or a clumsy toggling between apps. “As the platform of choice for consumers today, mobile messaging plays a huge role in the insurance industry, but to date there have been questions about the CONTINUED ON PAGE 22
Donna Peeples is Chief Customer Officer of Pypestream. She works with insurance brands around the world to strengthen relationships with customers through the company’s secure mobile messaging platform. During her 30-year career, Donna has held senior roles with extensive P&L responsibility and verifiable results in a variety of industries and global markets. She is a versatile strategist who combines her keen market sense and strong orientation in top line growth and negotiations with her experience, entrepreneurial spirit, and business acumen to transform innovative ideas into profits. Prior to joining Pypestream, Donna was Chief Customer Officer for AIG Property and Casualty, where she was responsible for leading communication, management, and service delivery strategies and practices for customers across more than 60 lines of commercial and consumer insurance in more than 130 countries worldwide. Donna has also held various leadership positions at AGL Resources, Optimum Energy Sources, Peachtree Natural Gas, Shell Energy, Lennox Industries and United Guaranty. In 1996, she founded Motivated, Inc., a customer experience and sales training company. She is also a member of several boards, including the Customer Experience Professionals Association and the Rutgers CX program, where she teaches along with other experts in the field.
IN THE MATTER OF THE LIQUIDATION OF COLONIAL COOPERATIVE INSURANCE COMPANY Supreme Court County of New York Index No.: 400236/10 NOTICE Pursuant to an order of the Supreme Court of the State of New York, County of New York (“Court”), entered on October 4, 2010, the then-Superintendent of Insurance of the State of New York and his successors in office were appointed as liquidator (“Liquidator”) of Colonial Cooperative Insurance Company (“CCIC”) and, as such, has been directed to take possession of CCIC’s property and liquidate its business and affairs pursuant to Article 74 of the New York Insurance Law (“Insurance Law”). The Superintendent of Financial Services of the State of New York has now succeeded the Superintendent of Insurance as Liquidator of CCIC. The Liquidator has, pursuant to Insurance Law Article 74, appointed Gail Pierce-Siponen, Assistant Special Deputy Superintendent (“Assistant Special Deputy”), as her agent to liquidate the business of CCIC. The Assistant Special Deputy carries out his duties through the New York Liquidation Bureau (“NYLB”), 110 William Street, New York, New York 10038. The Liquidator has submitted a motion to the Court seeking an order: (i) approving the Liquidator’s recommendation to allow the claim of the New York Property/Casualty Insurance Security Fund (the “P/C Fund”) for expenses and losses it incurred and paid from April 1, 2016 to June 30, 2016 in the amount of $7,109 (the “Remaining Portion of the P/C Fund Claim”); and upon the Court’s approval, the Remaining Portion of the P/C Fund Claim becoming an allowed claim; (ii) approving the Liquidator’s report on the status of the CCIC liquidation proceeding (the “Liquidation Proceeding”) and the financial transactions delineated in such report; (iii) authorizing the payment of administrative expenses, including such expenses for the closing of the Liquidation Proceeding; (iv) terminating and closing the Liquidation Proceeding; (v) releasing and discharging the Liquidator, her predecessors and successors in office, and their agents, attorneys and employees, from any and all liability arising from their acts or omissions in connection with the Liquidation Proceeding; (vi) authorizing the NYLB to continue, after the termination of the Liquidation Proceeding, to receive and disburse assets to those creditors of CCIC with allowed Class two claims who are eligible to share in a pro-rata distribution, and to pay any and all administrative expenses incurred in connection with the collection and disbursement of any such assets; and (vii) granting the Liquidator such other and further relief as this Court deems appropriate and just. The Return Date on the Liquidator’s motion is the 7th day of December 2016, at 12:00 o’clock, p.m., before the Court at the Courthouse, 111 Centre Street, New York, New York, Room 623. If you wish to object to the Liquidator’s application, you must serve by first class mail a written statement setting forth your objections and all supporting documentation upon the Liquidator at the following address: Superintendent of Financial Services of the State of New York as Liquidator of Colonial Cooperative Insurance Company, 110 William Street, 15th Floor, New York, New York 10038, Attention: General Counsel. The application, including the Closing Report, is available for inspection at http://www.nylb.org and at the above address. In the event of any discrepancy between this notice and the documents submitted to Court, the documents control. Requests for further information should be directed to the NYLB, Creditor and Ancillary Operations Division, at (212) 341-6241. Dated: October 7, 2016. MARIA T. VULLO, Superintendent of Financial Services of the State of New York as Liquidator of Colonial Cooperative Insurance Company. INSURANCE ADVOCATE / October 17, 2016 21
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security of message streams and having the ability to log communications with customers,” said Paul Carroll, CEO of Insurance Thought Leadership, who has been following technology trends for the past 30 years. “Pypestream fills those critical gaps, while also delivering a robust messaging platform that integrates with existing systems.” Lynx Services, a subsidiary of Solera Holdings, Inc., which is in the process of
implementing Pypestream’s mobile messaging solution, is a great example of how businesses in the insurance industry will use chatbots. Pypestream will develop automated chat capabilities to be used by auto glass repair/replacement servicing companies to initiate and complete transactions. In other words, an auto glass repair shop may send a text message, such as “I’m having trouble with ClaimPoint” to Lynx over Pypestream’s platform. On the back-end, the chatbots will use a guided decision tree model with dynamic rout-
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“By automating answers to common questions via the Pypestream messaging platform, we’re able to improve the customer experience by providing real-time 24/7 support, while also managing operating costs through efficiency.”
ing where customers are given options within the message stream. “LYNX Services is excited about the strategic relationship with Pypestream and the implementation currently underway,” said John Wysseier, Managing Director, Solera Insurance Services. “By automating answers to common questions via the Pypestream messaging platform, we’re able to improve the customer experience by providing real-time 24/7 support, while also managing operating costs through efficiency.” At the same time, agents will be available to answer questions if the chatbot isn’t sufficient, Wysseier adds. Pypestream has also developed integration between the chatbots and Lynx’s back-end system that allows agents to review the message stream and the customer’s history to provide knowledgeable service. As the trend of automation and chatbots in the industry continues, customers are going to continue to enjoy better experiences. And any great experience starts with listening to customers. By staying conversational and focusing on responses that add the most value possible to customers, insurers have an opportunity to truly differentiate their service though intelligent automation, while saving costs on traditional call centers.[IA]
Call us today to discuss your technology needs in more detail. At Maple Technologies we have an Aspire solution that will respond to your business requirements and fit your budget.
www.insurance-advocate.com 22 October 17, 2016 / INSURANCE ADVOCATE
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10 Wake Up Calls on Social Media Marketing for Your Agency uIf you read the title of this article and thought to yourself, “My agency doesn’t need social media,” then I have some unfortunate news for you: you’re falling behind. For those of us already embracing the power of social media, I applaud you, because the world of marketing is going digital, and social media is one of the most powerful tools we have available when it comes to nurturing long-term client relationships. If you aren’t on social media and you’re looking to get started, I would suggest that you check out our content on social media marketing on paradisopresents.com, and that should help you get the ball rolling. For those of us looking to ramp up our efforts with our social media online though, I want to discuss five myths and leave you with five tips that should be a bit of a wake-up call for you in the social world. Myth #1: Social media is only meant to be used by B2C companies. Although many times in the past social media has been hyper-focused on B2C-type (business-to-customer) companies, it is not true that social media is only meant for these companies. While we operate within the insurance space, it’s important to note that as Independent Agents we are both B2C and B2B (business-to-business) companies since we sell/write both personal and commercial policies. When it comes to your social media marketing, you can focus on building long-lasting connections with your existing customers, while potentially marketing your products/services to companies in need of commercial policies as well. You just have to find the right balance. Myth #2: B2C Social media marketing strategies are strictly B2C, and don’t apply to B2B companies. This is also not true, and I’ll explain why. Traditionally, people have a much more refined and professional approach when it comes to marketing to B2B companies. While this is a good point, it doesn’t 24 October 17, 2016 / INSURANCE ADVOCATE
Although you may establish strong B2C relationships through Facebook, Twitter or Google+, you could find more success marketing to B2B companies through emails, blog articles, videos, or infographics.
mean that your B2C strategy should be considered null when it comes to marketing to B2B companies. Although you may establish strong B2C relationships through Facebook, Twitter or Google+, you could find more success marketing to B2B companies through emails, blog articles, videos, or infographics. While the platform you use to reach out to them may vary, the strategy could still be very similar. B2B companies are still sold by a well thought out story that displays value, trust, and personal experiences from peers behind your agency’s products and/or services. Myth #3: Social media is all about generating more leads. WRONG. Social media can be about generating leads, but if that’s all you think it’s here for, you’ve completely missed the point. I would actually argue that lead generation is only a secondary function of marketing via social media, and that the primary function is to nurture existing client relationships. Think about it this way, when we have a new client and/or customer come into our agency, we want to establish a strong, long-term relation-
Christopher Paradiso, CPIA , is President of Paradiso Financial & Insurance Service. He has been acknowledged by several insurance publications as a leader in the industry for his use of digital marketing and social media to help brand his agency and promote other small businesses within his community. Chris has also been recognized for his charity work with The Connecticut Children’s Medical Center. In 2011, Chris introduced “Paradiso Presents LLC,” a social media program aimed at teaching small agencies to not only survive, but compete in today’s complex online marketing world. Chris resides in Stafford Springs, CT with his wife and two children, Mia and Gianni.
ship with that client/customer so that we can capitalize on renewals. You will, of course, find new leads on social media from time to time, but if your focus isn’t on nurturing client relationships via social media to provide an outstanding customer experience, then you could be missing out. Myth #4: Social media doesn’t have an ROI. Entirely false. Social media’s ROI is unlimited depending on your strategy. It could create new leads, but as I mentioned earlier you can establish long-lasting and
rewarding relationships with your clients if you encourage them to stick around for the long haul. It is a great way to turn a professional relationship into a more approachable and personable one. If you ever question your ROI on social media, there are built-in analytics for each network, or you can look at purchasing an analytics tool as well if you feel as though you need a second look. Myth #5: Your competitors will know all of your secrets. Let’s be real folks, marketing is about staying ahead of the game. If your marketing efforts are working, your competition is likely to attempt to mimic you, and that’s okay. Your strategy and the why behind it will all remain in-house, but the how behind it will be the only thing your competitors can check out. Not to mention that if your competitors see your success and aren’t seeing it themselves, then they will move forward with fear instead of authenticity. Stay a step ahead, and don’t worry about what your competition has going on; if they are trying to copy you, then you’re doing something right. Alright, now that we’ve covered a few myths behind social media, I hope that you are a bit more comfortable with using this platform as part of your agency’s marketing strategy. I’d now like to leave you with five tips that should help ramp up your strategy. Tip #1: Show your products in action. Show the product in action? But all we sell is a piece of paper that ensures our customers have the coverage they need, right? Not exactly; social media is a time for you to get creative. One way we show our products in action is that we have a video highlighting all of the features of our mobile app. We also hosted a huge event for Flag Day at our agency and created free t-shirts for the whole town with our agency logo to commemorate our veterans who served, and we had clients displaying their free shirts all over our social media. Not only does that encourage others to interact, but it shows that we want to be involved with our local community. You just need a touch of creativity! Tip #2: Be real; be authentic. Yes, people will not appreciate the fake you, or else they would just buy their insurance from “The Lizard” or “Flo, the
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INSURANCE ADVOCATE / October 17, 2016 25
[ ON M Y RADA R ]
BA R RY Z A L M A
Rescission of PIP Policy Available for Fraud The “Innocent Third Party Rule” Does Not Eliminate Right to Rescind uWhen an insured obtains a policy of insurance by misrepresentation of a material fact or fraud, the insurer may rescind the policy in Michigan. However, when an innocent person is injured by the insured before the policy is rescinded, statutes and courts attempt to protect the innocent and require the defrauded insurer to indemnify its insured and cannot assert its rights as the victim of a fraud. In Michigan, the right to rescind in such a situation was resolved on August 30, 2016 in State Farm Mut. Auto. Ins. Co. v. Michigan Mun. Risk, Court of Appeals of Michigan, — N.W.2d —-, 2016 WL 4533622 (Aug. 30, 2016). The Supreme Court of Michigan sent the case back to the Court of Appeals because in its original opinion, it affirmed the trial court’s denial of summary disposition to QBE Insurance Corporation (QBE) on the ground that the “innocent third-party rule” barred rescission of the policy of insurance at issue. The Supreme Court, in lieu of granting QBE’s application for leave to appeal, vacated the court of appeals opinion with respect to QBE and remanded the case, instructing us to hold this case pending the outcome of Bazzi v. Sentinel Ins. Co., ––– Mich.App ––––; –– – NW2d –––– (2016). As Bazzi has now been decided, the Court of Appeals concluded that the “innocent third-party rule” did not bar QBE’s claim of fraud as a defense to an insurance contract, and that the trial court therefore erred in denying QBE’s claim of summary disposition.
PERTINENT FACTS QBE moved for summary disposition. QBE asserted, inter alia, that it was entitled to rescind its policy of insurance provided to Gray because Gray had procured her policy by defrauding QBE. According to QBE, Gray had supplied false information on her application for insurance by affirmatively indicating that the Cutlass was registered to her, when in fact it was reg26 October 17, 2016 / INSURANCE ADVOCATE
Insurance coverage required by statute, such as that of the No-Fault Act, MCL 500.3101, et seq., cannot be rescinded after an innocent third party has sustained injury which is the subject of the coverage required by statute.
istered to Tina Poole, Gray’s mother. Had Gray truthfully completed the application, QBE would never have issued the policy. Under such circumstances, QBE argued that it was entitled to rescind the insurance policy issued to Gray, and thus was entitled to be dismissed from the suit. In support of its argument, QBE provided the application for insurance that had been submitted by Gray, which stated that the named insured “must be the registered owner” of the insured vehicle (the Cutlass). Gray had indicated on the application that she was the registered owner of the vehicle, when in fact the vehicle was registered to Poole. Gray testified at her deposition that she did not own the Cutlass. Insurance coverage required by statute, such as that of the No-Fault Act, MCL 500.3101, et seq., cannot be rescinded after an innocent third party has sustained injury which is the subject of the coverage required by statute.
ANALYSIS However, because the “innocent thirdparty rule” did not survive our Supreme Court’s decision in Titan Ins. Co. v. Hyten, 491 Mich. 547; 817 NW2d 562 (2012), the trial court erred in denying summary dis-
Barry Zalma, Esq., CFE, has practiced law in California for more than 42 years as an insurance coverage and claims handling lawyer. He now limits his practice to service as an insurance consultant and expert witness specializing in insurance coverage, insurance claims handling, insurance bad faith and insurance fraud almost equally for insurers and policyholders. He also serves as an arbitrator or mediator for insurance related disputes. He founded Zalma Insurance Consultants in 2001 and serves as its only consultant. Look to National Underwriter Company for the new Zalma Insurance Claims Library, at www.nationalunderwriter.com/ZalmaLibrary. The new books are Insurance Law, Mold Claims Coverage Guide, Construction Defects Coverage Guide and Insurance Claims: A Comprehensive Guide. The American Bar Association, Tort & Insurance Practice Section has published Mr. Zalma’s book “The Insurance Fraud Deskbook” available at http:// shop.americanbar.org/eBus/Store/Pro ductDetails.aspx?productId=214624, or 800-285-2221 which is presently available. Legal Disclaimer: The author and publisher disclaim any liability, loss, or risk incurred as a consequence, directly or indirectly, of the use and application of any of the contents of this blog. The information provided is not a substitute for the advice of a competent insurance, legal, or other professional. The Information provided at this site should not be relied on as legal advice. Legal advice cannot be given without full consideration of all relevant information relating to an individual situation.
[ O N MY R A DA R ] However, this Court must further consider the posture of this case relative to the underlying issue of fraud.
position to QBE on this basis. Bazzi, ––– Mich.App at ––––, slip op at 1. We see no reason to reiterate in full the holding of Bazzi. Suffice it to say that it is precisely on point with respect to the issue presented in the instant case, and is precedentially binding. Further, the Court of Appeals agreed with the Bazzi panel that the public policy concerns engendered by the abrogation of the “innocent third-party rule” are more appropriately considered by the Legislature, not this Court. Having concluded that the trial court erred in its denial of summary disposition on the basis of the “innocent third-party rule,” we vacate the trial court’s order in that respect. However, this Court must further consider the posture of this case relative to the underlying issue of fraud. It further opined that while it was inclined to believe that there was fraud in obtaining the insurance just from what’s before me, there at least could be some triable issues in that regard. Based on the Court of Appeals review of the record, it could see no reason to disturb that finding. Because this Court in Bazzi v. Sentinel Ins. Co., ––– Mich.App ––––; ––– NW2d –––– (2016), held that the “innocent thirdparty rule” was implicitly and effectively abolished in Titan Ins. Co. v. Hyten, 491 Mich. 547; 817 NW2d 562 (2012), for purposes of mandatory personal protection insurance benefits, commonly referred to as PIP benefits, under the no-fault act, the Court of Appeals had no right to apply the rule and required the trial court to order the QBE policy rescinded.
ZALMA OPINION In every state, including Michigan, fraud is a basis for rescission of an insurance policy because there is no meeting of the minds between the insurer and the putative insured. Gray lied on the application concerning a material fact, the registered owner of the vehicle. QBE was defrauded and never was allowed to agree to the risk it thought it was taking. The policy was void from its inception. The innocent victim was not without a remedy.[IA]
[ TH E S OC IA L NOTE BOOK ] CONTINUED FROM PAGE 25
Progressive Girl.” They want to see your staff, and they want to see your agency and other customers to get an idea of what it’s like to do business with your agency. It’s important that you have a healthy balance of organic and stock content within your social media, and trust me—there should be much more organic content. People can tell whether or not you were behind the camera when it comes to your visual content marketing, and pictures that you take yourself (or that you have professionally taken of your staff/agency) will go much further than stock content in the social world. Tip #3: Create galleries. If you organize your social media visuals into galleries, or albums, your posts will get more traction in the social world. On Pinterest, you can separate your content into organized boards, you post to specific communities with common interest on Google+, and on Facebook you can organize your photos into albums or upload them as a gallery with Facebook’s built-in upload services. If you have a lot of photos or visuals that all revolve around the same subject matter, it is a good idea for you to upload them as a gallery on Facebook to increase interaction and engagement, because users who are interested in the content will take the time to stop and explore the rest of your gallery after they’ve had a small preview. In our case, we can upload galleries highlighting features of our app, a gallery for our Flag Day campaigns, a gallery for our staff, and more. Again, you just have to have a touch of creativity to find success here. Tip #4: Follow sizing guidelines when it comes to visual content marketing. Yes, there are certain sizes, or dimensions, of visual content that work best on each social network. In order for your posts to find the most traction, interaction, and engagement from your audience, you should be optimizing your visual content for each individual medium in the social world. There are visual content creation tools that can do this for you: one is Canva, which is free to use on their basic platform, and another is Adobe Spark, which is also free to use. These platforms allow you to select which social networks you’d like to post to, what type of content you’d like to post, and then guide you through your content creation process to optimize the
You will…find new leads on social media from time to time, but if your focus isn’t on nurturing client relationships via social media to provide an outstanding customer experience, then you could be missing out. sizes and other settings of your visuals. If you have a marketing professional working in-house like I do, just have them follow social network sizing guidelines while creating content for your agency. Tip #5: Consistency is everything. I’m here to tell you that without consistency, you will fail on social media. If you want to embrace its power, you have to be consistent—you can’t just dip one foot into the water. Consistency comes into play in a few different mediums in terms of social media, and the first thing you should consider is your agency’s brand. Your brand is important in your visual content, your message, your posts, and more. When it comes to visual content, anything that has been edited or Photoshopped should represent your brand, although you should have a balance of branded and 100% organic content. Also in terms of consistency, your posts in general should have a consistency with timing. If you start posting to Facebook once a day for a month and then stop for a few days, your audience will know, and they won’t appreciate it. Be sure to be consistent with your agency’s brand, your agency’s message, and your posts in general, because consistency will bring you a strong ROI in the social world. Well everyone, I hope that after debunking these five myths, you’re a little more comfortable with social media, and that these five tips will help you sharpen up your loose ends in the social world. For those of you who haven’t gotten started on it quite yet, I again would encourage you to check out our content at paradisopresents.com, which should help you pick up some momentum. To all Independent Agents and Brokers, happy marketing as usual, and I’ll see you on social media![IA] INSURANCE ADVOCATE / October 17, 2016 27
[ ON T H E LEV E L ]
JAMIE DEAPO
Lemonade–A Fairy Tale with an Unhappy Ending? uBy now you’ve probably heard of Lemonade, the so-called “peer-to-peer” insurance company offering home, condo and renter’s insurance in New York. It rolled out recently, touting itself as a new brand of insurance company designed to take the typical insurance company and turn it into a new hybrid that is highly automated, competitively priced and able to allow policyholders to work together to keep losses down so excess profits can be donated to a charity of their choice. By squeezing out all the negative things inherent in most traditional insurance companies, Lemonade professes to offer a new sweet solution that will quench consumers’ thirst for a better way to buy insurance. Why does a company with such a noble objective need to hire as its “Chief Behavioral Officer” a best-selling author and professor of psychology and behavioral economics from Duke University? Is it possible the company’s promises of being different and better aren’t as accurate as Lemonade is leading consumers to believe? Let’s examine some of the facts regarding Lemonade. • Lemonade flaunts itself as a B Corp, meaning it is a for-profit company certified by the non-profit B label to meet “rigorous standards” of social and environmental performance, accountability and transparency. Such a designation is important to younger consumers looking to do business with socially conscious companies. While Lemonade’s parent company might be a B Corp, its insurance company is a standard stock insurance company. • Lemonade does offer very competitive rates, as confirmed by a former IIABNY Chair of the Board. However, the company provides a standard ISO 2010 edition of the HO-3, HO-4 and HO-6 policy form that very likely is not providing consumers with the breadth of coverage they expect and want for the exposures they have. 28 October 17, 2016 / INSURANCE ADVOCATE
Why does a company with such a noble objective need to hire as its “Chief Behavioral Officer” a best-selling author and professor of psychology and behavioral economics from Duke University? • Lemonade indicates it doesn’t transact business with a traditional agent; however the company actually owns a licensed insurance agency (Lemonade Insurance Agency LLC) to which it pays a 20 percent flat fee. • The Giveback clause is where Lemonade determines how much money it has remaining after all fees, claims, reserves, required surplus and reinsurance are paid. The company then “gives back” what is left to the policyholder’s common cause. Unfortunately, the end of that clause says: “Giveback is Lemonade’s policy and expression of intent, but it is not a contractual obligation to you, nor the cause you selected. We reserve the right to suspend or amend the Giveback policy from time to time.” • Lemonade has a Digital Assistant meant to provide consumers with helpful information on selecting coverage. Unfortunately, the Terms of Service say: “The information provided by Lemonade’s Digital Assistant is not and should not be construed as insurance advice. Lemonade is not liable for any inaccurate, missing or misconstrued information and makes no guarantee as to the quality and precision of the content. Any insurance purchasing conclusions and decisions such as coverage amounts, limits and
Jamie Deapo is AVP of Membership & Member Programs for IIABNY and is an approved CE instructor in New York. Prior to being with IIABNY, he was an independent agent in the Syracuse area for 15 years. Jamie started his career in 1972 working for insurance carriers, and he has held various underwriting and marketing positions with several national as well as regional companies. He is a past president of the Independent Insurance Agents of Central New York and served on the board of directors of IIABNY.
deductibles are completely and solely the responsibility of the insured.” • The most important part of any insurance program is how claims are handled. The only way policyholders can truly determine the quality of the protection they purchased is by whether a claim is paid and how it is handled. That’s more important than the cost of coverage. How will Lemonade handle a claim? Based on its terms of service, that’s hard to say. Only time will tell. It’s possible to believe the process may not be an easy one based on its focus on taking interaction with people out of its business model. In the Terms of Service, Lemonade states: “A claim representative may be communicating with you regarding your claim.” The first few words of the Claims Submission section of the Terms of Service offers a clue to its feelings about claims. It says, “If you elect to report an insurance claim,” implying that a policyholder who has suffered a loss may not wish to report a claim. I wonder how many policyholders Lemonade believes will have a loss, even a small loss, and not seek to get paid under their policy. The CONTINUED ON PAGE 34
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[ COURTSIDE ]
L AW R E N C E R O G A K
EUO No-Show Denial Upheld: Sufficient Basis Existed for Demand
Lawrence N. ("Larry") Rogak has been practicing insurance law since 1981. He has defended over 23,000 lawsuits and arbitrations and has represented over 75 different insurance companies and self-insured corporations. Lawrence N. Rogak LLC is listed in Best's Recommended Insurance Attorneys, a distinction that requires written recommendations from at least 12 insurance carriers. A 1981 graduate of Brooklyn Law School, Mr. Rogak has published more books and articles on insurance law than any other New York attorney in the field.
In the matter of the Arbitration between Fawzy Salama PLLC and State Farm Mutual Automobile Insurance Company Edited by Lawrence N. Rogak The issues in this arbitration are the Applicant’s unpaid bills for evaluations and electrodiagnostic testing, denied by the Respondent based on the Applicant’s failure to cooperate for an examination under oath. The Applicant brought this arbitration proceeding to obtain payment of $1,921.13 for the service dates running from June 16, 2009 to July 28, 2009. The conciliation submissions of both parties were made part of the record, as well as additional arbitration decisions that were submitted by the Respondent’s attorney at the hearing.
J U S T
The issues in this arbitration are the Applicant’s unpaid bills for evaluations and electrodiagnostic testing… In support of their position, the Applicant submitted their denials, the EUO scheduling letters, two opinion letters from the New York State Department, the affidavit of their SIU investigator, Laura Cevallos, corporate records of the 101st Ave. Management Company, and various arbitration decisions. Counsel for the
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Applicant argued that the affidavit of Laura Cevallos was insufficient, standing alone without the references cited, to establish a reasonable basis to conduct an examination under oath of the Applicant. The affidavit of Laura Cevallos reads as follows: “LAURA CEVALLOS, being duly sworn, deposes and says the following under the penalties of perjury: 1. I am employed as an investigator in the Special Investigation Unit (“SIU”) by State Farm Mutual Insurance Company (“State Farm”). I have been so employed for the past six years. In the course of my employment, I investigated the eligibility of Medical Office of Fawzy Salama, PLLC (“Fawzy Salama”) to receive payment for no-fault benefits. Based upon my investigation, I have personal knowledge of the facts set forth in this affidavit and the reasons why State Farm sought an Examination Under Oath (“EUO”) of Fawzy Salama. 2. State Farm investigated Fawzy Salama due to questions surrounding the rendition and necessity of services; billing practices; and adherence to applicable New York statutes which grant authority to provide the services billed to State Farm, including the New York State Business Corporation Law, Education Law and Public Health Law; and whether the charges constitute “basic economic loss” within the meaning of New York Insurance Law Section 5102(a)(i). 3. According to documents filed with New York State, Fawzy Salama was incorporated on April 3, 1998. According to bills, Fawzy Salama renders services out of 24 Bradley Avenue, Staten Island, New York, an address also used by Pro-Care Medical Billing & Management, Inc., a medical management company. 4. Fawzy Salama renders services out of 24 Bradley Avenue concurrently with Richmond County Chiropractic Care, PC; Island Physical Therapy Rehabilitation, PC; TJG Acupuncture, PC; and Walter Pizzi, MD. These medical providers use the same billing address (P.O. Box 90537, State Island, New York 10309). A review of the medical records submitted to State Farm by the providers suggested that the treatment may be rendered based on a predetermined protocol. The reports of the initial evaluations are similar, with patients referred for MRIs and neurological consultations on the first visit. A sampling of files was sent by State Farm to an acupuncturist and to a neurol-
…All of the bills received by State Farm for chiropractic services at 24 Bradley Avenue listed Richmond County Chiropractic Care, PC’s treating provider as its alleged owner, Robert Attanasio, DC. This suggested that the services billed by Richmond County Chiropractic Care, PC (and possibly the other providers at the address) were really rendered by independent contractors.
ogist for review. The acupuncturist concluded that the treatment rendered was inadequate and not in accordance with traditional Chinese medicine. The neurologist concluded that the clinical deficits noted in patients were unbelievable. 5. On February 22, 2008, I traveled to Fawzy Salama’s office at 24 Bradley Avenue, Staten Island, New York. When I arrived at 24 Bradley Avenue, which was a house, I asked to speak with the doctor or office manager. A female behind the front desk at the office told me that the office managers were Grace Vagnone and Brian Edmonds, but that neither they nor a doctor were present. The female behind the desk would not permit me to inspect the facility. 6. A second female who identified herself as a chiropractor wanted to know why I was present at the office. It is unclear who this female chiropractor was. All of the bills received by State Farm for chiropractic services at 24 Bradley Avenue listed Richmond County Chiropractic Care, PC’s treating provider as its alleged owner, Robert Attanasio, DC. This suggested that the services billed by Richmond County Chiropractic Care, PC (and possibly the other providers at the address) were really rendered by independent contractors. 7. Richmond County Chiropractic Care, PC, and Fawzy Salama by extension, are connected to PCs that were illegally owned by laypersons. Richmond County CONTINUED ON PAGE 34
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ON THE LEVEL
FOREWORD
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Chiropractic Care, PC billed State Farm for services rendered at 95-12 101st Avenue, Ozone Park, New York which is the address for 101st Avenue Management Company. A search of the Lexis/Nexis database showed that the contact person for 101st Avenue Management Company is Robert Borsody. Robert Borsody is an attorney who has been identified as facilitating the nominal ownership of professional medical corporations by health care professionals, with true ownership and control of the PCs secretly vested in laypersons. In 2000, State Farm procured an affidavit from Dr. John Grauerholz, who identified Robert Borsody as the individual who facilitated his “nominal” ownership of “at least 29” PCs using management and lease agreements as the model. 8. A search of Accurint, which is a locate-and-research database tool available to government, law enforcement and commercial customers such as State Farm, revealed that the office managers at 24 Bradley Avenue, Grace Vangone and Brian Edmonds, were both associated with ProCare Medical Billing & Management, Inc. Grace Vagnone and Brian Edmonds were also listed as purchasing 24 Bradley Avenue on June 28, 2007. In my experience in State Farm’s SIU, when health care providers share the same address as a management company that owns the property, and there are questionable treatment and billing practices occurring at that location, the medical providers are often owned, operated and controlled by the unlicensed laypersons who own the management company in violation of New York State laws. 9. In light of the aforementioned, State Farm attempted to procure the examination under oath (EUO) of Fawzy Salama. To date, Fawzy Salama has not appeared for EUO. State Farm’s request for the EUO was made in good faith.” I have considered the arguments of both sides. I find that the affidavit of Laura Cevallos is sufficient to establish a reasonable basis for the Respondent’s request for an examination under oath of the Applicant. The denials are sustained.[IA]
most important claim concern for Lemonade policyholders should be whether the basic coverage they are purchasing is going to protect them the way they expect. Earlier in this column, I mentioned the Chief Behavioral Officer and his credentials. He is the real threat to you as an inde-
vide consumers with additional benefits, such as financial counseling, estate planning, grief counseling, and travel assistance for beneficiaries, as part of a group life or health insurance policy. Currently insurers in New York are limited in their ability to offer these additional benefits. LICONY will ask regulators and legislators to start to remove some of the obstacles to the online offering of life insurance products. The changes being contemplated would facilitate internet sales of life insurance products, something that is becoming more prevalent every day, particularly with millennials. Life insurers will invest approximately $462 billion in New York’s economy in 2016. Let’s hope they are heard. … Homes sold at a record-setting pace across New York state during August with 13,912 closed sales, according to the housing market report released by the New York State Association of REALTORS®. The previous record was 12,938 closed sales in August 2007. The statewide median sales price increased 3.8 percent compared to August 2015.The year-to-date (Jan. 1-Aug. 31) sales total of 82,791 was 11.3 percent above the same period last year. August 2016 closed sales increased by 8.1 percent compared to a year ago to reach 13,912. The year-to-date (Jan. 1-Aug. 31) statewide median sales price was $235,000, an increase of 2.2 percent from the same period in 2015. The August 2016 statewide median sales price of $257,291 represents an increase of 3.8 percent compared to the August 2015 median of $247,941. August pending sales reached 13,113, up 13.1 percent compared to a year ago. All data is compiled from multiple listing services in the state of New York and the data include townhomes, condominiums and existing single-family homes.[IA]
AAA Case No. 412010002401 AAA Assessment No. 17 991 03984 10 Insurer’s Claim File No. 32V769776 Howard D. Jacob, Arbitrator 34 October 17, 2016 / INSURANCE ADVOCATE
We also know basic homeowners, renters and condominium coverage do not always meet the protection needs of most consumers. pendent agent. He has helped carefully craft a story about Lemonade designed to draw consumers in using his knowledge of psychology and human behavior. Lemonade’s story is that it has taken a broken and bloated industry and fixed all the inherent problems. “Technology drives everything at Lemonade” is a direct quote from Shai Wininger, president and cofounder. Lemonade stresses it provides consumers an experience that is mobile, simple and remarkably fast. It’s all about artificial intelligence and bots, according to the company. Using technology allows it to cut costs, making its products more affordable. Lemonade goes on to tell consumers how it intends to give back underwriting profits to a charity they designate. All of Lemonade’s messages are carefully crafted to focus consumers on feelings and beliefs that advance the company’s message, and away from the major issues of professional expertise and interaction that assure consumers receive proper coverage and quality customer service. The vison is alluring to consumers as it has been crafted by an expert in psychology and behavioral economics. But we know plenty of promises are being made that may never come to pass. We also know basic homeowners, renters and condominium coverage do not always meet the protection needs of most consumers. Our job is to protect consumers from drinking in what Lemonade is offering that ultimately could leave them with a very unpleasant and sour experience in the
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