the
TEXAS CONNECTION TEXAS PROFESSIONAL INSURANCE AGENTS DIGITAL JOURNAL
MARCH 2015
In This Issue
2015 Convention Registration Opens When Getting Customer Signatures Isn’t Enough
Don’t Toss Those Old Liability Policies
How to Cover a Drone
Platinum Sponsor
Tony Harper Presidents Corner …………………………
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When Getting Client Signatures….………
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………………….... Don’t Toss Those Old Liability Policies .… TDI Enforcement Actions …….……..……. Our Partners ……..……………....……… By The Numbers …...…….………...……… Word Scramble ……...…….…………..…… Classifieds ………………………..………… The Last Word ………………………………
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How to Cover a Drone
On the Cover
Page 14 Page 16 Page 20 Page 22 Page 24 Page 26 Page 27
On the Cover Drive I-45 through Huntsville, Texas and you cannot miss this regal statue of Sam Houston, first elected president of the Republic of Texas. The statue, erected in 1994, stands 67 feet tall and ‘presides’ over the area day and night. General Sam once made Huntsville his home.
It seems incredible, but on a regular basis we hear about some idiot who leaves the baby in the car and runs into the store… for just a minute. That turns out to be half an hour or more and the idiot comes back to the car and finds the child unconscious… or worse. It’s reported that 38 kids died last year from heatstroke after being left in the car. Well, an ingenious Texas inventor has come up with a device to help eliminate that kind of situation. You may want to pass on to your customers, friends, and even strangers on the street. There is now a device attaches to the car window and a motion sensor will sense any movement in the car and call your cell phone, reminding you that you have stayed longer in the store than you intended. This, of course, will work with dogs also. You can read more about this by going to: http://www.dallasnews.com/news/ community-news/plano/ headlines/20150305-plano-womandesigns-prototype-to-stop-kids-fromdying-in-overheated-cars.ece It’s worth a shot… but we all know you can’t legislate morality… and idiots will continue to make bad decisions… in spite of modern technology.
THE TEXAS CONNECTION - TEXAS PROFESSIONAL INSURANCE AGENTS DIGITAL JOURNAL
Tony
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Producers and customer service representatives are advised from early their careers of the importance of securing a customer’s signature on an . The basic premise is that if accurately completed and signed by the applicant, an application possesses tremendous power in the event of some type of errors-and-omissions litigation. The signed application played a significant role in the outcome of that litigation in a substantial number of E&O cases. For agencies serious about reducing their E&O exposure, proper handling of applications is a great place to start. Unfortunately, there have been numerous E&O cases where the signed application lacked the power it should have had. For an application to really help the agency if E&O litigation arises, the customer must fully know the contents of the entire application. If the agency sends the customer the application to sign, the entire application must be sent. Sending only the signature page could cause a problem as it might enable the customer to disavow knowledge of the contents of the entire application. The goal is to ensure that applications work for your agency, not against it. Here are some key items to follow:
Complete, Current and Correct This is known as the “3 c’s requirement.” Are applications from your agency completed fully or are some questions left blank? If questions are left blank, why? The answers to these blank items could significantly impact the account’s desirability or pricing. How confident is your agency on the accuracy of the answers to the questions? In the haste to get applications submitted, producers/account executives may answer the questions believing they are answering honestly and correctly. This has the potential to cause some problems as carriers rely heavily on the application and presume the information to be truthful. What is your agency’s approach when the carrier underwriter calls with additional questions? As a producer or CSR, do you presume to know the answer or do you contact the prospect to check? It’s best to contact the prospect/ customer to ensure the information presented to the carrier is correct.
After a Loss What happens if, after a loss, the carrier discovers the information was incorrect? This is when your nightmare could start. The carrier may take the position that it would not have written the account had it known the correct information. Unfortunately, this scenario occurs much too often. At this point, the carrier will typically have two options: rescind the policy or honor the claim, but then take action against the agency. (continued on page 9) THE TEXAS CONNECTION - TEXAS PROFESSIONAL INSURANCE AGENTS DIGITAL JOURNAL
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Texas Insurance Professional Services Ray Reyes
or
Bob Dixon
(214) 618-2365
(832) 375-0787
ray@piatx.org
bdixon@piatx.org
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There have been many E&O claims where the carrier successfully sued the agent due to misrepresentation of the nature of the risk. This issue by itself heavily reinforces the benefits of having the insured sign the application to affirm the accuracy of the information.
The Best Approach Complete the application face-to-face with the prospect/customer, asking him or her the questions exactly as they appear and accurately noting the response on the application. After completing the application, the producer/CSR will usually request that the client sign the application. An additional requirement is recommended. Namely, don’t just ask the client to sign the application. Require the prospect/customer to review the entire application to ensure you have accurately stated the exposure, and then have the client sign it. This is one of the most important procedures for an agency to insist on. In virtually every state, the customer is held responsible for the contents of the application once he or she has signed it. If the client misled you in the completion of the application, his or her signature on the document could play a significant role if a problem develops. As stated previously, this means more than just sending the client the signature page to sign. If getting the signature is not feasible for some reason, explore the possibility of providing the customer with the application electronically, asking him or her to review and approve the information for correctness. Be certain your file is well documented with the insured’s approval.
Don’t Sign the Insured’s Name While the agency may believe the customer has authorized you to do so, don’t sign for the insured! After a loss, the customer may disavow giving you this authorization. Handwriting experts have found their way into E&O claims, so extreme caution should be exercised in this area.
Use All-new Information As a producer or CSR, have you ever completed “this year’s application” using the information from “last year’s application?” Avoid doing this. It is extremely dangerous and fraught with potential problems. Risks
change, so it is always best that the application is completed through current discussion with the customer.
Ensure Accuracy Review and reinforce with your staff the issue of providing your carriers with complete, accurate applications signed by the customer. This is also a great time for management to clearly state the expectation that applications will not be submitted to the carrier unless they are complete and accurate. This requirement normally falls, especially with commercial accounts, on the producers. Customer Service Representatives should be authorized to return an application to the producer if the application is incomplete or if the CSR is concerned about accuracy.
Work in Your Favor Applications you submit to your carriers are extremely important and must be handled accordingly. Your agency’s goal should be that the information in the applications is complete, current and correct (the “3 c’s”) and the application is reviewed and signed by the customer. While getting the insured’s signature may be an additional step that takes time, the power of this signed application cannot be emphasized enough. Anything less could spell trouble if a loss develops and the carrier believes it was misled. Turn the power of the application to work in your favor by mandating and enforcing these requirements.
by Curtis M. Pearsall, CPCU, AIAF, CPIA President – Pearsall Associates, Inc. and Special Consultant to the Utica National E&O Program
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The Federal Aviation Agency (FAA) expects that some 30,000 drones will be in use for business purposes in the U.S. by 2020. Some businesses are already using them. Do they have the proper insurance coverage? Drones, or unmanned aircraft, have moved beyond the world of espionage into the world of commerce. Real estate brokers are using them to videotape properties from the air; farmers use them to monitor their crops; insurance claims adjusters use them to view damaged property; the Forest Service is using them to monitor fires; and movie companies are using them in film production. Some businesses, such as Amazon, are even experimenting with using drones for package delivery. How would you insure a drone? We discussed this topic with risk management expert and RiskEpedia author Dick Rupp. He told us, “My instincts tell me that this is an aviation risk, which most standard commercial insurance policies exclude. I contacted several broker friends and, from some of the couched responses received, I suspect that there are already some reported claims involving drones that have either been denied or are being handled under a reservation of rights basis because of coverage questions.” These questions concern the regulation and legality of flying drones for commercial purposes in the United States. Civil and public users can only fly drones if
they have FAA approval. The FAA approval process includes certification of the aircraft and requires the use of a licensed pilot and approval of the purpose and location where the drone is to be operated. Hobbyists can only fly drones below 400 feet, away from airports and air traffic. In 2007, the FAA clarified the hobbyist rule to specifically exclude individuals or companies flying drones for business purposes. The FAA’s jurisdiction and rules have recently come into question. After the FAA fined an individual $10,000 for using a drone for commercial photography purposes, the National Transportation Safety Board dismissed the fine. The NTSB judge said that “the FAA has no authority over small unmanned aircraft.” The FAA has appealed the judge’s ruling that the agency does not have the authority to regulate commercial drones. It is scheduled to issue a proposal on the operation of drones weighing less than 55 pounds later this year. Until the regulatory situation becomes clearer, businesses operating drones could run into insurance policy exclusions that bar coverage for “illegal” activities.
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Businesses should also be aware of the limitations of basic business coverages when it comes to operating a drone. The commercial general liability insurance policy excludes bodily injury or property damage resulting from the ownership, maintenance or use of aircraft. Commercial property and inland marine insurance policies also have various forms of aircraft exclusions. Some of these policies extend to cover physical damage to the aircraft while on the insured’s premises or on the ground, but specifically exclude coverage while it is in the air. Businesses operating larger commercial drones, which can range in cost from $250,000 to several million dollars, can buy special inland marine/ aviation policies for the property exposure. Unless you have a specific aviation liability policy, however, you would lack coverage for liability exposures. Commercial drones have been used in Europe and other countries for several years. Regulations and specific insurance coverages have been developed overseas to spell out liability resulting from damage by drones. Overseas insurers have developed specific insurance language for their use. At least one specialty firm in the U.S. is providing drone insurance using aviation insurance forms. This insurance covers drones only for “approved coverage uses” (law enforcement, agriculture, land management, videography, etc.) spelled out in the policy declarations. The forms do not contain FAA Regulations violation exclusions, and claims have been paid under these policy forms. However, risk managers see potential red flags, since aviation coverage forms do not provide coverage for personal injury or invasion of privacy, which could result from inadvertent videography of individuals on their private property.
Texas PIA Offers Members Satisfying E&O Solutions “Fifteen minutes could save you 15%.... Everyone knows that… but did you know that not all E&O policies are the same? E&O is like other types of insurance… you buy it hoping you’ll never need it… but if you do… E&O can be the difference in whether you stay in business or not.
How about it? Do you know what your policy covers…. And more importantly, what it doesn’t? Texas PIA offers members, quality E&O markets and coverage. And members say they have saved as much as 40% when they switch to exclusive PIA programs. Call today and get an analysis of your coverage and a competitive quote from multiple markets. Call Texas Insurance Professional Services: Ray Reyes (214) 618-2365 ray@piatx.org
THE TEXAS CONNECTION - TEXAS PROFESSIONAL INSURANCE AGENTS DIGITAL JOURNAL
or
Bob Dixon (832) 375-0787 bdixon@piatx.org
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Imagine the worst-case scenario: a customer sues you for injuries allegedly caused by one of your products. Then make it worse: you can’t find the policy that might cover that claim. Most liability policies today are written on a “claims-made” basis, meaning they cover claims reported during the policy term, as long as they result from incidents occurring after the policy’s retroactive date. When you first buy a claims-made policy, your retroactive date will likely be the same as the policy’s inception date. Ideally, when you renew or replace that policy, the insurer will use the same retroactive date. This gives you continuous coverage back to the retroactive date of your original policy. Older liability policies are often written on an “occurrence” basis, which means they cover claims that arise from incidents that occur during the policy period, even if the claim is filed years later. These older policies often come into play in cases involving “long-tail” liability claims, such as environmental, product liability and other claims that can take years to develop. When you make a claim that might be covered by an old insurance policy, it’s your responsibility to prove the policy existed. Having the actual document in hand can prevent coverage disputes with your insurer. For this reason, risk management experts strongly recommend keeping all insurance policies, even expired ones, in a safe place, and maintaining a list of policy information (including insurer name, address, type of policy, policy number and inception/expiration dates) in a separate location.
Even if you can’t locate an old policy, you might be able to document its existence. Your broker might have a copy (although brokerage firms have no legal obligation to keep copies of clients’ expired policies); your accounting department might have records of premium payments; your risk manager might have notes or correspondence relating to the policy or other claims paid under it. If your organization has long-tail liability exposures, including pollution liability or products liability exposures, you have special risk management needs. Please contact us for an analysis of your exposures and coverage needs.
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TEXAS DEPARTMENT OF INSURANCE ACTIONS DECEMBER, 2014 ASI Lloyds of St. Peter sbur g, FL Order Number: 3691 Date of Order: 12/2/2014 Action Taken: Fined $40,000 Violation: Improperly used a form for writing residential property insurance that was not filed and approved by commissioner. Foster, Mary Hernandez of Houston Order Number: 3719 Date of Order: 12/16/2014 Action Taken: General lines life, accident and health license suspended until September 1, 2015 Violation: Failed to comply with continuing education requirements National Unity Insurance Company of San Antonio Order Number: 3707 Date of Order: 12/5/2014 Action Taken: Fined $30,000 Violation: Failed to comply with Texas Insurance Code and administrative codes in instances identified in market conduct examination
Contact Us Need more in formation on the benefits of membership? Have a question about member services? Give us a call: Texas PIA & Young Insurance Professionals 3632 Frankford Rd 200B Dallas, Texas 75287 (972) 862.3333 joe@piatx.org www.piatx.org
Sosa, Lou Ann of Rosenber g Order Number: 3706 Date of Order: 12/5/2014 Action Taken: Fined $1,000; must pay restitution of $416 Violation: Withheld money belonging to insurer Texas Mutual Insurance Company of Austin Order Number: 3746 Date of Order: 12/19/2014 Action Taken: Fined $12,000 Violation: Failed to timely comply with a commissioners order to produce information; Failed to notify the division of refusal to pay a medical bill; Failed to timely pay impairment benefits based on a designated doctors opinion
- The Insurance Sage
: https://wwwapps.tdi.state.tx.us/inter/asproot/fraud/indictments/clips.asp
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Texas Professional Insurance Agents Selects EFG Companies As Its Ancillary Products Partner -Partnership designed to increase insurance agent profit by at least 30 percent-
DALLAS, TX (March 10, 2015) Texas Professional Insurance Agents and EFG Companies, the innovator behind the award-winning Hyundai Assurance program, announced today that Texas PIA has selected EFG as its consumer protection products partner to drive greater revenue for its agent members. With increased pricing pressure from carriers and expanding competition, insurance agents across the U.S. are struggling to grow their business. To address this need, Texas PIA chose to partner with EFG’s Simplicity Division and provide its members with three differentiating products: Simplicity Home Protection which protects customers from the unanticipated costs of home ownership by covering household systems and appliances; Simplicity Vehicle Protection is a vehicle service contract which covers many of the most expensive components on a vehicle; and, Simplicity Repair Protection negotiates vehicle repair costs on behalf of the agent’s customer. As part of the partnership, EFG’s Simplicity Protection division will provide the technology, training, marketing and sales support to ensure successful implementation. PIA members will also have the security and the ability to profit from the knowledge that the products they are offering are backed by EFG’s nationally award-winning claims administration. “There is significant opportunity for independent agents to surpass their 2015 business goals,” said Mark Rappaport, President, Simplicity Division of EFG Companies. “The post-recession consumer is much more savvy with regard to protecting two of their largest investments, their home and vehicle. We haven’t met an agent yet who didn’t jump at the opportunity to grow their business by more than 20 percent.”
About EFG Companies EFG Companies combines almost 40 years of experience serving as an industry innovator of consumer and vehicle protection programs with the company’s commitment to raising the industry bar in providing superior client engagement. With their field and administrative teams AFIP and ASE certified, EFG’s professionals provide world-class product development and administration, go-to-market strategies, training and auditing support across a multitude of channels. www.efgcompanies.com
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WE APPRECIATE OUR PARTNERS 21st Century Managing General Agency
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Progressive
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Time to check on those New Year’s Resolutions! How’s that going for you? Let’s look at the numbers. As the authors of Book of Odds, a collection of statistics about everyday life, we love the New Year. The slate is wiped clean and we get to look at what resolutions people make and how long the keep them. According to a study by the University of Scranton, the top 10 this year’s New Year's resolutions are: 1. Lose Weight 2. Getting Organized 3. Spend Less, Save More 4. Enjoy Life to the Fullest 5. Staying Fit and Healthy 6. Learn Something Exciting 7. Quit Smoking 8. Help Others in Achieving Their Dreams 9. Fall in Love 10. Spend More Time with Family 1. Lose Weight Since 1 in 2.8 (35.6%) of adults in the US is obese and 1 in 2.6 (38.5%) of adults believe he/she is overweight, it's not surprising that losing weight is the top resolution for 2014. Barbie and Ken haven't gained a pound since 1959, but alas most of us have. 2. Getting Organized The average office employee spends 1.5 hours a day (6 weeks per year) looking for things. Americans spend 9 million hours looking for things. The top five items men look for in their homes were clean socks, remote control, wedding album, car keys and their driver's license. For women, the top five items were a favorite pair of shoes, child's toy, wallet, lipstick and the remote control. 3. Save More During 2013, the personal savings rate or savings as a percent of disposable personal income, was about 4.5%. Thus the odds a dollar of personal
income was saved in 2013 was 1 in 22.2. Current levels of saving are an improvement over the 2007 rate of 2.6% (1 in 38.7) but still a far cry from the 1971 height of 13.3% (1 in 7.5). What are the odds an adult has no savings at all? 1 in 3.2 or 31% of American adults. 4. Enjoy Life to the Fullest We work way too hard. The odds an American doesn't plan on taking all his or her vacation are 1 in 4, and half of those who vacation work or think about it during their time off. Play is as important to us as it is to cats. The odds an hour of a man's day will be spent at leisure or play are 1 in 4.1. The odds an hour of a woman's day will be spent at leisure or play are 1 in 4.8 5. Staying Fit and Healthy Staying fit and healthy is an aspiration but less than half of us are willing to do much to achieve it, especially as they get older. In the US, 1 in 1.7 adults 18-24 get the recommended amount of exercise a week and the odds drop as people get older, to 1 in 1.9 of those 25 to 34, 1 in 2 for those 35 to 64 and 1 in 2.5 for those 65 and older. If only paying for a gym membership did the trick by itself! 6. Learn something exciting The Department of Labor estimates that the average worker will switch careers 3 to 5 times during their working life. Continuing education can help a person pick a career that matches their abilities and interests. Not everyone attends continuing education classes for professional reasons. In fact, hundreds of thousands of people
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enroll in personal enrichment classes every year to learn new things and meet new people. The odds an employed person is engaged in: • Career- or job-related courses: 1 in 2.6 • Apprenticeship programs: 1 in 71.4 • Personal interest courses: 1 in 4.6 • Informal learning activities personal interest: 1 in 1.4 7. Quit Smoking In 2011, 19% of people 18 and over (1 in 5.3) smoke. In 2013, most people who smoked wanted to quit smoking all together (1 in 1.4 or 70%) but 1 in 2.5 (40%) will try to quit this year. However, a small minority, 1 in 14 or 7%, will succeed in quitting on their first attempt. 8. Help Others in Achieving Their Dreams Americans are remarkably generous with their time. Over 64 million people volunteered in the last year,
which is more than the population of the U.K. That's a lot of dream help! The odds a man volunteered in 2012 were 1 in 4.3, and the odds a woman volunteered in 2013 were 1 in 3.4. 9. Fall in love The odds an adult believes in love at first sight are 1 in 1.9, over half of us! The odds an adult believes there is any number of people with whom she or he could fall in love are 1 in 4.2. 10. Spend more time with family About 23% (1 in 4.4) of adults spend time helping household members, while about 20% (1 in 5) spend time helping their children. The average time spent per week on each of these activities is two hours. One of our favorite family activities is reading to kids at bedtime. The odds? A wonderful 1 in
The Bottom Line Of the 317 million adults in the US only 1 in 2.2 make a New Year's resolution. Of these 1 in 8 or 17.8 million will keep it for a year. Don't lose hope though. It turns out people who make a New Year's resolution are 10 times more likely to change their lives than those who don't.
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Arrange each of the following anagrams to form a single insurance related word. Keep in mind that the anagram is not a clue. It has nothing to do with insurance related word. Send us your answers to be entered in a drawing to win a fabulous prize! Feel free to call us if you’re stuck.
972.965.2025 Email to: Joe@piatx.org or fax to 972. 307.7888
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the
Last word A software marketer was at the pearly gates, and St. Peter, checking the life record, said: “Well this rarely happens, but you are right on the line… So, you get to choose… Heaven… or Hell… First, he took the software marketer down to hell… there was a wild party going on… loud music, dancing, drinking, etc. Then, he gave the tour of heaven… it was beautiful. True serenity, peace and tranquility everywhere… Back at the pearly gates, he asked: “Well, which will it be? The software marketer thought for a moment… and then said: “Well, there’s certainly nothing not to like about heaven… it’s truly wonderful… But, you know, I’ve been a software marketer for all my career… I’ve led a pretty fast life… and I’m afraid I would miss it. So, I choose Hell. Immediately, the software marketer was transported to a room where all manner of unpleasant torture was taking place… walking on hot coals... roasting over a flame... lashings and floggings… Yelling back up to St. Peter, he said: “Wait… Where’s the dancing... and the drinking... and the loud music?
“Oh,” said St. Peter, “That was just a demo.”
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