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Home » E&O Claim Scenarios » Page 2

E&O Claim Scenario: Umbrella Claim

Posted April 19, 2016 by Jason Cross Leave a Comment

Facts An agent had been servicing a client’s personal insurance account for many years, which included an auto, a homeowner’s and an umbrella policy. The client terminated the auto policy as he was able to procure auto insurance from another carrier for less premium. The umbrella and homeowner’s insurance policies remained in force. As a result of the termination of the auto policy, the umbrella policy only applied in the event of a claim under the homeowner’s policy. Umbrella Policy Coverage … [Read more...]

Filed Under: E&O Claim Scenarios

E&O Claim Scenario: To Borrow or Not To Borrow

Posted February 8, 2016 by Jason Cross Leave a Comment

Facts Mr. and Mrs. Smith are high net worth individuals. Much of their wealth, however, is in real estate. A few years ago, they met with an Insurance Agent who identified a life insurance need. Based on their situation, the Agent concluded that the Smiths could use $5 million in life insurance coverage. The Agent recommended a whole life policy that earns dividends and builds cash values. Based on their age and health, the annual premium for such a policy was $175,000. The Smiths did not … [Read more...]

Filed Under: E&O Claim Scenarios

E&O Claim Scenario: Know What You Are Selling

Posted December 15, 2015 by Jason Cross Leave a Comment

The Massachusetts Supreme Judicial Court recently issued a decision affirming the potential liability of an insurance agent and insurance company for oral misrepresentations made by the agent. In that case, the plaintiff alleged, and the trial court found, that the insurance agent had misstated the benefits provided by a life insurance policy; assuring the plaintiff that the policy provided a $500,000 death benefit when, in fact, it provided only $200,000. Despite the existence of policy … [Read more...]

Filed Under: E&O Claim Scenarios

E&O Claim Scenario: If It’s Not Documented, It Didn’t Happen!

Posted October 28, 2015 by Jason Cross

The Agent sold Dr. and Mrs. Jones two 20-year term policies in 2000, each having a $5 million death benefit. Dr. and Mrs. Jones are high wealth clients with many insurance and investment products in their portfolio. The monthly premiums for these particular policies were $300/month for Dr. Jones and $250/month for Mrs. Jones. Their policies were set up to pay the premiums through automatic monthly bank account deductions. The Update To The Policies In 2010, the Joneses wished to replace … [Read more...]

Filed Under: E&O Claim Scenarios

E&O Claim Scenario: “Imperfect File Administration?”

Posted September 2, 2015 by Jason Cross 1 Comment

Sharpen Your Skills With Our E&O Claim Scenarios We believe that insurance professional can improve the service that the client receives by sharpening their professional skills by looking over case studies and scenarios that have lead to E&O claims. Application Submitted to Two Carriers A client came to an agent seeking life insurance. The application was submitted to two carriers, Carrier A and Carrier B. An application was completed which denied the existence of a pre-existing … [Read more...]

Filed Under: E&O Claim Scenarios

E&O Claim Scenario: “More Than Just A Sale”

Posted August 6, 2015 by Jason Cross Leave a Comment

Improving Your Professional Skills We believe that an insurance professional can improve the service that the client receives by sharpening their professional skills by looking over case studies and scenarios that have lead to E&O claims. An Errors and Omissions Case Study: The Facts Sally was a 50-year-old who had worked for a large national transportation company for 20 years. At the time of the transaction in question, her annual salary was $60,000. Technological advancements plus … [Read more...]

Filed Under: E&O Claim Scenarios

Claim Scenario: “Boilerplate Language Not Always Best Defense”

Posted June 30, 2015 by Jason Cross Leave a Comment

Sharpen Your Skills With Our E&O Claim Scenarios We believe that insurance professional can improve the service that the client receives by sharpening their professional skills by looking over case studies and scenarios that have lead to E&O claims. This is part of our series for Life and Health Insurance Agents that looks in depth at E and O insurance claim scenarios. An Errors and Omissions Case Study: The Facts Dr. Johnson came to the Agent’s office to discuss his disability … [Read more...]

Filed Under: E & O Insurance, E&O Claim Scenarios

E&O Claim Scenario: “Something Old, Something New”

Posted May 26, 2015 by Jason Cross Leave a Comment

We think that every industry can help improve the service that the client receives by sharpening the skills of the professionals who do the work on a daily basis. This is part of our series for Life and Health Insurance Agents that looks in depth at E and O insurance claim scenarios.   Keep your skills sharp and review our previous E&O insurance studies: “The Vanishing Premium;”  “Do What You Know and Know What You Do," and "Customer Service: The Devil's In the Details." An … [Read more...]

Filed Under: E & O Insurance, E&O Claim Scenarios

E&O Claim Scenario “Customer Service – The Devil’s in the Details”

Posted April 1, 2015 by Jason Cross Leave a Comment

We think that every industry can help improve the service that the client receives by sharpening the skills of the professionals who do the work on a daily basis. This is part of our series for Life and Health Insurance Agents that looks in depth at E and O claim scenarios. (Review our previous E&O insurance studies: "The Vanishing Premium" and "Do What You Know and Know What You Do".) An Errors and Omissions Case Study Susan, a 60-year-old client with a history of medical problems, … [Read more...]

Filed Under: E & O Insurance, E&O Claim Scenarios

Claim Scenario “Do What You Know and Know What You Do”

Posted March 12, 2015 by Jason Cross Leave a Comment

Learning More About E&O Insurance Through Claim Scenarios We think that every industry can help improve the service that the client receives by sharpening the skills of the professionals who do the work on a daily basis. This is the second article in a series for Life and Health Insurance Agents, the first one was for the "Vanishing Premium". This series will look in depth at Errors and Omissions claim scenarios so you can sharpen your insurance claim handling skills. Training … [Read more...]

Filed Under: E & O Insurance, E&O Claim Scenarios

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