Cobine Carmelson

What is the dirty little secret of Insurance? part II

Jason — Thu, 12 Apr 2012 15:19:15 +0000

I’ve previously posted how your legal expenses cover probably allows you to take action against anyone except your insurance company. The second in this series moves us all towards the sticky wicket of Health & Safety. This week I write about why legislation is a prerequisite to getting claims paid, why insurer’s don’t make it clear that this is part of the insurance contract and how it is kept a secret.

Read Insurance’s dirty little secret – part I

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Why do insurers do this?

They are businesses. The fewer claims they pay the more their shareholders receive. However, they also need to attract customers, and cynically hiding the worst parts of their products and service allows them to do so. They make the cover out to be wide (using terms like comprehensive or all risks) yet the exclusions seem little (fine print).

They will decline the claim of one company on the same day as they accept the proposal of another (almost) identical company. Both companies will have similar risks yet insurance companies know MDs and FDs would not buy from them if there weren’t going to get a ROI. So they “sell” the benefits and make sure they have room to wriggle in their policy documents. You might only see the detail after you have parted with your premium.

Why is it dirty?

Legislation changes all the time and it’s difficult to keep up with it. Insurers know that businesses struggle, so they provide practical help to the top tier of their clients or those that are extremely high risk. That’s because losses suffered by some businesses are huge and it’s incredibly bad PR for an insurer to decline a ‘front page’ claim.

Brokers know this too. In a world where every premium increased every year most brokers would be happy. I meet lots of business people who are unaware of important terms and conditions. When a claim is refused or reduced the broker often blames the insurer. Sometimes they charge a client more to move to a different insurance company.

How is it kept secret?

The clause that catches most people out is in nearly every policy. It doesn’t even mention Health & Safety – it’s that ambiguous. It’s not even highlighted in the ‘key facts’ documents that the FSA insist make insurance buying clearer.

I know FDs that have checked insurance for years and never understood what this clause really meant. In black and white; if you are not following every piece of legislation current today you may find that a loss that happens tomorrow is not insured. And if they do pay it you might find your premium increases without a satisfactory explanation.

Wrap up: Are you keeping up with legislation? Insurers expect you to do your bit before they do theirs. An insurance policy isn’t a guarantee. Insurers are obliged to pay out when terms ad conditions of the policy (insurance contract) have been met.

See our top tips section for simple ways to help yourself today.

Business owner deflated by sinister claims tactics – part II

Jason — Tue, 27 Mar 2012 06:33:46 +0000

This is the second part of a two part blog about another dirty little secret of insurance. The attempted application of this one even shocked me, and I’ve had 21 years experience of exposing their secrets. You can read part one here.

Read on to find out how this scenario unfolded, how the secret affects both businesses and families, and what you can do to avoid being kept in the dark.

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Bicycle Theft Leads To Flat Service – Part 2

Having carefully selected the appropriate policy for a client whose family relied heavily on their bikes, it was a big headache when an excessive deduction was presented by the insurer, when our client’s bikes were stolen. This large deduction was not in the policy wording, which is of course a contract between insurer and their policyholder. Rather been dealing with the claim validators, we went straight to the management of the insurance company claims department. We know where they hide (whoops, I mean hang out!).

The claims department agreed that the deduction was not in the policy wording and fair wear and tear would be 20 percent. New bikes were ordered and a long argument avoided

The bicycle suppliers were instructed to send the new bikes directly to the client who was happy that he didn’t have to fork out an unreasonable amount to put himself back to where he was before the theft occurred.

Making sure that people are not financially affected by the unexpected is the main priority for us. Keeping inconvenience to a minimum is an important part of our service.

Deductions are plain wrong as they mean claimants do not get the return they were promised when they were prudent and invested in insurance. Avoiding reduced settlements is not easy, as it seems that staff in insurance claims departments are trained to make claimants feel uneasy.

Cynics might say that insurance companies purposely make it uncomfortable for people trying to get their valid claims settled. By making them stick to the letter of their own contract these hurdles can be overcome.

An amicable discussion about fact and contract is the way forward.

I personally have 20+ years of experience in dealing with claims department and actually help them stick to their procedures whilst getting claims settled. I also agree with the use of new technology, including lie detecting to sniff out fraudulent claims. If you have nothing to hide, it’s fine.

Wrap up: Thousands of business owners are still waiting for their damage and lost profit claims to be settled following the London riots last year. It is prudent to assess if there are risks to your way of working because of the actions of others.

Top Tip: If you have already been given a bike by your employer or company under the bike to work scheme make sure adequate cover is in place. When it comes to finding a replacement the bike should have been insured by the company or the rider. If a road accident is caused by a cyclist’s wobble who pays for the resultant damage and injuries?

Who to share this with: Business owners or bicycle users.

Business owner deflated by sinister claims tactics – part 1

Jason — Fri, 09 Mar 2012 09:01:07 +0000

This blog is about another dirty little secret of insurance. The attempted application of this one even shocked me, and I’ve had 21 years experience of exposing their secrets.

Read on to find out how this scenario unfolded, how the secret affects both businesses and families, and what you can do to avoid being kept in the dark.

Bicycle Theft Leads To Flat Service – Part 1

We often protect the personal assets and reputation of clients who have already instructed us to look after the very same for their business.

One such client contacted me just before Christmas after bicycles were stolen from his property, even though they were securely chained and anchored to cement.

A determined thief will get past any security. I recently shared a photo on twitter of a smashed jewellers window on Oxford Street when a Christmas shopper had helped themselves to a 100% discount.

In this case I knew that cover was in place for the bicycles because we had specifically addressed this requirement, as well as other specifics, before the cover was arranged.

Why don’t insurance companies want to deal with claims?

A lot of insurance company’s outsource their claims. It’s supposed to save them money. Their PR people say it makes them accessible for clients. In my experience it causes delays, and outsourced companies reduce settlements because they think it’s what the insurer wants them do. We deal with all these people on behalf of our clients because the service is so poor it would frighten the most legitimate claimant.

I knew this client used his bike to get to and from work which gave him a degree of flexibility and helped maintain fitness. The other bikes were used by his wife and children and an extended lack of such an amenity is not good for any family.

Cutting losses is fine, yet not when it breaches a contract

The first sign of trouble was when the insurance company used two separate companies to validate the claim. They argued over who was responsible for contacting the client. We were able to jump straight on this, and a series of daily chasers was placed in the diary to ensure the situation was managed effectively.

After daily chasing, the claim companies advised that they were going to reduce the settlement by 80% because they were entitled to make a deduction for wear and tear. So much for the “new for old” cover the insurance company promoted in their literature! They have hundreds of similar lines of small print to clarify the “cover” they describe in their sales spiel. An 80% deductions is outrageous and supports the myth that insurance companies avoid paying out. Which is not 100% true.

Sign up to our RSS feed or return here to find part two of this blog later this month and find out how we got this ended up.

Top Tip: Businesses are taking advantage of “bike to work” schemes because it is a tax efficient way to keep employees healthy. However, who owns the bikes? It’s a grey area. Having a healthy workforce reduces absenteeism, disciplinary procedures and subsequent increased costs of recruitment and training. Yet ownership of the assets can cause complications when an accident happens. Who is responsible if they were at work or on their way to work?

Wrap Up: Keep in mind that public transport in London is going to be problematic during the Olympics so you might want to “mobilise” your workforce as a way of maintaining business continuity throughout the games. Contact me if you would like details of excellent schemes.

Who to share this with: Business owners that are bicycle users.

What is the dirty little secret of Insurance?

Jason — Tue, 01 Nov 2011 09:00:00 +0000

There are hidden clauses that loom large in policy documents and some are more sinister than others. Here I explain what the secret is, why it is dirty and how it’s still a secret.

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What is insurance companies dirty little secret?

The insurance market has a reputation of escaping from legal contracts using small print.

When businesses have a dispute they often seek legal recourse. The complainant will sometimes have insurance to cover such disputes. They ask their insurer to cover the cost of taking action yet policies prevent insurance buyers from taking action against insurance companies. Not much help if an insurance company has refused to honour the policy they issued.

Insurers do not make this clear. It’s difficult enough when commercial disputes arise, it’s galling to find that you have been given a false impression by the people you had invested in. Insurers paying claims want to reduce the most obvious or exclude them. It’s unfair when the exclusion prevents you taking action against a supplier that has obviously got something wrong – as is often the case when claims are badly handled. But for insurance companies to close ranks in this manner, that’s pretty low. Whatever their reasons.

Why it is dirty?

Because it’s industry wide, it’s tantamount to a cartel. Have all insurers secretly agreed that they will support claims against any industry except their own? If not, why hasn’t an entrepreneurial insurer stuck their head above the parapet and issued a policy that covers taking such an action?

Insurance disputes are common and it’s not always the broker that makes a mistake. Insurers are often culpable yet it costs almost £20,000 to take action against them. That is bad for UK business. Of course, it could be down to the fact that the insurance actuaries have worked out that insurers nearly always win cases. I suspect this is because complainants often run out of money to fund their legal case. If I’m right the figures will always be skewed.

Why it’s a secret?

I doubt if insurance companies place this exclusion at the back of their policies by accident. It’s not front and centre as you would expect such a sweeping exclusion to be.

There are other secrets in policies that are difficult to unearth and comprehend. Yet the dirty little secret of not allowing your client’s to take action against your competition is the most sinister show stopper.

Wrap up: Insurance companies do not pay claims when the insurance contract between them and their policyholder has been breached. If they refuse to pay a seemingly valid claim policyholders need to dig deep to ensure they get what is due to them.

Top Tip: Spend time assessing the key risk to your business and make sure you understand your insurance policies which are legally binding contracts. Make sure that important contracts and agreements are not excluded from your policies.

Don’t forget, if you want to reduce risks to assets, income and reputation sign up to our RSS or email feed to the top right of this page to receive insurance tips, new posts plus details of events and promotions that could help you or your network reduce the risks facing them or their organisation.

See our top tips section for simple ways to help yourself today.

Accountants insurance is changing

Jason Cobine, Insurance Expert — Tue, 31 Aug 2010 05:00:43 +0000

Accountants indemnity changes 1st September

I thought you might be interested to hear about the new rules for accountant’s professional indemnity. Here I explain why it’s important to make an early report of claim circumstances, where problems with timing could occur plus a clear definition of what should be reported.

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Why should I report a minor concern?

Some policyholders believe that premiums go up if they report scenarios that are not really claims. If they don’t report a “circumstance” it proves to be a false economy. When the rules change it’s even easier to make a costly late notification.

Claims don’t happen often yet the early warning signs are common. Questioning fees, complaints about service and a lack of communication are typical indicators that a client or third party may become litigious. Especially if they don’t get their own way.

Have the new ICAEW rules made it clearer?

The new wording applies to cover effected on or after 1^st September 2010 and makes it clear that claims can and will be declined if “circumstances” are not reported before the expiry of a policy. The intention is to ensure that insurance companies are aware of possible claims before the policy expires.

There is no longer a wishy washy wording – previously insurers refused claims notified later than they would like. This was despite the policy being on a “claims made” basis meaning claims made after the expiry would be covered if the work was completed during the period of cover. The terms of notification were not clear.

Now, possible claim circumstances not reported within the policy period will not be covered. Period.

What is a circumstance?

Definitions in policy wordings can be subtly altered without the policyholder noticing. Insurance contracts are full of detail. A “circumstance” is anything likely to affect the underwriters view of the risk. That doesn’t mean all complaints should be reported.

It’s ridiculous to report all complaints so ask your insurance supplier to interpret what is termed reasonable by your insurance company. There is no need for the new rule to result in more red tape. The fact that I’m writing about it means it probably will at the change is embedded into the policy wordings. That is not the intention, it’s just the devil is in the policy detail. We all want claims settled promptly and correctly.

Wrap up: Attempts to make policies clearer add to confusion. Indemnity policies have strict timescales for reporting claims or circumstances. Guidance on what a circumstance is should be sought before a policy expires, ie. before the renewal date.

Top Tip: Uncertainty is not good for anyone. Ask your insurance supplier for clarification of expiry dates, notification deadlines and clarify what “circumstances” are real in your World.

Solicitors frustrated by broker tactics

Jason Cobine, Insurance Expert — Mon, 23 Aug 2010 07:00:06 +0000

Now silly season is upon us, I thought I would update you on what is actually happening in the solicitor’s indemnity market. I know quite a few solicitors and I understand their frustrations. Rather than wax lyrical, I’m going to stick to the good, the bad and the ugly in the current market.

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The good

There are a lot of hard working brokers out there who are satisfied that they have strong enough relationships with their clients and are not using “hard ball” tactics to scare their clients into renewal. You probably have one of those on your side and your terms and conditions will be reasonable.

Ensure you provide full and detailed information when requesting your renewal terms.

The bad

There are two realities to explain. A solicitor received his form, returned it and was given terms within 48 hours. He was also given 7 days (make that 5) to make his mind up. That’s not even legal.

Another practice (with the same supplier) has incorrect “claims” on the practice’s record and the supplier is refusing to correct them. Naturally, they are worried that the terms will be provided late and prove onerous.

The ugly

Some practices (mainly SP’s) have been refused terms by their current insurer already and are filling out forms (more in desperation than hope) whilst considering their future if they cannot find cover. Their supplier should have helped them with the complicated forms.

The reason for declinature is not being made clear or doesn’t add up. One broker refused to tell their client which insurance companies they had approached. That is not service as it leaves the policyholder with no real options.

Wrap up: Some suppliers are great at maintaining relationships and have secured excellent terms. Others are playing hard ball when they do provide terms, taking advantage of the fact that the competition need time to offer an alternative. Some are being obstructive or abandoning clients they cannot easily help.

Top Tip: If an application is declined request a detailed reason before applying elsewhere.