Life insurance not an antiquated idea

Life insurance is as important today for the modern family as it was years ago for the more traditional family. Yet life insurance is among the last things that people buy.

There are so many different types of insurance that the average person is confused as to which type of policy to buy and just how much is needed.

There are lots of formulas for computing the amount necessary. A good starting point is to take 10 years of income and subtract whatever savings are available for the family to live on. Again, this is just a starting point. Other concerns that need to be considered when determining the amount or face value of the policy are educational needs for the children, whether it is for college, vocational or trade school, or perhaps just to supply the funds necessary above and beyond the norm for things like piano lessons, band expenses or dance classes.

The choice as to the type of insurance can also be a confusing issue, but it all comes down to one "rule." Buy as much insurance as you can possibly afford. Since term insurance is the least expensive, the bulk of a family's insurance needs could be supplied by a good, level-premium term policy. Term insurance should be obtained from a quality insurance company, one with a good history of being around through good times and bad.

Look for established companies that have a good reputation and solid principles. Level-premium term policies have a fixed premium for a specific period of time — 10, 20 or 30 years. Thereafter, the policy becomes a yearly renewable term policy with annually increasing premiums. It is important to note, that within a few years of the end of the "level term" period the premiums will become quite expensive and usually the insured can no longer keep paying the premiums. It is expected that by that point in time, the family has been able to save significant sums through alternative savings programs — retirement accounts, mutual funds, or personally owned stocks and bonds. It is also expected that the needs for cash at that point in time can be supplied by the above mentioned savings accounts and the insurance is not as important — the children are grown and the house is paid off.

Some consumers losing life insurance coverage

By Pete Miller
October 28th, 2010

The current economic downturn may be causing consumers to drop their life insurance coverage, according to recent reports.

The Trends in Life Insurance Ownership study, conducted every six years by LIMRA, found only 44 percent of U.S. households reported having individual life insurance in August.

Today, 30 percent of households – 35 million – have no life insurance coverage, compared with 22 percent of households in 2004. Among households with children under 18, which arguably have the greatest need for life insurance, 11 million have no coverage.

Unlike home insurance and auto insurance, life insurance is not a legal requirement, one reason analysts say many consumers seem to be going without life insurance coverage.

"The need for life insurance is now more than ever before," says Byron Udell, founder and CEO of AccuQuote. "Especially if you have a family to support financially."

Reinstating coverage after defaulting on life insurance payments can also be difficult, as it is not often allowed by insurers. Of the companies that will allow a consumer to resume coverage, most require the insured to pay back the total sum of the missed premiums.

Can Diabetes affect Your Life Insurance?

Thursday, October 28, 2010
Oliver Pereira

Diabetes is a complicated disease and a serious lifelong condition and is a leading cause of blindness, heart disease and kidney disease. Providing fair and reasonable underwriting terms for people with diabetes can be tricky at the best of times and because of this, it can affect your chances to get life insurance.

Type 2 diabetes is by far the most common form of diabetes In New Zealand about 270,000 people have Type 2 diabetes and about one third of cases of Type 2 diabetes are undiagnosed. The numbers of people developing Type 2 diabetes is rapidly increasing. In some groups of people up to 12% of them will have Type 2 diabetes once they are aged over 40 years.

Type 2 diabetes most often occurs in adulthood usually after the ages of 30 – 40 years. In Type 2 diabetes, either the body doesn’t produce enough insulin, or the cells in the body don’t recognise the insulin that is present. The end result is the same: high levels of glucose in your blood.

Of all the people with diabetes about 10% of them have Type 1 diabetes. In New Zealand about 15,000 people have Type 1 diabetes. Type 1 diabetes most often occurs in childhood, often in children aged 7 – 12 years. However it can occur at any age – from tiny babies to very old people. Most people with Type 1 are producing none of their own insulin.

Because life insurance polices are allowed to charge your premium based upon your health status, getting a good policy can be extremely pricey or not even an option. Having diabetes puts you in an impaired risk category that will often make insurance companies asses this risk very seriously before offering you a policy.

Despite all this, though, there is hope in finding an affordable life insurance policy for yourself or for a loved one. There are many things you can do to make yourself more attractive to the insurance companies. One thing you can do is present yourself as a good risk. As diabetes is often a self-managed disease, you can make sure that you have good habits. This combined with a good blood glucose control and a healthy lifestyle can make you a more attractive candidate to insurers. Similarly, you will want to find an Insurance company that does what is called "clinical underwriting." While the insurance companies usually ask for medical information from the client’s doctor, any additional lifestyle information always helps in the underwriting process. In this process, as they access the risk of selling you a policy, they will consider your overall health and habits.

As with any insurance search, it pays to be persistent; don't take no for an answer and if one Insurance company turns you down, simply approach another one! Take referrals from friends and family and do your best not to be discouraged. Persistence and determination will pay off and remember that even with diabetes, you will be able to find good life insurance. Insurance companies with experience in impaired risk situations will be more likely to help you than ones without; keep in mind that there are many, many people in your particular situation and that affordable life insurance policy are quite possible.

One thing to remember is that the help of a good insurance agent in invaluable in your search for insurance. A good agent will be able to bring your case to the attention of the policy providers who will most likely be able to help you out and can greatly expedite the process. A good agent will also be able to get your case out to a number of places at once; life insurance is something that should not be delayed, and a refusal can take up a few weeks to process.

Even if you or someone in your family has issues with diabetes, this does not mean that life insurance will be impossibility for you. Having Life Insurance is not a luxury and provides security to your family and lifestyle.

Testimonial!

"BPC Corporation is a multibank holding company with the Bank of Putnam County being family owned for 109 years. Scott’s professional expertise has been a valuable addition to our organization. His knowledge and ability to explain the coverage in a “common sense” approach has enhanced our understanding of the insurance we currently have and identified additional areas of coverage available. Scott has always been very responsive, objective, and unbiased in his answer of various questions. We look forward to a long term working relationship."





Gary Medley, CFO

BPC Corporation

Cookeville, TN

Employee Theft

Morey Stettner does a nice job overviewing the issues of employee theft and employee dishonesty in his article at www.chiefexecutive.net

Tort Defendant Not Permitted to Call Evidence from Plaintiff's Accident Benefits Assessors

Beasley and Scott v. Barrand, 2010 ONSC 2095 (S.C.J.)

This case involves the interpretation of the new requirements for experts pursuant to Rule 53.

The tort defendants in this trial sought to call evidence from three doctors who had assessed the plaintiff on behalf of his accident benefits carrier. The defendants made efforts to have the doctors brought into compliance with the new Rule 53.03 by having them sign an Acknowledgement of Expert’s Duty.

Justice Moore refused to allow the doctors to testify given that they could not comply with Rule 53.03. They were retained by an insurer that was not before the court, were not treating physicians and their instructions were not clear from the evidence. Justice Moore Held:

I am not to be heard to state that experts retained by accident benefits insurers cannot give opinion evidence in a tort action; rather, I say that such experts should first comply with Rule 53.03. I say “should” for there may be cases where that is not possible and then the court may consider relieving against non-compliance to ensure a fair adjudication of the issues upon their merits but this is not one of those cases.

This case places great constraints on the ability of the defence to call evidence with respect to the plaintiff’s injuries. It imposes a high hurdle for the defendants in order to call evidence relevant to the plaintiff’s injuries. Perhaps the accident benefits assessors could be called as fact witnesses which would mean r. 53.03 would not apply. It appears that this would be an area that would benefit from appellant intervention.

It Will Never Happen To Your Business

Every 5 minutes a business in the US has a fire. 300 each day. Some are little fires. Some are devastating fires.



Thousands of businesses are impacted by windstorms, water damage, lightning strikes, floods, and vandalism every year. Let's say 100 each day.



That is one business hit by catastrophe every 3.5 minutes, every day, all year long. That's almost 150,000 businesses every year.



Then there are the lawsuits. The US Department of Justice estimates that there were about 27,000 civil trials in state courts in 2005. US district courts see about 49,000 trials each year. That's 76,000 civil trials in the US. Let's assume that half of them are against a business. We are talking about 38,000 lawsuits.



In all, 188,000 businesses face catastrophe each year. That's more than 500 business catastrophes every single day.



Now, how about that business insurance review?

Before hiring a lawyer...

The GlobeandMail.com has an interesting article entitled Before hiring a lawyer, be sure to do your homework, by Tony Wilson.
You can read it at http://www.theglobeandmail.com/report-on-business/your-business/start/tony-wilson/before-hiring-a-lawyer-be-sure-to-do-your-homework/article1771820/

First Circuit holds that company is entitled to coverage for claim against its directors and officers for unfair stock redistribution

About a year ago I wrote several posts about Genzyme Corp. v. Fed. Ins. Co., 657 F.Supp.2d 282 (D. Mass. 2009) , a case concerning coverage for settlement of a shareholder claim for unfair stock redistribution. Judge Gertner of the U.S. District Court held that there was no coverage.

In Genzyme Corp. v. Fed. Ins. Co., __ F.3d __, 2010 WL 3991739, the First Circuit has reversed in part, and remanded. It disagreed with Judge Gertner's conclusion that coverage for the loss is barred as a matter of public policy. It also held that while the policy's "Bump-Up" clause does not cover the amount paid by the corporation to settle the claims against it, the policy does cover any settlement amounts paid under an indemnification obligation with respect to the directors and officers. Because a portion of the claim may have been paid to settle claims against directors and officers, the First Circuit remanded the case to the District Court to consider the question of allocation.

Statistics from our consumer advocacy hotline...

We received nearly 13,000 calls last month to our free hotline for Washington residents with problems or questions involving insurance. Along the way, we helped consumers recover $776,937 in delayed/denied claims and similar problems.

We have experts in a wide variety of insurance matters, and we can often help resolve difficulties getting claims paid, help you find health coverage, etc.

We're not an insurer, agent or broker. We're the state agency that regulates the insurance industry in Washington state. We tend to get between 11,000 and 15,000 calls a month.

Got a problem or question? Give us a call: 1-800-562-6900 or e-mail us at AskMike@oic.wa.gov.

Storm headed for western WA, rain and high winds Saturday night and Sunday

The National Weather Service has issued a "special weather statement" for much of western Washington late this weekend. From it:

A potent storm will slam into the region Saturday night and Sunday, resulting in locally heavy rain and strong winds, especially on the coast. Another blast of strong winds impacting a larger part of the area is possible on Monday.

If you experience damage and have insurance questions, try our winter weather information, which covers common insurance questions about everything from sinking boats to fallen trees to power outages.

Washington residents with insurance questions or problems can also call our consumer advocacy staff at 1-800-562-6900. We'll try to help.

Why Get An Insurance Review?

I was asked the other day why an unbiased insurance review was important.



I replied, "How would a $100,000 uninsured loss look on your financial statements?"

Cease and desist order issued against Choice Home Warranty

Washington State Insurance Commissioner Mike Kreidler today issued a cease and desist order against CHW Group, Inc., doing business as Choice Home Warranty and http://www.choicehomewarranty.com/.

The company is believed to have sold at least 92 home warranty service contracts to Washington residents. The contracts cover repair or replacement on major systems and appliances in the person's home, and promise that Choice Home Warrant will pay for repair or replacement of those that fail.

The problem: the company isn't authorized to transact insurance in Washington state. Nor is it registered here as a service contract provider.

Kreidler ordered the company to mail a copy of the order to all Washington home warranty service contract customers. The company must also report to the state how much it's collected in premiums from Washington consumers.

The company has the right to demand a hearing. The order takes effect today.

We'll post a link to the order shortly.

Updated: As promised, here's the link.

Work Comp Insurance Rate Rankings By State

Each year Oregon surveys the workers' compensation insurance rates of the states and ranks them.



This year's ranking just came out.

Help For Bankers Who Buy Insurance For Their Banks

Here is the point I make with bank clients that seems to help the most with understanding bank insurance issues:



For insurance coverage of theft and fraud, look to your bond. Employee theft, robbery, ATM theft, computer hackers...



For coverage for allegations of negligence, go to your directors and officers, general liability, auto liability, e-banking liability, and umbrella.

The Supreme Court of Canada on a Duty to Defend - part 3

Justice Rothstein, for the Supreme Court of Canada in Progressive Homes Ltd. v. Lombard General Insurance Company of Canada, 2010 S.C.C. 33., helpfully affirmed that CGL insurance policies are most typically written in three sections, being (i) coverage, (ii) exclusions and (iii) exceptions to the exclusions.

Within the first section, the onus is on the insured to show that the pleadings fall within the initial grant of coverage.

The next section, exclusions, should be read in light of the initial grant of coverage and do not create coverage in themselves. Exclusions only preclude coverage when the claim otherwise falls within the initial grant of coverage.

The third section, exceptions to exclusions, also do not create coverage but bring an otherwise excluded claim back within coverage where the claim fell within the initial grant of coverage in the first place.
Justice Rothstein concludes that the pleadings reveal a possibility of “property damage” and also sufficiently allege an “accident” such that the claim in the pleadings falls within the initial grant of coverage provided by the policy. The insurer, Lombard, then argued that the “work performed” exclusion precludes coverage. Lombard argued that there was no “subcontractor exception” to the exception and therefore work performed by subcontractors was also excluded. However, Justice Rothstein concluded that the exclusion did not clearly exclude subcontractors’ work and that there is a possibility of coverage so that the duty to defend is triggered.

This decision helpfully sets out the law in this complex area in a clear and succinct way. Hopefully this will help eliminate some of the confusion.

Work Comp Hints and Tips

I was recently interviewed by the trade magazine, Hardwood Floors on workers compensation issues.



Get the article here.



Snippet:



“Many business owners aim for an x-mod of 1.0, a figure which indicates your claims are no higher

or lower than the average,” Simmonds says. “To me, though, that’s like getting a ‘C’ grade in school.”

Monthly Insurance Column for Credit Union Insurance Buyers

www.CUManagement.org posted the first of my monthly columns on credit union insurance issues - Insurance Matters.



Third Thursday of ever month I'll post a different credit union insurance piece. Comments and questions welcome.



This Month's Topic: Employment practices liability insurance tips and traps

We Get Letters... Non-Profit Liability Insurance

The Email:



Scott,



I am the volunteer executive director of the xxxx Football Boosters, a non-profit group that raises funds for the xxxx High School Football team in a part of Los Angeles.



We have a grant pending. They've requested proof of liability insurance. We don't have it. We'd like to get it. You were recommended through Guide Star as the expert.



Your quotes or recommendations would be appreciated.



Thanks!

David





My Reply:



I'm glad you contacted me.



I don't sell insurance but can point you.



First, check with the school to see if you are a part of the school and therefore covered by the school's insurance.



Short of that...



Find an insurance agent who is involved in your group. If not direct involvement, find an agent who works with a business owner who is engaged in the group.



The idea is for an agent to want to do more than just sell you a small policy.



I hope this helps.





Scott Simmonds, CPCU, ARM, CMC

Insurance Assurance Consulting

U.S. District court holds that Automatic Extended Reporting Period requires that claims be reported but not made during extended period

NEET is a small environmental consulting business. It purchased from American Safety consecutive claims-made policies, with the policy periods ending on March 2 of each year.

A claims-made policy provides coverage if a claim is made and reported during the policy period, regardless of when the loss occurred. That's in contrast to the more usual occurrence-based policy, which provides coverage if the loss occurred during the policy period, regardless of when the claim was made.

The policies contained an Automatic Extended Reporting Period which provided that they will cover a claim made and reported to American Safety within 30 days of the end of the policy period, but only if no other similar insurance is in force during that time.

In February, 2008, NEET received a demand that it pay for remediation of an oil spill caused by heating oil tanks NEET allegedly installed improperly. NEET forwarded the demand detter to its insurance agent on March 6, 2008.

In a motion for summary judgment American Safety argued that for the Extended Reporting Period to apply the claim had to be both made and reported to the insurer during the 30 days after the policy expired. In New England Environmental Tech. v. Am. Safety Risk Retention, __ F. Supp. __, 2010 3622250 (D. Mass.) the court disagreed, holding that the policy could reasonably be construed to require only that the claim be reported to the insurer within 30 days after the policy expired. It also held that denying coverage to claims reported within the 30 day period would not assist the goal of claims-made policies of setting future premiums.

American Safety then argued there was no coverage because NEET had "other similar coverage" (the next consecutive American Safety policy) in effect for the policy period beginning on March 3, 2008. In somewhat convoluted logic the court held that the consecutive policy was not "other similar coverage." The heart of its decision is that failure to provide coverage because a consecutive policy was in place "is counterintuitive to a reasonable insured."

The court granted summary judgment to American Safety on NEET's 93A and 176D claims, on the grounds that American Safety's interpretation of the policy was plausible and there was no evidence it had acted in bad faith.

Steps To Cut Business Insurance Outlays

Several weeks ago I was tracked down by Morey Stettner, a writer for Investors Business Daily. We talked about business insurance and policy renewal strategies.



See the full article here.

Which insurers sell individual insurance plans in Washington?

• Asuris Northwest Health
• Group Health Cooperative
• Group Health Options
• Kaiser Foundation Health Plan of the Northwest
• KPS Health Plans
• Lifewise Health Plan of Washington
• Premera BlueCross Individual Plans
• Regence BlueCross BlueShield of Oregon
• Regence BlueShield
• Time Insurance Company

 

To see who's selling coverage in your county, click here.

 

And to look at their rates, click here.

Kreidler orders Regence to cover children

Washington State Insurance Commissioner Mike Kreidler this morning ordered Regence BlueShield this morning to stop illegally denying insurance to children, effective immediately.

“Regence is in clear violation of state law that prohibits insurers from denying insurance to people on the basis of age,” said Kreidler. “I was shocked and deeply disappointed when Regence announced its decision last week to stop selling insurance to kids.”


The Affordable Care Act requires all health plans to cover kids with pre-existing conditions. However, to accommodate the insurance industry’s concerns that people would only enroll their children when they became sick, the federal government let states create a special open enrollment period.

Kreidler issued an emergency rule creating a special enrollment period from Nov. 1-Dec. 15. During this time, anyone looking for an individual health plan for their families or just their children can enroll their kids without having to take a health screen.

But Regence Blue Shield, the largest health insurer in the individual market, notified Kreidler on Sept. 27 that, effective Oct. 1, it would no longer sell individual health insurance policies to kids.

Here's a link to the full press release.

Update: And here's the response from Regence, which says it was shocked and disappointed by the order. From their press release:

It is important to stress that our eligibility changes do not apply to those insured members covered under small or large group policies. We've been very clear that we will insure kids during open enrollment periods when the child is not the sole subscriber -- and we will do so regardless of health status.

The Supreme Court of Canada on a Duty to Defend - part 2

“Leaky condominiums” have become notorious in British Columbia.  In this case, Progressive Homes served as a general contractor and built several housing complexes.  Several actions were initiated against Progressive Homes alleging significant damage to the housing complexes caused by water leaking into each of the buildings.  Progressive Homes sought a defence to these actions from its insurer, Lombard, pursuant to commercial general liability insurance policies. 


The policies require Lombard to defend and indemnify Progressive Homes when Progressive is legally obligated to pay damages because of property damage caused by an occurrence or accident.  Lombard refused to defend the claims and Progressive brought an application for a declaration that Lombard is under a duty to defend.


Justice Rothstein went on to declare that an insurer is required to defend a claim where the facts alleged in the pleadings, if proven to be true, would require the insurer to indemnify the insured to the claim. It is irrelevant whether the allegations in the pleadings can be proven in evidence. What is required is the mere possibility that the claim falls within the insurance policy. In examining the pleadings to determine whether the claim falls within the scope of coverage, the parties to the insurance contract should not be bound by the labels selected by the plaintiff but by the true nature or substance of the claim.

Justice Rothstein, for the Supreme Court of Canada, reiterated some significant principles of insurance policy interpretation, including that when the language of the policy in unambiguous, the court should give effect to the clear language and should read the contract as a whole. Where the language of the insurance policy is ambiguous, courts should prefer interpretations that are consistent with the reasonable expectations of the parties and courts should avoid interpretations that would give rise to an unrealistic result. Where these rules of construction failed to resolve an ambiguity, courts will construe the policy contra proferentem. Subsumed by the contra proferentem rule is that coverage provisions should be interpreted broadly and exclusion clauses narrowly.

Progressive Homes Ltd. v. Lombard General Insurance Company of Canada, 2010 S.C.C. 33.

Testimonial - Nice Words

Note sent to me by a long-time client today...

By the way, I know you don't hear me say it nearly often enough, so I'll seize this moment and opportunity.



You do terrific work and we truly appreciate all that you have done to counsel and assist us over these past years.



The discussions you have helped us have around our insurances has elevated our level of thinking and awareness, and we couldnt have achieved that without you.



You have become a true business partner and I look forward to our continued work together.

Besides all of that, you're a great guy and you're easy to talk to and learn from and spend time with.



So, Thanks for all you bring, and all you do to make us as knowledgeable and savvy and cost-effective and proactive as you do.



Best Regards,

Denise M. Vachon

Executive Director

The Park Danforth

Portland, Maine

Another decision finding wiggle room for attorney's fees in PIP case after insurer tenders payment of medical bills

I wrote here about a recent Appellate Division case, Metro West Med. Assocs. v. Amica Mut. Ins. Co., which held that payment of outstanding PIP bills by an insurer does not necessarily prevent the award of attorney's fees under the PIP statute. Another Appellate Division decision has come to the same conclusion.

Howard Physical Therapy provided medical services to Joel DaSilva for injuries he suffered in a motor vehicle accident. Howard submitted to DaSilva's insurer, Premier, a request for PIP reimbursement of medical expenses. Premier paid some of the bills and refused to pay the remainder, asserting that the balance was unreasonable "upon review by an outside company."

Howard took no further action for more than four years, when it filed suit. Two weeks after Howard filed suit, Premier offered to pay the balance plus costs incurred by Howard in filing and serving the complaint. Howard rejected the offer. Premier then sent Howard a check for only the unpaid bill amounts, and moved for summary judgment. The District Court allowed the motion for summary judgment.

In Howard Physical Therapy, Inc. v. Premier Ins. Co., 2010 WL 3855302 (Mass. App. Div.) the Appellate Division reversed the summary judgment decision. It cited Metro West for the proposition that "the mere payment of the balance, in and of itself, would not justify summary judgment for Premier." Rather, the insurer must show that it had "a valid reason not to pay, and that it paid an invalid claim for reasons unrelated to its merits."

The court noted that although Premier had based its original decision, not to pay the full bill, on a review of the bill by "an outside company," there was no indication that the bill was reviewed by a registered or licensed practitioner in the same field as the practitioner submitting the bills, as required by statute. For that reason the Appellate Division reversed the District Court's summary judgment decision.

The court held, however, that Howard could not amend the complaint to add a count for breach of G.L. c. 93A, where Howard had not sent a demand letter prior to suit and Premier made a reasonable offer of settlement within 30 days after suit was filed.

Scott's Rules of Insurance - Rule 5 - To Get Great Rates You Must Be Attractive To Insurers

Getting good rates, in part, depends on you. Put your best face forward to your insurance company (current and potential). Show them you are a quality risk by having policies and procedures in place to control losses and manage claims.



Ask your agent what issues are worrisome to insurers? Find out what you can do to minimize those concerns.

The Supreme Court of Canada on a Duty to Defend - part 1

Recently, the Supreme Court of Canada held, by unanimous decision, that an insurer will be obligated to defend a claim where the facts alleged in the pleadings, if proven to be true, would require the insurer to indemnify the insured for the claim regardless of whether the allegations in the pleadings can be proven in evidence.  What is required is the mere possibility that a claim falls within the insurance policy.   Progressive Homes Ltd. v. Lombard General Insurance Company of Canada, 2010 S.C.C. 33.

The focus of the policy interpretation should first and foremost be on the language of the policy itself.  Justice Rothstein, for the Supreme Court of Canada, carefully reviewed the terms of the insurance policy.  I think this case helpfully emphasizes and reiterates the principle that the terms of the insurance contract itself must be carefully reviewed.  Not all insurance policies are the same and it is important for an insurer or coverage counsel to carefully review the terms of the policy.  The Supreme Court of Canada has emphasized that the duty to defend must be determined on the terms of the insurance policy.

Creeps Creeping into Your Business

A client just called in the midst of a dilemma.



Ten years ago an employee sexually harassed another employee. He was reprimanded and the harassed employee did not want further action taken. Last year he did it again and was dismissed.



Now he has put out a request that his former employer hire him as a contractor.



Why would you want someone like this working in your business?  Why do you want to be known (even to a small population) as the place that hires the creeps.



Bad behavior has consequences.  Everyone deserves a second chance.  However, how many times do you let the same dog bite you?

The Part of Your Insurance Premium You Control

The insurance underwriter is the person at the insurance company that prices your policy.  As with all humans (mostly) underwriters judge books by their covers.  Underwriters can increase your insurance premium by 25% and they can decrease your premiums by 25%.

The following are important in the underwriter's impression of your business.  Providing information about the positives and curtailing the negatives will get you more competitive premiums and better insurance coverage.

Always put your best foot forward.

Your Housekeeping

Your Management Procedures

Your Claims Management

Your Inspection Results

Looking For Trouble

Strong Leadership

Your Industry Leadership

Your Good Press

Your  Impressive presence

Comprehensive information provided

Undoing Obama Care

Good article by Steve Forbes on pealing back the new health-careless program - http://goo.gl/SSZF

The Ex-CEO

This just submitted as an ad for the upcoming Super Bowl...

Appeals Court addresses exclusion for residential construction work

FSS Automatic Sprinkler Corporation subcontracted with CB Construction Company to install fire protection sprinklers at the Stoneleigh Condominium project. The project converted the former Norfolk County Jail into a building of luxury condominium units. (I find that to be the most interesting thing about this case.)

In April, 2003, a sprinkler pipe leaked and caused water damage. FSS's insurer, Tudor, declined coverage, citing an exclusion for residential construction work.

In FSS Automatic Sprinkler Corp. v. Tudor Ins. Co. 77 Mass. App. Ct. 1122, 2010 WL 3629579 (unpublished), the Massachusetts Appeals Court held that the exclusion was ambiguous and therefore does not exclude coverage.

The decision does not quote the entire exclusion, and its discussion of it is so confusing that I can't figure out what the exclusion actually says. (That appears to be a result of the court's drafting, not the policy's.)

So, I can't provide an analysis. If you're dealing with an exclusion for residential construction work, this case might provide guidance in context.

Flood Zone???

Free service will check if your home or biz is in a flood zone. It will also notify you of changes.



www.FreeFlood.com.



It worked for me. Tell me what you find about your own property. Any surprises?

Ufos seen by evolutionists

UFOs & Evolution The alleged presence of little green men from outer space and the distinguished scientists who espouse molecules to man evolution seem to have nothing at common at first glance. However, for those of you who have watched the movie "expelled: no intelligence allowed" starring Ben stein, the relationship is clear. FamousHarvard evolution apologist Richard Dawkins, actually proposed that the human race was seeded by aliens. This is not the first time UFOs have been identified with evolution. In fact, there is still a giant satellite dish scanning the heavens listening for any pattern of transmission from the cosmos. It is called SETI, which stands for the Search for Extra Terrestrial Intelligence. For years now, scientists have monitored space static looking for anything unusual. Anything remotely resembling a pattern or code gets instant attention. However, nothing but static has ever been heard and no E.T. ever seems to phone us. However, just imagine if late one evening, the following message was received by SETI: "Dear Earthlings, We have been monitoring your planet for years now. We have devised how to speak your language and beam it to you. We live on planet Dawkinopia, billions of light years away. We just wanted you to know you are not alone. Sincerely, Little Green Dawkinians " Pandemonium would ensue! Every news channel would cover it. So-callled experts would comment on what that means to humans on earth, and to our scientific and religious institutions. However, would anyone dare ask if their transmission from space was just random gibberish that just happened to sound like words? That, given billions of years of constant static beaming randomly, eventually something resembling a "message" with a salutation, punctuation, proper spelling, syntax and logical sequencing would just one day occur by accident. No one would do that! Clearly the message is too complicated to have just occurred randomly, regardless of time for unlimited attempts. However, that is what evolution does. It says over billions of years of random mindless attempts, DNA would be coded so that: A horned lizard can shoot blood three feet out it's eyes for defense; A baby kangaroo is the size of a coffee bean at birth and is raised in a pouch; A porcupine has thousands of sharp quills while a peacock unfolds a gorgeous display of delicate feathers; A camel can go weeks in the desert without water; A sea cucumber discharges it's insides to protect itself and then grows a new stomach; A bombardier beetle has two chemicals that mix just right to blow out burning chemicals for defense; And a human laughs, cries, writes and can appreciate art, music and logical arguments. Random? No. Richard Dawkins is right about one thing; an intelligence from the heavens did place man here. And even made an extra terrestrial visit... He is known as God and His Son changed my life. _________ See more of Mr. Peel’s articles oninsurance-coveragelaw.blogspot.com. Mr. Peel may be available to speak to your church or club. ContactPeelLawFirm.com.

Fraudulent Car Accidents

In today's Globe and Mail (October 4, 2010) it is reported that the Insurance Bureau of Canada is warning about a "concerning trend" of insurance fraud.

"There has been a rise in crashes that are orchestrated to claim lucrative no-fault insurance payouts and, to avoid detection, perpetrators are increasingly involving innocent drivers in their pre-planned collisions."

According to the article, "Toronto is the hotbed, with organized crime being linked to several staged accidents. Insurance industry investigators involved in a recent probe, dubbed Project 92, say they’ve identified more than 40 staged car accidents carried out by one particular crime ring alone, 17 of which have already been criminally investigated. Police have laid 291 charges against 39 individuals in the sting, 20 of whom have been convicted."

http://www.theglobeandmail.com/report-on-business/insurers-beware-national-watchdog-raises-alarm-for-fraud/article1740676/

Figure Adequate Liability Insurance Limits

How about a way to figure out how much liability insurance a business should have?



I have seen many such formulas. I have never bought into any of them.



Here are the "normal" liability insurance policies for most businesses:



Auto Liability Insurance - Pays for bodily injury and property damage caused by a motor vehicle accident. Should include coverage for accidents caused by the operation of owned vehicles and non-owned vehicles (by an employee, for example). My Minimum Recommendation: $1,000,000.



General Liability Insurance - Pays for bodily injury and property damage liability. Most policies also include coverage for libel, slander, wrongful eviction, false arrest, and publication that violates privacy. Coverage applies at your locations, at other locations in the course of your business, for products liability, and for completed operations. My Minimum Recommendation: $1,000,000 each occurrence / $2,000,000 in the aggregate.





Employers' Liability Insurance - Part of workers' compensation insurance. Pays for bodily injury that comes from the employment relationship but excludes injuries covered under workers' compensation. The best way to describe this coverage is with an example. A boatbuilder comes home every day with fiberglass dust in his clothes. The dust gets into the air at home and in the clothes of the family in the laundry. A child in the home gets sick from the dust. That would be covered by employers' liability. My Minimum Recommendation: $100,000 (most umbrella insurers will require $500,000).





Employment Practices Liability Insurance - Liability insurance for acts of employment harassment, wrongful termination, failure to hire, discrimination, and other similar allegations. EPL policies almost always provide for defense cost coverage within the limit of coverage - increasing the amount of insurance you need. My Minimum Recommendation: $1,000,000.





Fiduciary Liability Insurance - Protects the fiduciaries, directors, and officers of employee welfare plans (group insurance, pension plans, 401k plans) against actual or alleged wrongful acts. Covers liabilities imposed by the federal law ERISA. My Minimum Recommendation: $1,000,000.





Directors' and Officers' Liability Insurance - Provides coverage for allegations of third parties for mismanagement, failure to act properly, and other "wrongful acts" against directors and officers. Coverage also can be included for the organization, known as entity coverage. Not all companies need D&O insurance. The coverage is necessary for non-profits and companies with diverse ownership interests. If you have a small company with 3 owners all active in the business, you can probably do without D&O. These policies almost always provide for defense cost coverage within the limit of coverage - increasing the amount of insurance you need. My Minimum Recommendation: $1,000,000. More coverage may be advisable depending on exposure to loss and the assets of the organization. It is also a value decision. Get quotes at a variety of limits and judge the value of the protection compared to the cost.





Umbrella Liability Insurance - Provides extra liability coverage above the general liability, auto liability, and employers' liability coverage. Also known as excess liability. Every business should have at least a $1,000,000 umbrella. There is no magic to this number. $5,000,000 is a more realistic minimum.



I know of a four employee, $200,000 sales contracting firm that accidentally burned down a $7,000,000 church. Not many insurance agents would have suggested beforehand that the contractors buy a $10,000,000 umbrella. Obviously, hindsight is 20/20.



You have to decide how high is up. Again, get quotes at a variety of limits and judge the value of the protection compared to the cost.

The Simmonds' Business Insurance Index™ For October, 2010

Here's my read of the current marketplace for upcoming business insurance renewals:



Renewal Premiums: -5%

Renewal Coverages: Liberal Terms

Buyer's Outlook: Long-Term: Prices Flat



I have seen no real change in the insurance marketplace this month. I am, however, changing the premium part of the index to -5%. Since July I have shown "-5% to flat." I'm not convinced, in hindsight, that flat is really where the market has been / is. Competition still will push your premium down.



I was interviewed a few days ago for a business website. I said, "If an entrepreneur renews his insurance with the same agent and the same insurer with no "push-back," his renewal premiums will increase @5%. Renewing with the same agent/insurer with push-back will result in a slight reduction or a flat renewal. Competitive bidding will result in a 10 to 20% reduction in premium. The trick is how you manage the bid process."



I also talked about the magic of six words, "Is that really your best price?"



The writer expressed surprise that business insurance premiums are negotiable. They sure are. Most underwriters can increase or decrease base rates by 25%. That's a 50 point swing!



I have long said that a great deal of the discretionary part of premiums is dependent on how the insured appears to the underwriter. Is the insured an attractive risk? Does the agent present the account in a favorable way?



The insurance press continues to predict a soft market for the rest of this year. I agree. I am urging my bank clients to lock in the bond and directors' and officers' premiums for 3 years.



Prices will go up. The problem is predicting when. I do know that bringing competition into your renewal will improve your coverage and premium.