Professional Liability on Policyholder Education: Agent or Carrier Responsibility?
Every policyholder must be educated about claims and their coverage. That everyone agrees on. The insured should know the extent of their coverage, what they are paying for, what is and isn't covered, and what to do in the even they need to file a claim. But whose responsibility is it?
Clients rely upon their brokers and agents to procure and negotiate insurance policies that meet their unique needs. And because of their participation in procuring coverage, a broker can find themselves at the center of a coverage debate. There is an ongoing debate in the insurance community about where responsibility of policyholder education lies. Is it the duty of the agent who sells directly to the insured to educate them on their policy?
There is an increased demand on the policyholder to know the details of their plans. Add healthcare reforms that are beginning to roll out, and it further complicates the situation.
What happens if a policy holder who is unaware of the details of their coverage has to file a claim? Disputes can arise if the coverage is not as represented, there is a gap in coverage afforded, or a dispute with the insurer. Insurance agents and brokers have been held liable to insured or applicants for insurance on a number of theories including breach of contract and professional negligence. Oftentimes, a disparity in knowledge between the insured and an agent and broker can cause conflict. It is costly, on both parties. And whatever the circumstance, these disputes can be minimized with a strong emphasis on policy education.
It can be difficult to communicate the intricacies of insurance coverage to policyholders- once they know the price, sometimes eyes can glaze over. But nevertheless it is essential to make sure, in communication between the broker and agent, that it is covered.
At PLRisk, we believe in building solid relationships with our insurance carriers so that we can negotiate the best rates and offer agents a diverse selection of coverage options. Our unique ability to understand the complexity of business risks allows us to build customized programs to specifically address exposures. Furthermore, we have extensive resources to help agents stem losses through effective risk management and proper claims analysis.
We invite you to take a look at each of our programs, such as Professional Liability for Insurance Agents/Brokers, Errors & Omissions. Directors & Officers, as well as EPLI. Discover more about how we can help meet your clients’ needs. Please give us a call at (855) 403-5982, email us, or complete the above form, and one of our staff professional liability specialists will contact you.
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