The most critical time in the agent/policyholder relationship arises at the moment that a loss is reported to the agent. Years of effective marketing can be lost at that critical moment. This is not to mention the genuine desire on the part of most agents to assist their clients. However, out of genuine concern, agents can unwittingly expose themselves to tremendous liability. The purpose of this paper is to explore ways in which an agent can be truly helpful during the claims process while at the same time avoiding agent liability.
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Holder Expectations upon Notification of a Loss
As all experienced agents know, the policyholder is, to some extent, traumatized when he/she experiences a significant legitimate loss. When reporting the loss to the agent, the policyholder is not just performing a policy requirement, but seeking assistance and assurances. His/her mind is filled with questions concerning whether the insurance coverage was sufficient, whether the premiums had been paid and, most critically, whether there is coverage. Other questions arise as to what needs to be done in order to perfect the claim and as to when the claim will be paid. How an agent responds to these concerns will dictate whether the policyholder renews coverage and what comments he/she will give to others. At the same time, the way in which the agent responds to the concerns of the policyholder could result in significant liability.
In the next chapter of POST-LOSS LIABILITY, we discuss ways in which an agent could unintentionally create liability for the agency.
About the Author:
Michael W. Johnston is a founding partner of the Houston, Fort Worth, Lubbock and San Antonio Law Firm of Johnston Legal Group PC. He graduated with honors from Trinity University and Baylor Law School where he was an associate editor of the Baylor Law Review. For the past twenty-nine years, Mr. Johnston has been a civil litigator concentrating his practice in consumer, personal injury, commercial and insurance litigation. Mr. Johnston represents well known insurance companies in connection with first and third party insurance claims. He is Board Certified in Civil Trial Law by the Texas Board of Legal Specialization and the National Board of Trial Advocacy. He is also Board Certified in the field of Consumer Law by the Texas Board of Legal Specialization. Mr. Johnston is formerly a Texas Wesleyan School of Law Adjunct Professor of Insurance Law. For the past five years, Mr. Johnston has been designated as a “Super Lawyer.” Mr. Johnston is licensed to practice before all state courts in Texas and Oklahoma, the United States Supreme Court, United States Court of Appeals for the Fifth Circuit, the United States Court of Claims and the United States District Courts for the Northern, Southern, Eastern and Western Districts of Texas.