Reminding insureds of reporting requirements may be the best service you can provide.
There is a garden variety of claim issues that we face several times a year. We have written about it in the past, but because it continues to occur, we believe it bears a reminder: Late reporting of claims can jeopardize coverage. In some cases, the insured does not report a claim because the matter appears at the outset to be a nuisance matter which will be quickly resolved or at least resolved within the retention. In other cases, the insured may not recognize that the matter at hand is, in fact, a claim which requires reporting. Most commonly, EEOC charges are over looked as claims. Other times, requests for arbitration or appeal constitute claims.
Below are some examples of late reporting we have experienced.
Financial Consultant Alleged Professional Liability Error.
Our insured acted as a consultant on the sale of financial instruments. Our insured was named as an additional defendant in a complaint brought by the seller of the instruments against the buyer who did not follow through on the transaction due to disputed terms of the transaction. Our insured was named as an additional defendant due to our insureds communication with the buyer throughout the sale. The insured was unaware that there was potential coverage under the professional liability policy for a suit which involved a typical business transaction; moreover, the insured expected the matter to be summarily resolved, and defense was handled by insured’s client. Consequently, the insured did not report the matter to the professional liability carrier within the claims made and reported 60- or 90- day window. The matter was discovered as a result of an application question reporting that the insured was a party to a lawsuit. The carrier is faced with deciding whether to accept the defense, and if accepted, when to start the defense fees meter running so that the SIR can be spent.
This all-too-familiar pattern has emerged: The insured receives an EEOC or state civil rights commission charge, has 21 or 28 days to respond, and dutifully answers the charge, often by using the HR counsel to whom the insured turns for routine matters. When the suit is presented several months later, the insured submits the claim to the management liability / EPL carrier who denies coverage due to late reporting. EEOC and similar charges are, after all, part of the Definition of Claim. In some cases, the insured has even obtained a “no reasonable cause” finding from the EEOC. Coverage is still jeopardized, and in many cases denied. This happens with regularity, so our best advice is to stress with the delivery of each wrongful act policy, the importance of promptly reporting EEOC charges and other charges.
ABOUT CINCINNATI INTERMEDIARIES
Cincinnati Intermediaries is an insurance wholesale broker focused exclusively on the placement of management and professional liability insurance. They have sound expertise in Management Liability, E&O, D&O, Miscellaneous Professional, Cyber, Architects & Engineers, Financial Institutions, Lawyers and Non-Profits. Headquartered in Cincinnati, OH, they operate nationwide and are able to assist retail insurance agents with placement of coverage nationally. Cincinnati Intermediaries represents the majority of the admitted and surplus lines insurance carriers that focus on professional liability insurance in the United States.