If you change insurance company on you Professional Liabilit

by LAGOOSMAN » Thu Jun 11, 2009 10:18 pm

I had the same insurance company from 2002-2006 then switched in 2007.

I just received a claim from work done in 2002.

My current company is "mostly" denying the claim and researching the rest. Can I take my claim to my prior insurance company and will they honor the claim?

Total Comments: 5

Posted: Fri Jun 12, 2009 04:03 am Post Subject:

Depends on a couple of things. Check the policy to see if it's a "claims made" policy or an "occurrence" based contract. As well, you may be subject to a statute of limitations (SOL).

A claims-made policy requires that the loss occur during the policy period and the claim is actually made within the policy period. Commercial liability contracts also have weird things like "tails" and "retroactive dates" that personal lines policies don't have. You should have an extended reporting period ("erp"), which means that you have a period of time after the policy expires in which you can still report a claim and have it covererd. Unfortunately, I really doubt that you have an erp with a "tail" that long. 7 years is a looooong tail, giving that the standard erp is 60 days. Reeeeeeally doubt that there would be coverage under a claims-made contract.

Retroactive dates are periods of time prior to the inception of a policy that may provide coverage in the event of an unknown loss, and are associated with claims-made contracts. Again, doubtful you're within the time period allowed, but again- you need to check on these things.

If it's an occurrence based contract, this simply means that the loss must occur during the policy period, but doesn't require that the claim actually be reported during the policy period like a claims-made policy. Carriers hate late reporting of claims, but if you had no knowledge of the loss, what can they say? They may gripe, but keep pushing. You mentioned that they are doing something, but not enough. You may be up against a statute of limitations (very likely, almost a certainty) and if not, your carrier will listen to you and what they do is entirely up to them.

Statutes of limitations may also protect you. Depending the the other laws in your state, the claimant may be subject to similar SOL laws. You know what "SOL" means, don't you? S*** outta luck. :D

Check your contract, if you still have it, and if not- call your agent/agency that handled the business at that time. Hopefully they still have records. Most states require that they keep records on their insureds for three years after expiration of the policy, and most agencies keep records forever. Let us know and maybe we can help! :idea:

InsTeacher 8)

Posted: Fri Jun 12, 2009 05:24 am Post Subject:

y current company is "mostly" denying the claim and researching the rest. Can I take my claim to my prior insurance company and will they honor the claim?



What do you mean by mostly denying the claims? Have you had other claims too with them?

Please do as Teacher has said, go though the old policy document as well as the new one. Those would certainly reveal something.

~ Jeremy

Posted: Fri Jun 12, 2009 07:42 pm Post Subject:

By mostly denying the claim - i mean i received a 21 page letter with part of the policy marked with comments excluded or right to deny. This is my first claim and I as such have never had to deal with anything like this before.

Posted: Sat Jun 13, 2009 01:23 pm Post Subject:

If you are looking for some help, could you please answer the questions that were in my previous post? Thanks!

InsTeacher 8)

Posted: Mon Jun 15, 2009 05:43 am Post Subject:

By mostly denying the claim - i mean i received a 21 page letter with part of the policy marked with comments excluded or right to deny.



Okay does that mean that they have sent you a letter of claim denial? What does the letter state anyway?

It may be that they had sent an acknowledgement of receiving the claim and would investigate into it before releasing the check. However, if your claim doesn't meet the policy terms they would reserve the right to deny it. Is it something like that they have stated in the letter?

~Jeremy

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