In addition to a panel of experts, AOA also has partnered with James Wm. Kallman, PhD., ARM, RD, as an editor who created the final version of the e-book. In addition to having continuing education, the e-book also will have an insurance-pedia functionally, the AOA said. Kallman is a full-time professor at the St. Edward’s University in Austin, Texas, who also teaches professional education courses in risk management, risk control, risk financing and financial management.
This loss-control initiative is what AOA is all about, says the organization, bringing the best talent and resources together to create the nation's first risk management initiative for helping agents reduce claims, and provide them with a practical guide to their agency operations.
Following is an example of the e-book’s content, taken from Chapter 15: When the Insurer Denies Coverage of the Client’s Claim, by Alan Jampol, Esq.
“An unexpected policy claim denial is frustrating to the broker and the client—and is potentially litigious for the broker. A client whose expectation of coverage, whether or not reasonable, is disappointed will often allege the broker did not procuring appropriate coverage. This disappointment applies to either a claim denial or a limitation of coverage. The disappointment is exacerbated when the insurer refuses to provide a defense for the client.
Where the client’s expectation of coverage is unreasonable or unrealistic, the broker must carefully explain to the client why the denial was proper and why it is unreasonable for the client to expect coverage. When the client’s expectation is reasonable, and particularly when, the client reasonably expects to be defended by the insurer, the broker should zealously support the client’s request for coverage.
An insurer’s unexpected or disputed denial of a claim should trigger the broker’s concern about a subsequent errors and omissions claim. This uncomfortable situation can interfere with the otherwise good relationship between the client and the broker. The broker must employ skill and good judgment to balance the support of the client’s cause, the commercial relationship with the insurer, other intermediaries, and the protection of the broker’s legal position.
Insurance agents have additional problems. The insurer expects the agent to support the insurer’s position. The insurer will sometimes assert that the problem arose from the agent’s mishandling of the placement. In that event, the agent must be keenly aware of his or her legal duties to the insurer under the agency agreement.”
