Claims Magazine-November 2013

Issue Gallery ›

  • A Subrogation Wake-Up Call

    Mark T. Mullen

    Subrogation has its roots in the equitable notion that the party who in good conscience is responsible for a loss should pay for the loss. Property insurance policies provide the natural opportunity for accomplishing that goal when a loss is caused by a third party and, absent insurance, that third...

  • NICB: Questionable WC Claims On the Rise

    Arthur D. Postal

    Even as the overall number of workers compensation claims wanes, the suspicious onesor those designated questionable claims (QCs)are actually increasing, according to the National Insurance Crime Bureau (NICB). When the Des Plaines, Ill.-based not-for-profit organization examined referrals dating from Jan. 1, 2011 through June 30, 2013, it found that medical...

  • Prevent Bad Faith and Unnecessary Litigation with Active Claims Management

    Suzanne M. Ganier

    Undoubtedly, most claims executives will readily tell you that they have a strong claims management program, which is a crucial component of any claims department. They will point to policies, procedures, guidelines, and claims audits. They would also point to stringent litigation and billing guidelines for attorneys. But do they...

  • Hole-in-One Insurer Charged in 11 States for Golf Tourney Scams

    Christina Bramlet

    These days, plenty of golf tournaments draw big crowds (and big bucks) when featuring hole-in-one promotions. Despite the relatively tiny success ratethe odds of an amateur golfer hitting a hole in one are about one in 12,500players nevertheless line up for their chance at glory and, of course, those fabulous...

  • What a Difference a Court Makes

    Diana B. Reitz, CPCU

    Individual words and their placement in insurance policy forms are what we use to interpret coverage: to trigger it, to deny it, to negotiate it. Courts that are called upon to rule on whether there is coverage in a particular situation do this all the time. They review the arguments...

  • How Soft Skills Complement Tech Fluency

    Kevin Quinley, CPCU

    In his new book, Average is Over, Tyler Cowan maintains that America is dividing itself into two main groups: At the top will be 10 to 15 percent of achievers, whose self-motivation and mastery of technology will allow them to soar into the future. Then there will be, well, everyone...

  • ‘Big Sister’ Is Watching Us

    Ken Brownlee, CPCU

    I never had a sister. I suppose if I did, Id have wanted her to be a bubbly fun-loving neat-appearing soul much like Progressive Insurances fictional sales girl named Flo, who offers insurance coverage by the box. For a number of years in the 1960s, I handled a lot of...

  • Regulators Share Top 10 Gripes About P&C Insurers

    Christina Bramlet

    Insurers can and must improve their claims-handling and underwriting practices in several key areas. Thats the message market conduct regulators are sending to both life and health and property and casualty (p&c) insurers.

  • The Cost of Reticence

    Christina Bramlet

    Sometimes we drop the ball. In a day and age where culpability can cost one dearly, it is probably best to never err, or at least cop to it. In a profession that demands perfection, claims professionals are fallible, insurers liable, for a host of disappointments and unfortunate events. Problem...

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