|
Failure to place coverage
A customer requested automobile liability coverage from her agent to be
bound as of January 1. The agent misplaced the application and did
not find it until January 10. The agent immediately bound coverage
effective January 10. On January 11, the customer notified the agent
that ton January 8, she was responsible for a three-car accident
in which two people were killed. The agent was held liable
for the total amount of liability coverage requested by the
customer as of January 1. The agent was liable for
$500,000.
Failure to update information
In March, a customer, with an agent's help, completed a life insurance application for ABC
Life Insurance Company. The agent did not submit the application. On August 5, the agent
met again with the customer to discuss coverage offered by XYZ Life Insurance Company.
During the meeting, the customer confirmed that there had been no material change in his
health since March. He authorized the agent to procure life insurance from XYZ Life.
On September 15, the agent prepared an XYZ Life application using information from
the ABC application and the August 15 meeting, signed the customer's name,
and sent it to XYZ Life. The agent did not ask the customer if his health had
changed between the August 15 meeting and September 15. In fact, the customer
was treated twice, beginning on September 6, for viral pneumonia. The policy
was issued October 6.
When the agent telephoned the customer to tell him that the policy had been issued,
the customer's wife informed the agent that the customer had been hospitalized.
The agent instructed the wife to pay the premiums, which she did. The agent
forwarded the premiums to XYZ Life. The customer died on October 15. After
XYZ Life denied the wife's claim, she sued the company.
The court awarded the
wife $500,000(the face
amount of the policy) plus interest.
XYZ Life successfully sought indemnification
from the agent for the full amount of the judgment.
Cancellation error
A husband requested, in writing, that his agent cancel the term life insurance policy
covering his wife. The agent mistakenly canceled the husband's policy,
leaving the policy in force for his wife. Three weeks later,
the husband died of a heart attack. The life insurance company
denied coverage. The surviving wife sued the life insurance
company and the agent, ultimately recovering the value of the
life insurance policy including interest, plus punitive damages.
The insurance company and the agent were held liable for the value
of the life insurance policy $250,000, plus
interest.
Renewal error
An agent renewed a local business owner's policy through the same
carrier with whom the policy had been placed during the prior policy year.
The client had disclosed on all prior and current applications that the
majority of its cargo was shrimp. The agent failed to inform tthe client
that this carrier no longer covered seafood under its cargo provision. The
agent's error was discovered three months later when the client had
a major shrimp loss and the carrier denied coverage. The agent was found
responsible for the damages and incurred defense costs. The agent
was held liable for the $35,000 shrimp loss, plus an
additional $40,000 in defense costs.
Failure to consult with customer
A customer requested $1 million in replacement-cost coverage on a restaurant. The
agent obtained quotes from several insurers, and the customer selected
ABC Insurance Company. Before the policy was issued, ABC notified the agent
that it could not issue replacement-cost coverage but proposed to write
actual-cash-value coverage. The agent accepted the proposal without
consulting the customer. When the restaurant was destroyed by fire, ABC
paid only $435,000 - the actual
cash value of the building. After settling with ABC, the customer sued
the agent. The court found that the agent failed to exercise reasonable
skill, care and diligence in procuring the requested
coverage, and it awarded the
customer $135,000, less the
deductible and the actual-cash-value settlement already received.
Negligence
In discussing various automobile coverages with a customer, an agent failed to
advise the customer that he should have collision insurance. While driving
his new car, the customer skidded on a patch of ice and slammed into a telephone
pole. The customer's policy did not cover damage to the car. The customer
claimed that the agent failed to notify him of the importance of the
collision insurance. The parties settled for $25,000.
Negligence
A company's risk manager purchased a directors and officers (D&O) liability
policy for his company. The risk manager was not advised that the policy
excluded coverage for employment practices claims, or that the company could
purchase such coverage by endorsement. The risk manager became aware of the
exclusion when an officer of the company was named as the defendant in a
wrongful termination action. The company sued the insurance agent for damages
suffered by the company, as well as legal
expenses incurred, in a wrongful termination settlement.
The company recovered from the agent the $250,000
they had paid to settle the original wrongful termination suit.
Misrepresentation
A lawyer decided to switch her professional liability coverage from her existing
insurer to a new carrier. She asked her agent whether the new policy covered
prior acts; the agent confirmed that it did. After the inception date of the
policy, but before the policy was issued, the lawyer was sued for malpractice
as a result of a wrongful act that occurred prior to the inception date. When
the policy arrived, it indicated that the retroactive date was the same as the
policy inception date; therefore, the claim was denied. The lawyer sued the agent for
fraudulent misrepresentation.
The lawyer was awarded $500,000.
Negligence
A surplus-lines agent placed Smith & Jones' professional
liability coverage with Fly-By-Nite Specialty Insurance Company,
a new company that offered the lowest rates for the requested coverage.
Soon after the binding, Fly-By-Nite went bankrupt and was unable to pay
its share of a claim filed against Smith & Jones. Smith & Jones sought
recovery from the agent for failing to investigate the financial
stability of Fly-By-Nite and for placing coverage with an unsound
insurer. Smith & Jones were awarded $250,000
to cover the claim the insurer was unable to pay, as well as an additional
$100,000 in punitive damages.
Negligence
ABC Insurance Company prohibited an agent from writing D&O
lliability coverage on a bank without a regulatory
exclusion. The agent bound the coverage without
the exclusion. As a result of the mistake, ABC agreed to pay
certain claims that otherwise would have been excluded. ABC
sought indemnification from the agent. ABC Insurance Company was awarded
$500,000, the cost of the claims that should have
been excluded from the original policy.
|