Sample Q & A
The following reference questions have been asked of the librarians in the past. We reproduce them to give some idea of the types of inquiries we receive on a daily basis: if the particular topic happens to be of interest to you, so much the better! Feel free to also check out our blog for other insurance related topics of interest.
Q: I have a few questions that I was hoping you could answer for me, namely: the cost to insurers, if they were even insured, for the Hindenburg disaster in 1937; the 1911 Triangle Shirtwaist Factory fire; and the sinking of the Titanic.
A: While payout amounts were not readily available, the total amounts of insurance limits written on these three subjects of disaster were: the Hindenberg, 6 million reichsmark; the Triangle Shirtwaist company building, $199,750; the Titanic, $5,566,820. Of course, loss of life was the worst part of these events, but this aspect was not quantifiable. We supplied this person in California with information about the sources for our answers so that he could consult them directly.
Q: Would you please search your files for a copy of the California Standard Fire Insurance Policy in effect in 1914?
A: California promulgated standard fire insurance policy forms in 1909 and again in 1949. We located a copy of the 1909 edition in our historical file of standard policies, along with the standard forms of several other states.
Q: My boss has been asked to write an article for a trade association publication that discusses the subject of equipment breakdown coverage. Can you send some materials on that subject?
A: A search of our database articles index provided a substantial list of possibilities, from which we chose eight that seemed particularly apt, including those summarized as “equipment breakdown is more than just boiler and machinery” in the Fall, 2001 issue of The John Liner Review, “equipment breakdown insurance increasingly needed by all insureds” (Rough Notes, August, 2000), and “boiler and machinery as a multi-peril exposure: equipment breakdown can lead to other exposures” (Risk & Insurance, February, 2000).
Q: Was any form or type of insurance written in the United States before it was written anywhere else?
A: We learned that title insurance has the “unique distinction” of being the only form of insurance invented in the United States. It has been said that the first title insurance company, the “Law and Property Assurance Society”, existed in Pennsylvania as early as 1853. Not only did it insure against defective titles, but it also guaranteed the repayment of loans and mortgages.
Q: I’m trying to get in touch with the Massachusetts Casualty Insurance Company, and I can’t find any listing. Can you help?
A: Tracing insurance companies is something we are eminently prepared to do, whether the request comes from a law firm, a consumer, or (as happens quite frequently) from a funeral home. Massachusetts Casualty changed its name to Centre Life Insurance Company in 1999. Sometimes we are asked to find the successors to insurance agents and brokers: that can be a bit more difficult, but quite often we can help with those inquiries as well.
Q: Two insurance agents are trying to get my business. One is saying the other is offering me a rebate, and that doing so is illegal. What is a rebate, and is it illegal?
A: Rebating is indeed illegal in Massachusetts and elsewhere. Questions can arise, though, as to the exact meaning of “rebate”. This consumer did not tell us what the accused agent was offering, so we had to respond in generalities. Among other things we learned through examining the treatise Responsibilities of Insurance Agents and Brokers by Bertram Harnett is that offering at no charge a service that would ordinarily generate a charge may be considered a rebate.
Q: I have heard about a study of workers’ compensation mental stress claims arising from September 11th terrorism by a group called AMCOMP. Do you have it?
A: We didn’t have it, but now we do. AMCOMP donated a copy to our collection, for which both the patron and the librarians were very grateful!
Q: My insurance company has denied coverage for a vandalized DVD player that I had installed in my new Toyota Sequoia, saying the vehicle is a truck and that coverage does not apply to such devices installed in a truck. I thought my Toyota was a station wagon. Who’s right?
A: This Massachusetts consumer’s insurer seemed to be on firm ground in denying the claim described. The Massachusetts auto policy explicitly excludes coverage for “custom furnishings or custom equipment” installed “in or upon any pick-up truck, van or similar vehicle”. Similar language is contained in the ISO Personal Auto policy. The Toyota Sequoia is listed in the truck category of the Toyota section of the symbol and identification section of the Massachusetts manual.
Q: I’m looking for something that succinctly summarizes the pros and cons of workers’ compensation self-insurance groups. Is there any such thing?
A: We showed this patron a page dated October 2000 in the International Risk Management Institute’s two-volume set Risk Financing: A Guide to Insurance Cash Flow that displays the exhibit “Advantages and Disadvantages of Workers Compensation Self-Insurance Groups”: she seemed quite pleased with it.
Q: I am responsible for arranging my company’s insurance program and for buying insurance. My boss says he thinks our brokers make too much money on our account. How can I figure out if he’s right?
A: The section entitled “Evaluating Broker Compensation” in Practical Risk Management: the Professional’s Handbook proved extremely helpful. Three distinct approaches for evaluating broker compensation are described. This insurance buyer left feeling far better armed to understand and explain broker compensation issues than when she came in!
Q: I’m from New York State, and I’m writing an article on the history of workers’ compensation laws. Am I correct that my state was the first to enact such a law?
A: New York State was indeed a leader in enacting compulsory workers’ compensation laws, but the law was short-lived: passed in 1910, it was declared unconstitutional by the New York Court of Appeals in 1911. In 1911 Wisconsin, Nevada, New Jersey, California, and Washington passed laws that endured. New York, after amending its constitution, reenacted a law in 1914, and by 1921 all but six states (plus the then-territories of Alaska, Hawaii, and Porto [sic] Rico) had compensation acts. Enactment was not always smooth: in fact, the enactment of a law in Missouri in 1925 represented “the climax of a bitter and persistent battle”. Whoever said that insurance and its history is boring?
Q: As a risk management consultant, I am interested in knowing what factors are important to clients when they are deciding which consultant to hire. Can you show me anything that might be enlightening?
A: A search of our database index of journal articles quickly produced an extensive list of likely sounding items. Proving most useful were “Engaging Expectations” from the October, 1991 issue of Reactions (“…how to pick the best consultant for the job and what to expect for your money”), “How to Choose, Use, But Not Abuse a Consultant” from a 1994 issue of Risk Management Letter, and “Choosing the Right Consultant” from the August 3, 1998 issue of the National Underwriter.
Q: Please find for me an explanation of coverage for “advertising injury”: it’s just for people in the advertising business, right?
A: Not right. David Gauntlett includes a summary of this and related subjects in the treatise Insurance Coverage of Intellectual Property. Chapter 2, “The Scope of Advertising Injury Coverage” includes discussion of the duty to defend, the causation qualification, the duty to indemnify, and interpretation of the term “damages” in this context.
Q: For reasons I don’t want to divulge, I am interested in articles from the mid-1980s that address the subject of rebating in the life insurance industry. What can you show me, if anything?
A: This person seemed to think we would be unable to help him, which posed a (very surmountable) challenge. Relevant items came from sources such as Life Association News (“the case against legalized rebating, March, 1985) Best’s Review Life/Health (“rebating: poultice or poison?”, September, 1986) and the Journal of Insurance Regulation “the tangled insurance premium rebating question”, March, 1987).
Q: Is there any reference source that indicates the residual market share of the workers’ compensation business in various states? How about average indemnity costs by state for workers’ compensation cases?
A: The first place we look for any questions about workers’ compensation statistical data is the Annual Statistical Bulletin of the National Council on Compensation Insurance. The 2001 edition of this excellent publication included charts addressing each of the above issues.
Q: I am calling from Connecticut. My husband and I are relocating to Massachusetts and will be insured by Blue Cross. If we divorce, can I count on retaining my Blue Cross coverage?
A: Not for sure. Section 8F of Chapter 176A of Massachusetts law outlines ex-spouses rights in this situation. Coverage is continued unless a “judgment absolute of divorce or of separate account” provides to the contrary. We sent a copy of the law.
Q: “Sick building syndrome” is something I’ve heard mentioned but know little about. Has anything been written regarding the syndrome, particularly in conjunction with insurance coverage issues?
A: Several pertinent items were identified through a search of our database. One was “Mold: A Growing Liability” from the February 2001 issue of Risk & Insurance, and another was one written by member Marvin Milton and published in the March 30-April 5. 2001 issue of New England Real Estate Journal: “Rust, Rot, Mold and Mildew: Causing Measurable Damage in Buildings”.
Q: My company is small, and we need to be able to travel to visit prospective clients FAST. Can we purchase a jet airplane in cooperation with another company or companies, and are there any particular insurance implications of such deals?
A: The answer to both parts of this question is “yes”. Insurance Library member Donald Malecki addresses the subject admirably in the June, 1998 issue of Malecki on Insurance. “Owning a corporate jet is made easy, covering the liability is what may be difficult” aptly summarizes his discussion of fractional ownership of aircraft and the resulting insurance challenges.
Q: As a consumer, I am very confused by what I am reading about mutual companies and stock companies and demutualization and mutual holding companies. Would you please show me something that simply explains who owns mutual insurance companies?
A: We first provided this person with several insurance dictionaries and glossaries. Having started with simple definitions, he was ready to move on and looked at the article “Changes in Mutual Life Insurer Ownership Form” in the March, 1999 issue of the Journal of the American Society of CLU and ChFC (now known as The Journal of Financial Services Professionals). We don’t know if he liked the idea of demutualization any better than when he came in, but he understood it better!
Q: Please provide me with some articles contemporaneous with the merger of St. Paul and USF&G.
A: We culled a dozen articles from the late- 1997 to mid- 1998 time frame that discussed this transaction and management changes associated with it.
Q: I recently passed the examination to become a licensed insurance adviser in Massachusetts and understand that I must use written agreements with my clients regarding the services to be provided and my compensation for those services. Can you provide me with any guidance or help in drafting such an agreement?
A: This newly-licensed adviser should most definitely investigate membership in the Massachusetts Society of Licensed Insurance Advisers (we gave her the name and telephone number of the person to contact about membership). Among the many benefits of membership is access to a “Model Agreement for Insurance Counseling Services” developed by the Society in conjunction with attorneys at the law firm of Morrison, Mahoney & Miller.
Q: It seems to me I haven’t heard too much lately about insurance claims involving asbestos. Are they fading from view?
A: We think not. The Wall Street Journal published articles in their issues of February 7th and March 5th, 2001 citing statistics on mounting claims and saying plaintiffs lawyers have turned asbestos into a “court perennial”.
Q: May I see something on waivers of the right to recover from others in the context of workers’ compensation insurance?
A: As is often the case, a publication from International Risk Management Institute in Dallas was most informative. Best was the section titled “Workers Compensation Waivers of Subrogation” in their manual IRMI Workers Comp: A Complete Guide to Coverage, Laws, and Cost Containment.
Q: I own a small business, and my property and liability insurance premiums represent a large part of my expenses. Are insurance companies’ profits higher than those of most industries?
A: Of course, numbers and statistics can be tricky to interpret sensibly, but a table developed by the National Association of Insurance Commissioners and reproduced in the February 21, 2000 issue of Property Insurance Report seemed to belie huge insurer profits. The chart shows Rates of Return on Net Worth for commercial multi-peril insurers compared to the return for “Fortune All-Industry”. The figure given for insurers for 1987-1998 is 5.8; for all-industry the number is 12.8.
Q: I am calling from Alabama. Is there a Massachusetts law governing the process for filing claims under disability insurance, and for the payment of such claims?
A: We faxed this caller subsections A, 5-9 of section 108 of chapter 175 of the Massachusetts General Laws.
We utilized our print copy of the Massachusetts laws for this person. We also have a complete set of Massachusetts insurance regulations. For similar questions, we often consult the newly-revamped Massachusetts Division of Insurance website, found at http://www.state.ma.us/doi . Experiment with it a little, and you will find a wealth of information of potential interest to insurance professionals and consumers alike. Most state insurance departments maintain websites—call us if you’d like any addresses.
Q: There was a story in my local newspaper about a horrible traffic accident involving a pick-up truck. Just how many accidents a year involve small trucks, and are they involved in a disproportionate share of accidents?
A: The 2000 edition of the Insurance Information Institute’s Fact Book includes a chart entitled “Motor Vehicle Crashes by Vehicle Type” utilizing data from the US Department of Transportation and the National Highway Traffic Safety Administration. In 1997, the rate of property damage- only accidents for passenger cars was 4,104 per 100,000 registered vehicles, while the rate was only 3,439 per 100,000 registered light trucks. However, the corresponding rates for fatal crashes were 24.11 and 27.68.
Q: Recently I attended a meeting and the speaker referred to the “Florida case” in the context of bank sales of insurance. I didn’t want to speak up, as everyone else seemed to know what case he was talking about, but what case WAS he talking about?
A: Chances are good that the case referred to is that one known officially as Barnett Bank of Marion County, N.A. v Gallagher 43 F.3d 631 (11th circuit 1995). The treatise Insurance Activities of Banks by Karol K. Sparks indicates “The Barnett decision effectively eliminated antiaffilation laws as to section 92…A state law fails if it prevents or significantly interferes with the ability of national banks to sell insurance from small towns”.
Q: How involved are insurance companies with retirement plans and retirement plan investments?
A: The ACLI (American Council of Life Insurance) Life Insurance Fact Book 1999 provided two relevant tables for this visitor, “Retirement Plans Held by Life Insurers by Type (1998), and “Assets Held in Retirement Plans with Selected Financial Institutions”.
Q: Enclosed please find insurance policies on my parents we discussed on the phone last week. I have been unable to locate these insurance companies. My bother and I hope you can.
A: This caller sent copies of policies dating in the 1940s from two different life insurance companies. One of the companies was still in business under the same name, but the other had merged or been acquired several times in the past decades: we were able to trace it to its current incarnation through use of successive AM Best Life Reports.
Q: What is the Insurance Fraud Bureau? What does it do? Does it do a lot of whatever it does?
A: Articles from The Standard and The Insurance Times, along with other sources, provided both background and statistical information on the “IFB”. Operational as of May, 1991, the bureau represents a rare public/private partnership between the insurance industry, the Massachusetts Attorney General, and other state offices. It is a central resource for fighting insurance fraud. As of June 1999, 2,921 of a total of 15,105 referrals received from insurance companies and from a hotline (1-800-323-7283) had been selected for investigation. Those investigations resulted in 562 indictments and complaints, and 296 convictions. It is estimated that the activities of the IFB, combined with Massachusetts auto insurance reforms, saved $1 billion during the past decade. We also have information about insurance fraud prevention and detection activities in other states.
Q: I am considering the possibility of selling my insurance agency during the next year or so. What can I look at to give me some idea of how my agency compares with its peers? I am particularly interested in knowing if I represent more or fewer insurance companies than other agents.
A: A variety of publications were provided for perusal, among them issues of the Middleton Letter. In the August 1999 publication of that newsletter it is indicated that the average agency responding to their survey represented 7.4 commercial carriers (down from 8 the prior year) and 6.1 personal lines companies (roughly the same as the prior year). Close to 70% of premium volume was placed with the top three markets, compared with 64% the prior year—a change attributed to industry consolidation. It can’t hurt to be well informed before retaining legal assistance for such an undertaking!
Q: Is there a federal law requiring insurance agents to maintain premium trust fund accounts?
A: There is no federal law on this subject, but we provided a chart published by the National Association of Insurance Commissioners that lists and summarizes pertinent laws and regulations on a state-by-state basis.
Q: The salvage industry is of interest to me. How can I identify the companies who are active in the field and learn about them?
A: The list of articles produced through a search of our database on this subject was lengthy and productive. As indicated in the August, 1999 issue of Claims magazine, the word salvage should not evoke just wrecked cars, rusted machinery, and algae-covered boats; their directory of salvage specialists yields many internet addresses along with more traditional street addresses and telephone numbers.
Q: I’m desperately in need of an explanation of what I see called “funding agreements”. What the heck are they? My on-line search has not been productive.
A: This caller was very happy to see two reports by Moody’s Investors Service, one published in December of 1998 and one in April of 1999, which give an excellent overview of such agreements. A search of our database produced a list of articles in which recent problems of some “FA” issuers were highlighted.
Q: I recently read a brief description of the Federal Riot Reinsurance Program. Can you provide any information on events that might have triggered payments under the program, and data on what those payouts were?
A: We found in our files an article published in the June 23, 1979 issue of The Insurance Advocate entitled “Federal Riot Reinsurance—the Payout for the New York Blackout”. Testimony given Gloria Jimenez, then Federal Insurance Administrator, included data indicating total reported riot losses due to the blackout of almost $12.9 million and Federal Riot Reinsurance payments of a bit more than $3.1 million
Q: Is there anything you can show me which will indicate how much of the average consumer’s expenses are accounted for by insurance premiums?
A: This inquiry is right up the alley of our friends at the Insurance Information Institute, and they did not disappoint. In the 1999 edition of their Fact Book a table, based upon data from the U.S. Bureau of Labor Statistics for 1995, shows insurance expenditures accounted for 6.8% of average household expenses. The statistics were further broken out by line of insurance, with health insurance highest at 2.% and auto insurance second at 2.2%
Q: Please search your files and let me know what is the earliest edition of the CGL form that you have.
A: The earliest form we have in our files is dated December 1, 1947, although we find references to edition dates of January 11, 1943 and February 1, 1943. If anyone has an earlier one, we would be very grateful for a copy!
Q: My employer wants me to get up to speed on current developments in the field of Directors’ and Officers’ Liability Insurance. Can you help steer me in the right direction?
A: We identified a number of items of interest to this person from a variety of sources. In addition to overview discussions of the D&O market, articles addressing the effects of the Private Securities Reform Act of 1995 and Year 2000 concerns were made available.
Q: I’m here to look at the 1983 AM Best Report on AFIA.
A: The AM Best Company included a blurb on AFIA in the section entitled “Underwriting Organizations and Combination Policies” in their 1983 book, but no report since this was a cooperative effort of 6 member insurers and not an insurance company itself. We helped fill in the AFIA profile by showing this patron an article from the August, 1981 issue of Institutional Investor(“AFIA Mounts its International Challenge”) and one from the July, 1984 issue of that journal, “CIGNA’s Big Gamble on AFIA.
Q: I recall that sometime in the 1980s a popular magazine (as contrasted with insurance industry trade magazines) published an article on the general unavailability of insurance coverage. I’d like to read it now to see if it gives me any perspective on the current marketplace. Do you know what I’m talking about?
A: Time magazine’s cover story of March 24, 1986, “Sorry, America, Your Insurance Has Been Cancelled” was provided this visitor and seemed to fit the bill.
Q: I believe the first million dollar award by a jury was made sometime in the 1960s. Can you find something in writing confirming (or correcting) my off-hand impression? Circumstances of the award would also be of interest.
A: Jury Verdict Research, Inc., of Solon, Ohio is a prime source for published information on jury awards. “JVR” indicates that the first such award was made in 1962 to actor John Henry Faulk who claimed he was blackballed after being labeled a communist in the 1950s. Compensatory damages in the amount of $1,000,000 and punitive damages of $2,500,000 were later remitted to $400,000 and $50,000, respectively.
Q: How and where can I obtain a copy of the NAIC’s Casualty Actuarial (Technical) Task Force Clarification of Revised ALAE definition?
A: This document is available through the website of the NAIC (National Association of Insurance Commissioners) at www.naic.org. We also found two inquiries which had been submitted to the NAIC Director of Research, and the responses to those inquiries. They help clarify subjects such as differentiating between adjustment of a claim and defense of a claim and the degree to which medical cost containment and utilization review expenses should be reported as ALAE.
Q: Please send me the Massachusetts law pertaining to Medicaid real estate liens for those who have purchased long-term care insurance.
A: Massachusetts Division of Medical Assistance regulations state that “No recovery for nursing facility or other long-term-care services may be made under 130 CMR 501.910( C) if the recipient…on the date of admission to a long-term care institution had long-term-care insurance whose coverage met the requirements of 211 CMR 65.00.” We were and always are happy to provide a copy of 211 CMR 65.00.
Q: Would you please send me a representative “direct action” statute? I understand such statutes enable plaintiffs to commence actions directly against a tortfeasor’s liability insurer.
A: We provided this patron with a copy of Rhode Island law Chapter 7 (“Liability Insurance”), sections 27-7-1 and 27-7-2, “Direct liability of insurer” and “Rights of action against insurer”. We also referred them to an article in the May 15, 1998 issue of Insurance Litigation Reporter, entitled “Direct Actions – Current Developments”. The article provides a good narrative description of the subject as well as a state-by-state survey of related laws and cases.
Q: Has anyone published loss ratio data by industry? We would like if possible to know the loss ratio associated with the insurance of hotel and motel businesses.
A: Rough Notes magazine regularly publishes such data in their “Regional Target Markets” section. The data, and data on niche markets in general, is produced by Insurance Market Research Corp. at 39 E. Hanover Ave., Morris Plains, NJ 07950 (201-898-4706). The loss ratio they reported for the universe of approximately 42,700 establishments in 1996 was 69.7%, “making careful selection of risk imperative.”
Q: Can you assist me in finding some current items to read concerning the computation of an insurance agency’s value for acquisition purposes?
A: A search run on our database index of articles produced a list of 23 pertinent items which were published in 1997 or 1998—our interpretation of “current” for this question. The Hales Report yielded some very likely-sounding references, as did other sources such as the Middleton Letter and Best’s Review.
Q: I have been employed by a large high-tech company for many years, but am considering the option of striking out on my own. Would it be possible for me to come in and read something about the liability exposures of computer consultants?
A: This person seemed very alert to what must be considered when contemplating a career change such as he described! He spent a morning reviewing items describing typical claims and exposures, and then researched the coverage available for those exposures.
Q: Is it possible to look at copies of insurance forms that are no longer in current use? I am sending a list of policy forms with “MLB” prefixes, all of which are dated between 1966 and 1973.
A: We have an extensive collection of outdated standard policy forms, and could find all of the forms listed.
Q: I am looking for a sample “defense only” insurance policy: can you provide me with such?
A: We located and provided a specimen policy entitled Employment Practices Legal Expense Insurance which seemed to fit the bill. This Lloyd’s form, similar to many directors’ and officers’ liability forms, provides for reimbursement of payments actually made by the insured, and does not contemplate the insurer assuming the duty to defend lawsuits.
Q: My mother suggested we purchase flood insurance for our home. While we do live on the coast, I have never heard of flooding in our area, is it really necessary?
A: We pointed this patron in the direction of the National Flood Insurance Plan website. According to the Plan, “Everyone ives in a flood zone – it’s just a question of whether you live in a low, moderate or high risk area.” They have a flood risk assessment tool right on their website where you can enter your address in to help gauge your risk. For fast facts on floods and flood insurance check the website at: http://www.floodsmart.gov/floodsmart/pages/fastfacts.jsp
Q: I am looking for the oldest standard commercial umbrella policy, what is the earliest version I can get?
A: Using old pages from the Umbrella Book and the 9/02/00 edition of Insurance Advocate magazine, we determined that the Insurance Services Office didn’t promulgate a standard commercial umbrella form until 2000, although in 1986 they did provide advisory language for companies drafting their own umbrella policies.
Q: A New York Times article I was reading listed Massachusetts as one of the states that allows children up to the age of 25 to stay on their parents’ health plans. Is that true? If so, what law can I cite when talking to my insurance company?
A: As of January 1, 2007, this is indeed true: looking at Massachusetts General Laws Chapter 175, Section 108, subsection 3 you can see that it is a part of the new universal health care bill. To better understand all of the changes you can read chapter 58 of the 2006 Session Laws.
Q: Are many claims typically made alleging malpractice against physician assistants (I am one)? How does the rate of such claims compare with the rate of claims against physicians?
A: Using the first 17 years of data available from the National Practitioner Data Bank (1991-2007), the writer of a doctoral dissertation (a summary of which is available through the Physician Assistant Experts Network, LLC) summarized “…the cost of malpractice payments in 2008 dollars exceeded $74 billion dollars from 1991-2007 for PAs, APNs [Advanced Practice Nurses] and physicians alone…of this $74 billion, only $245 million were PA malpractice payments…there was one malpractice payment for every 32.5 PAs while there was one for every 2.7 physicians”. We left it to the inquirer to check the original source of the data (the NPDA) if she felt it advisable since, as we all know, data is subject to varying interpretations.
Q: I am looking for information available for research into the Boston Protective Department. Is any of this information available in your library?
A: Our collection includes the annual reports of the Protective Department for many years beginning in 1875. Anyone is welcome to come in and access this collection.
Q: I overheard discussion of a Massachusetts company or association referred to as the “PCI”: I believe it has something to do with community development. Can you tell me what it is?
A: In 1999, as a response to state legislation, thirteen Massachusetts-based property/casualty insurance companies established the Property and Casualty Initiative, LLC (PCI) as a state wide community loan fund. Complete information about the PCI can be found on their website at http://pcifund.com.
Q: Can you provide a state-by-state survey of the discoverability of liability insurance available to defendants?
A: We provided an article published in a 2006 issue of The Journal of Insurance Regulation of the National Association of Insurance Commissioners that stated 13 states have explicit pertinent laws (some mandating discoverability, some not). We also sent a summary of case law in all states.
Q: I was recently in an automobile accident that has been determined to be entirely the fault of the other driver. I really love my car, and I want to be able to drive one like it while my car is being repaired. The other person’s insurance company wants to allow me only $30 per day for a rental. Can they do that?
A: In a letter dated February 23, 2003, Victor A. Fanikos , who was at that time Assistant General Counsel at the Massachusetts Division of Insurance addressed this situation. He stated that regarding Part 4 (Damage to Someone Else’s Property) of the Massachusetts Automobile Policy, “It appears that the general rule in the United States…is ‘Damages for loss of a motor vehicle may be measured by the cost of hiring or renting a similar motor vehicle while repairs are being made’”. He went on to say that in his years with the Division it has been the custom and practice of insurance companies to “expect that a person who owned a Chevrolet would rent a Chevrolet and a person who owned a Cadillac or Lincoln would rent a Cadillac or Lincoln”. He also noted that there is no minimum or maximum per day dollar limit to the damages that an insurance company must pay under Part 4 of the Massachusetts Automobile Insurance Policy. If you would like to get a copy of Mr. Fanikos’s letter in full, or a copy of the case he identified as the leading Massachusetts case on this subject, just email us.
Q: I am a life insurance producer, and one of my rather elderly clients has been approached by someone offering to facilitate a “life settlement” arrangement for them. They know nothing about such arrangements, and I, not being involved in such transactions myself, would like to understand the concept better, as well as to give my client something to read that isn’t from the settlement-seller but is generic and balanced. I am wary, especially since the life settlement person is telling me that I will collect a large commission if the deal is consummated. Can you help?
A: We have a wealth of information on the life settlement concept and industry. This caller chose some articles from a 26-page index produced by our propriety journal database on the subject and we were happy to send them, along with an invitation to come in and look at additional materials of potential value. It’s always gratifying to help someone who is looking out for their clients so conscientiously!
Q: A friend of mine is very active in a local target shooting club, and the club would like to participate in competitive events with other such clubs. In order to do so, they are being required to demonstrate that they have a liability insurance policy in force. They don’t. Can you give me the names of any insurance companies that might be able and willing to provide such coverage in [state was named]?
A: We were able to send this consumer a list of approximately 20 firms that list such coverage as being among their capabilities in the state of interest. Many of these firms were brokers or agencies, so it is likely that the number of actual insurance companies in the marketplace is fewer, but it was nonetheless felt that contacting the entities that were included on the list should facilitate contact with someone who could help.
Q: I have been asked about demographics of insurance agencies. I’ve searched the BLS and they don’t appear to have this type of information do you have any other suggestions?
A: Indeed we did! We provided the patron with information from a National Underwriter/Deloitte co-sponsored study on producer satisfaction which happened to have some demographic information and then provided her with a slightly more thorough discussion from The Independent Insurance Agents and Brokers of America diversity section: http://na.iiaa.org/Diversity/%20DivTK%20edits%208_25_05.pdf page 12 had a lovely graph with information.
Q: I know that UnitedHealth Group got in trouble for their reimbursement techniques. Is it possible to find the documents relating to that settlement?
A: Actually this information was readily available. There is a whole website dedicated to this class action with pdfs of a number of pertinent documents available: http://www.uniteducrsettlement.com/
Q: I know that in the antebellum period it was possible to buy insurance on slaves. Do you have a sample of a policy like that?
A: We do have a sample of just such a policy. It is found in a book entitled History of Insurance in Philadelphia for Two Centuries (1683-1882). The book notes that such policies were not issued in Pennsylvania, but some Philadelphia companies offered them to insureds in the deep south. This book, which also includes, among other things, a translated Italian marine policy from 1385 is available for “adoption” through our adopt a book program.
Q: Do you have anything actually interesting to read?
A: Of course we’d like to say that all of our materials are interesting but we can understand that sometimes the titles overlap and start to blur. . . Reinsurance Practice and the Law, The Law of Reinsurance, Modern Reinsurance Law and Practice, Reinsurance in Practice. There are some real gems hidden in our general collection though. Take the last reinsurance book listed for example, there is a great exchange of letters in the front which start: “Assuming that you have not succumbed to one or another of the diseases that often accompany a misspent life. . .” How can you not want to continue reading? There have also been some notably interesting articles over the years, including a January 2003 article published in Contingencies entitled One-Armed Bandit or Robin Hood: Assessing the Odds in Las Vegas Casinos or the December 2001 article in Claims: The Silver Screen’s Seven Most Endearing Claims Adjusters. The questioner will be relieved to know, though, that we have also started a fiction section in our collection. So far, we’ve got the entire collection of Sue Grafton Mysteries starring the former claims adjuster turned detective Kinsey Millhone. If you have any insurance fiction looking for a home, we’d welcome your donation!
Q: Do you have any current information on an organization called the Underwriters Bureau of New England?
A: It’s not uncommon for us to get company tracing questions. Usually it’s not too difficult a task with all of the resources we have here at the library. We also get requests to trace agencies and brokers. This is slightly more taxing but we do have some items in our collection to help. Associations are by far the most difficult to trace. Through a combination of resources (the Cyclopedia of Insurance, our Card Catalog, The Proceedings of the Casualty Actuarial Society, and III’s Factbook), persistence and sheer luck, we were able to figure out that the Underwriters Bureau of New England merged into what is now the Insurance Services Office.
Q: I’m working on a complex environmental case involving the release of some substances. We’re trying to figure out if we have insurance coverage. Do you have a list of what substances are considered to be pollutants?
A: It turns out we had two items that fit the bill. Munich Reinsurance kindly sends us a copy of their publication: Environmental Coverage Case Law every year. In their publication, they have a section called “what is a pollutant” where they list a number of substances and then cite related cases and their findings. The International Risk Management Institute Also has a publication which provides similar information.
Q: Do you have anything actually interesting to read?(Yes, we’re totally recycling this question)
A: Currently topping our list is the first ever satire edition of The Insurance Journal (published in August). We have extra copies if you’re interested, or you can go to their website and read it there. We can also recommend Bet Your Life, a Novel by Richard Dooling. We don’t want to give too much away, but it involves viatical settlements. As always, if you have any insurance materials (fiction, non-fiction, periodicals etc) looking for a home, we’d welcome your donation!
Q: I heard from someone that with Obamacare you no longer have to meet the family maximum out of pocket on health insurance to stop paying out of pocket is this true or just an urban myth?
A: What you were told was true, but it requires a little bit of clarification. All non-grandfathered health insurance programs which renew in 2016 must limit out of pocket costs to consumers to $6,850 per plan year regardless of whether the individual is on an individual health plan or on a family plan. This means that while the family plan’s out of pocket limit might be higher, individuals no longer need to meet the higher family limit before a particular individual can stop paying out of pocket — they must only meet the individual limit of $6,850. For more explanation and some examples, you can visit the Department of Labor’s FAQ on the change or the definition of out of pocket maximum on Healthcare.gov.
Q: What is the difference between Self-Insurance and Captive Insurance?
A: It’s sort of a fingers and thumb situation. All captive insurance companies are a type of self-insurance. At the basic level self-insurance is a specific fund a company sets aside (often the money they would pay in insurance premiums) to be used to cover payments of losses. It is different from non-insurance or payments of deductibles because the funds are intentionally set aside to cover specific risks (health insurance, liability insurance etc.) and there is a formal plan for paying losses. Self-Insurance gives the company flexibility in investing the money and can sometimes reduce expenses for them.
Captive Insurance is an actual insurance company owned by one or more non-insurance entities. It is not just funds in an account set aside for losses. The captive insurance company’s primary purpose is to finance the risks of the owners or participants. Captive insurance companies do have to follow insurance regulations and statutes like a regular insurance company, though often they have slightly different requirements.
Q: I am on the board of my daughter’s pre-school. Like all schools, we’re always looking to cut costs where we can so we can spend more money on the students. When we got our insurance renewal it included Hired Non-owned Auto insurance. There is no busing of students and when they go on field trips, which are rare, they are in parents’ cars. Shouldn’t the parents’ insurance cover any accident?
A: The Hired, Non-Owned auto coverage should be perfect for the scenario described. This Property Casualty 360 article describes some of the scenarios where this insurance might be critical. We also provided the patron with an excerpt of a Risk Report article which discusses Hired & Nonowned Auto as part of “Casualty Insurance Gaps to Avoid.”
We did suggest that the patron confirm with their producer that the insurance would cover volunteers who were driving as well as employees, but the bottom line is this is definitely a coverage to keep. If someone tries to sue the school for an accident that occurs while in a parent’s car on a school field trip, the insurance should step in. It also usually covers claims when the parent’s insurance might have insufficient limits.
Q: Are Massachusetts Public Adjusters Required to take an ethics course?
A: The short answer is no.
There were changes not too long ago to Public Adjuster credits, in that the Massachusetts no longer will accept classes approved for producer credit to count toward an adjuster license. The adjuster courses must be separately approved and cannot be offered in conjunction with producer approved classes. On the Prometric website if a class has been approved for Adjuster credits it is designated by the prefix “AD.” Adjusters are required to have 15 adjuster (AD) credits per 3 year renewal. The Library does have some classes approved for adjuster credits and would be happy to bring any of them on-site. If you’re interested in learning more about on-site classes or adjuster approved classes, please feel free to email.
Before we leave the topic, we do feel it’s important to mention that Massachusetts Producers are required to get 3 hours of ethics instruction during every three year renewal. These classes are designated by Prometric as “MAE” (as opposed to “G” on their website). Agency Checklists did a series of articles in 2014-2015 which provide more detailed information on the changes that took place with the Massachusetts producer continuing education requirements.
Q: We just found out we’re going to have a baby and we know we need to contact our health insurance, but is there anything else we should be considering as far as insurance?
A: After congratulating the new parent, we told them we were impressed with their question. There are a lot of aspects of insurance which a child can affect and most people don’t think about it until it’s too late! Luckily, the Massachusetts Division of Insurance has a handy new parent guide. We also recommended that the patron contact her insurance producer as producers are primed for just these sorts of questions.
Q: I keep hearing about InsurTech but I don’t really know what it is, can you point me in the direction of some resources?
A: Investopedia has a great definition/quick outline of what InsureTech is. We also think the World Insurance Report 2017 provides some great information on InsurTech (you can download a free copy by registering with Capgemini). Locally, Agency Checklists has also done a few articles on InsureTech. Looking for more answers? You should definitely consider registering for our free webinar series offered in conjunction with Strategy Meets Action. The first seminar, “How Emerging Tech and InsurTech are Sparking Innovation” is THIS Wednesday, November 1, 2017. Future topics will be: “The Power of Advanced Analytics and AI”; “Significant Shifts in Distribution and Underwriting”; and “The Changing Face of Claims.”
Q: I saw on CBS News that FEMA spends more on fighting people who have flood insurance claims than paying actual flood claims, is that true?
A: We believe that what the patron was referring to is a series that CBS did this spring. In response to that report, FEMA issued a press release indicating that less than 0.0002% of the money spent on the Louisiana floods went toward litigation, with the rest going toward settling and paying claims. We can’t speak to the specific issues the insureds on CBS had but it’s a good reminder to go over your policies and to be sure you understand what is and isn’t covered by your policy. The Massachusetts Division of Insurance has a good section on FAQs related to floods comparing coverage from homeowners Insurance, commercial property insurance and flood Insurance. FEMA also provides a National Flood Insurance Plan summary of coverage to help figure out what is covered by the policy. When in doubt, it’s always good to talk to your agent or broker.
Q: As an independent agent I know that insurance is critical to my finances, but I was wondering how much of an impact does the insurance industry have on our economy as a whole?
A: What a great question! An economist from The Insurance Information Institute recently issued a white paper entitled: How Insurance Drives Economic Growth that addresses this very topic in great detail. We also thought that as an independent agent the patron would be interested in The Economic Impact Study which The Massachusetts Association of Insurance Agents puts out every few years. The most recent one is from 2015, but they’ve just collected data this year and will likely have a new study out this fall.
Q: We’re looking for a copy of an umbrella policy called “The Defender” from The North River Insurance Company sometime in the mid-80s. Is this the sort of thing you might have?
A: While we have a large (near complete) collection of standard policies (both ISO and AAIS), we always warn patrons that our collection of company specific policies is less thorough. In this case, we had just what he wanted: a 1985 Defender policy put out by the Crum and Forster Group (which included The North River Insurance Company as well as United States Fire Insurance Company, Westchester Fire Insurance Company, and International Insurance Company). Just goes to show it never hurts to ask for exactly what you want!
Q: In an antique store I came across a policy issued by a company called: “What Cheer Mutual Fire Insurance Company.” I was so tickled by the name, I wondered whether they still exist.
A: We agree, that is a GREAT name, unfortunately, they no longer exist under that name. We found the company listed in the Best’s Insurance Report we have from 1900 and traced them forward to today. Through a series of mergers and name changes, they are now part of Factory Mutual Insurance. It turns out we even have a couple of sample policies from them in our collection as well. We’re always eager for more donations to our collection of company specific forms, so next time you’re antique hunting, or if you’re just looking to downsize your collection, please keep us in mind!
Q: Is there an annual list of leading women in insurance?
A: Business Insurance has had a “Women to Watch” award ceremony every year since 2006. For a list of honorees going back to 2006, you can click here.
Q: I’ve heard there’s a new issue with hackers taking over a computer system and ransoming it back. Who exactly does this affect and is there insurance for it?
A: While everyone with a computer could be susceptible to ransomware, we have seen two recent articles on the topic. Lawyers Weekly mentioned the it in their June 20, 2016 edition. It was one of several areas they suggested that Law firms might be in danger of cyber attacks. They discussed broadly how stand alone cyber insurance might help. Perhaps a more thorough article, though was the one in Risk Management’s May 2016 edition. It discussed how hospitals have been affected by ransomware and suggested both cyber liability policies as well as kidnap and ransom policies as possible ways to insure such attacks. If you’re a member of The Library, you can access a list of additional articles we have indexed on cyber liability and other topics in our member portal. If you want an even more thorough examination of cyber liability policies, also keep your eye out for our cyber liability class which will be taking place sometime in the late fall!
Q: I’m thinking about becoming a Lyft driver but I’m not sure about how to insure myself/how much it might cost, do you have any resources?
A:The first resource we provided was a great visual produced by USAA for Ridesharing Gap Insurance which helped explain the insurance issues surrounding driving programs like Lyft. We were able to direct the potential driver to an excellent article put out by Agency Checklists in April 2017 which addressed her questions more thoroughly. While it focused on MAPFRE’s TNC endorsement, it also provided some background information on legislation and how TNC endorsements work in general. There was even a section with an estimate for insurance costs.
On the MAIA website, we were able to find additional information, including some specimen endorsements from Allstate and Plymouth Rock who also offer ridesharing coverage in Massachusetts.
Q: I’m moving to Vermont and I’ll need homeowners and auto insurance, can you help me figure out who offers that?
A: We were able to provide information on the top insurers by market share for home and auto through Best’s By Line By State Reports. We also provided a link to the NAIC’s Consumer Information Source where the patron could look up consumer complaint information. To truly help with the maze of purchasing insurance, though, we did recommend that the patron consider a Trusted Choice agent.
Q: I’ve just inherited a boat but I have no idea how to insure it. I am also considering options for making money off of it like renting it out or putting advertising on it. Someone said that might make insurance even more complicated. Do you have any information on who might insure boats and what kind of insurance I can get?
A: In this case, the heir is in luck, at least according to two Rough Notes articles we found on the topic, here and here. It appears that the boat insurance market is currently highly competitive meaning insureds can expect good pricing as well as bundling and niche offerings including for “peer to peer rental.” The articles even provided contact information for companies providing insurance solutions for this product. Both articles note that the insurance is not standard and can vary significantly between carriers. In such cases, we always recommend contacting an informed agent or broker to help navigate.
Q: How does the reference process work in Massachusetts and must it be begun before the two year statute of limitations on a claim?
A: We provided a link to the law as well as links to two handy guides on reference, one from Property Insurance Coverage Law and one from Sloane & Walsh.
We reminded the consumer that we were not legal professionals, but that three cases we found indicated that the reference proceeding must be started prior to the end of the two years. The cases we thought addressed this topic were: Hawley v. Preferred Mutual, J&T Enterprises v. Liberty and Nunheimer v. Continental Insurance. One case indicated reference should be begun at least 10-20 days prior to the deadline so the insurance company would have the legal amount of time to respond. Nothing we found indicated that delay and negotiation on the part of the Insurance Company affected the two year time limit (though it might affect a bad faith claim).
Q: Is it possible to purchase coverage for mold for a home?
A: ISO has a few endorsements which can provide limited coverage for mold depending on which homeowners policy you have. We provided the consumer with a copy of the HO O4 27 Limited Fungi, Wet or Dry Rot, or Bacteria Coverage endorsement which can be attached to the HO 03 as well as some brief analysis on the endorsement.
Q: Can you suggest any expert witnesses to determine the earning potential of an insurance professional?
A: We suggested that the patron consult the ARIAS US Arbitrator Search System as many of them also act as expert witnesses. The SEAK Expert Witness Directory also has a list of insurance experts.
To do some of her own research, we also recommended checking out the IIABA Agency Universe Study or their Best Practices publication which can often provide some information on salaries.