Coverage decisions tend to be expensive one way or the other. If an insurance company determines coverage exists, then it has to pay for the underlying claim. If the claim was not really covered by the terms of the insurance policy, then the company has incurred an expense that was unnecessary and which adversely impacts the year end financial picture. Decisions to deny coverage, when in fact it exists, is even more expensive. There is the litigation expense plus the potential bad faith claim.
Christopher J. Boggs wrote a commentary about what his 19 years of experience in the insurance industry had taught which he was kind enough to share.
- Only good lawyers realize they don’t know everything about the law
- Someone who truly understands insurance can explain its concepts in simple language. The person with no idea how it works masks his ignorance with $10.00 words and legalese
- There is ALWAYS more than one possible answer to a coverage question. One is just more correct than the others based upon the particular situation
- Only “newbies” know everything about insurance
- Regardless of how much I know (or think I know) about insurance, there is always MUCH more to learn. It is NEVER okay to guess at the answer to a coverage question
- It’s perfectly acceptable to say, “I don’t know”, as long as you follow it up with “but I’ll find out and get right back to you.”
The only other thing I have to add from my 25 years of coverage analysis is the answer is always simple – just ask either side! They always know the answer!