Rarely are clients immediately aware of the wrongful or erroneous actions of the "professional" they trusted to perform specific duties or services; mainly because "professional" acts or errors do not or only seldom cause immediate injury. A "professional's" wrongful acts or errors may not manifest in client injury until long after the act is perpetrated or the error is committed.
Two mutually exclusive goals are beginning to result in apparently unintended results within the executive and professional liability markets. The quest for underwriting profits and the desire to develop clear (to whatever extent possible) coverage language have rapidly changed the coverage landscape within these two lines of coverage.
The 35-year history of the claims-made policy form has not brought it stability or standardization. In fact, claims-made forms have begun to incorporate with increasing frequency additional and exclusionary language that is unfavorable to the policyholder.
The claims audit is the anathema of day-to-day claim operations. Nothing is more disruptive. Yet, if properly defined, nothing is more informative and helpful in improving a claim management program. This article will examine the need for a regular auditing program and provide a recipe for a three-dimensional approach to the process in order to maximize the accuracy of the audit results.
Professional liability claim management is a unique area of insurance claim responsibilities. Indeed, there are as many ways to supervise, manage, and investigate professional liability claims as there are different lines of professional liability coverage. This article will address the key issues that are involved in the investigation and resolution of nonmedical and non-D&O claims under professional liability policies.