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GIB, Inc.
2910 Morning Creek Rd
Suite 4
San Diego, CA 91914
PH: (619) 661-0641
FX: (619) 661-0642
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What to Do if You Have Been Declined Insurance
Coverage or Have Special Coverage Problems
Once you have been declined malpractice insurance coverage
by a carrier, obtaining coverage from a second carrier may be difficult. For one
thing, a second carrier is likely to ask whether you have been declined by another
company. Second, the same problem that caused the original declination of coverage
is still likely to exist, making your chances of securing coverage doubtful. The
same holds true if you have special coverage problems (e.g., a large percentage
of you practice is in securities). However, there are some things you can do to
increase the chances of obtaining coverage for yourself or your firm.
Helpful Tips
1. Provide as much information as possible to the insurer up
front. Don’t wait to be asked about past claims or potential problem areas. Be as
forthcoming as possible. Avoid answering any question on the application form with
“not applicable.” Explain every thing that might be declinations of coverage.
2. Explain fully your firm’s docket control system. Describe
the system in detail. Emphasize that you have some sort of cross-checking mechanism
by more than one person to ensure accuracy and efficiency. If you are a sole practitioner
and have no office staff, explain your circumstances and ask the insurance company
to tell you if your system is insufficient and, if so, what you should do to improve
your office management procedures.
3. Include on the application form all memberships in professional
associations (e.g., state and local bars and the American Bar Association) and attendance
at CLE events.
4. If you have problems due to unusual circumstances, insure
your broker makes direct contact with an underwriting supervisor of the insurance
company. In your situation, what your broker should try to do is override the underwriting
guidelines, which have little flexibility. Only an underwriting supervisor has the
authority to supersede those guidelines. Work with your broker to send a letter
to the manager of the underwriting department with the following basic message:
“I realize that I am an exception to your guidelines. Please review my application
individually.”
5. If you have been declined by another carrier, you face a
serious problem. On the section of the application that asks, “Have you been declined
for coverage by another insurance company?” answer “yes.” Explain why you were declined
and what steps you have taken to correct the situation. For example, if you were
declined because of inadequate docket control procedures, explain fully the systems
that you have implemented. In short, do everything you can to let the insurance
company know that you are not a bad risk and that past problems have been rectified.
6. Participate in a “Risk Management Audit Program.” This is
an audit of the firm’s physical location by an independent, skilled auditor. Ask
the auditor to specifically comment on your behalf regarding any insurability concerns
that the underwriter may have.
Excerpt from the American Bar Association Web Site
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