Monday, May 24, 2010

When Perception Shouldn't Equal Reality

I am an attorney, and I regularly represent insurance companies.  Apparently in the view of some, like the two gentlemen I spoke with this afternoon, that puts me in disreputable company.

People with insurance coverage questions or involved in insurance coverage disputes who surf the Internet looking for answers sometimes find their way to this blog, and some of them call or email me.  Like James from New York, who inquired this afternoon about where he might find some more case law or legal treatise resources on a particular issue of New York insurance law.

I read James's email and considered not responding.  After all, he, like the others who send unsolicited emails to me, should have no expectation that I will take the time to respond.  But I did.  Respond.  Nothing too crazy.  Just some links to some posts within these pages, instructions on navigating to Subpart 60-2 of Title 11 of New York's insurance regulations, and a perfunctory disclaimer that my reply did not constitute legal advice or create an attorney-client relationship.  

Two hours later James's perception intersected with my reality.   He replied with a thank you email, which began:
This is great and quite wonderful of you.  Are you sure you are an attorney?  I can't remember when I have been so informed and kindly treated by a member of your profession.  
Ouch.  Really?  If James has had much interaction with attorneys in the past, his compliment to me serves also as an indictment of the legal profession.  And regardless of the accuracy of that perception, its very existence should be troubling to all who have attained membership to the bar.

Less than an hour later I returned a telephone call to Steven from California, who owns rental property in Buffalo and had a question about vandalism coverage.  In describing the background of his loss and very first property insurance claim, he told me of a telephone conversation he had had with his insurance agent -- bearing the same company name as his insurer -- earlier today.  In response to Steven's remark that it seemed to him that his insurer was looking for grounds to deny his claim, his agent said, "Don't all insurance companies look for a way to deny coverage?"

Ouch.  Really?  If that's the perception of even producing agents, insurers should be concerned.  I know no one who likes paying insurance premiums, but when the consuming public think insurers look to deny rather than pay their claims, something's wrong.  And as with James's perception of attorneys, the very existence of what is now Steven's perception of insurers should be troubling to insurance companies.

The last slide of every single one of my PowerPoint presentations on insurance coverage and fraud topics reads:

Remember, the glass is half full,
not half empty.

Seek to determine whether payment
can be made, not denied.

When it comes to attorneys, insurance companies, and insurance company attorneys, perception should not necessarily equal reality.


Cheryl said...

Your e-mail rings so true. Just yesterday I was accused by an agent of my company of looking to not deny a claim. I indicated whole heartedly that I was personally offended, I get paid to look for coverage and pay for covered claims under the insurance contract. The hardest part of my job is telling people there is no coverage!

Roy A. Mura said...

Most people think that their insurance agents, independent or branded, advocate for them on claims, not the other way around. For the sake of keeping their covered loss ratio low and contingent compensation high, however, unfortunately some agents advocate for the denial of their customers' claims. I understand that situations sometimes arise in which there is a close coverage call, but in those instances, one would think that the one with the closer, more personal relationship with the policyholder would want the claim paid. Agents are, in some respects, front-line underwriters and are in the best position to identify unacceptable risks. If they place such risks and covered losses occur, they should not blame the insurer for paying the claims.

The irony of Steven's situation is that it was his agent who called him in California to tell him he needed a vandalism rider on his policy, given that he lived across the country and was not local to keep an eye on his property. Steven thought he was buying extra coverage to protect himself against the risk of a tenant trashing his rental property. I haven't seen the policy language yet, but he may have been mistaken. Or taken.

Anonymous said...

May I also add to your comments that not only do you take YOUR time with potential clients, you also take YOUR time to assist and respond to fellow members of the bar! And yes, you ARE a rare breed and a honor to all of us in the bar who are like you! Thanks, and remember to pass it forward.

Daniel A. Zahn, Esq.

Larry Rogak said...

I took a deposition of an insured this week in a DJ action which arose when my client -- the insurer -- disclaimed in a liability suit because of late notice and the fact that the occurrence took place in an uninsured location. From the moment I walked into the deposition room, the insured -- a homeowner -- looked at me like I had just run over her dog. Her answers to each of my questions were given in a hostile and venomous tone. I finally had to say, "May I ask why you seem so hostile to me?" Her answer: "Because YOU denied me coverage."