Thursday, July 6, 2017

Be Wary Of Insurance Agent Malpractice

By Catherine Lee


When professionals we trusted commit fraud and misrepresentation, the public is outraged. This outrage most often takes the form of massive lawsuits, and the situation can get tense for everyone involved. If large numbers of people are victimized, then even insurance agent malpractice cases experience the reality of a class-action suit.

Such misuse of a career can take many forms, and often the victims do not know they have been had till years later. What occurs in most cases is related to simple green on the part of the agents, and a general ignorance on the part of their victims. Very few people can make sense of most any policy they sign up for, and in some cases they are simply trying to stay within the law.

With their ability to hide behind the assumed ignorance of their insureds, these cases can be complicated to sue, and nearly impossible to prosecute. Assessing the true intent of the agents is a grey area that the insureds might not even know to pay attention to. It is not ill advised to suggest that conversations with their agents be recorded for this reason.

Overcharging is one of the more common forms such fraud can take. These cases generally only come to light when the insureds follow up with their insurer directly. There have been cases where young people have been charged in excess of $200 a month for minimum coverage that should have only cost $50.

Misrepresentation of policy provisions is a much sneakier form of fraud, and much more difficult to prove. Insureds who are wary enough to either record conversations with their agents, or confirm communications in writing may not be able to prove their case. Some agencies try to avoid the very risk of this sort of backlash by having their agents memorize a sales pitch, and this script becomes their defense in court.

This was a troublesome issue for many Floridians who discovered their named peril policies failed to name water damage as a covered risk. Their home or business may have been covered for the wind damage, but the ocean swell damages were not included. When the customer does not know what they are looking at in a policy, they might not realize that they are being sold a product that will not adequately protect them from financial ruin.

In the case of policies that are all-risk, shady agents have been known to submit exclusions to policies months or years after the original product is sold. They intentionally make the document enumerating a new exclusion somewhat vague as to how it changes the coverage. If the insureds fail to keep what their agents send them, then they lack an actionable cause they can prove in court.

Vague wording or any inconsistencies in a policy should, within any contract, be read to the benefit of the insureds. The truth of the situation is that the process of establishing that an inconsistency or some form of vague wording even exists can take months. This is plenty of time for the average home or business owner to lose everything as a result of what they probably believed was a covered loss.




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