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Errors and omissions and the requirements made and reported



See the full video at https://youtu.be/DvxXr2Toh5w and at https://rumble.com/vny2t6-a-video-explaining-the – difference-between-claims-made-and-occurrence-policy.html

When buying faulty and missing insurance, the insured must be aware that the insurance will always only respond to claims made and reported during the insurance period. since the application becomes part of the insurance and is included in the insurance, the insured guarantees the absolute truth in every statement made in the application. They differ from traditional "occurrence" -based policies, mainly based on the extent of the risk they insure against. With non-life insurance, coverage is provided only if the document that gives rise to coverage is discovered and made aware of the insurance company during the insurance period. The core of a complaint policy is notification to the carrier within the insurance period. Claims or discovered policies are mainly reporting policies. If the claim is reported to the insurer during the insurance period, the carrier is legally obliged to pay; if the claim is not reported during the insurance period, no liability will be added.

Insurance companies prefer non-life insurance because it enables a more accurate calculation of risks and premiums. There is no long tail liability for losses that occurred during the insurance period for an "occurrence" policy but were reported dozens of years later. This theoretically results in lower premiums for an insured because there is no open "tail" after the expiration date of the insurance.

I Personal Resource Management, Inc. V. Evanston Insurance Co . 7 NE3d 1025, 2014 WL 962930, (Ind.App. 03/12/2014) Personal Resource Management, Inc. (“PRM”) and Margaret A. Ditteon (together “the insured”) appealed the district court's introduction of a summary judgment in favor of Evanston insurance company on the insured's complaint about breach of contract.

The Indiana Court of Appeal chose the easy way to resolve this dispute – it found that the claims were not made within the insurance or there were documents that did not fit into the definition of "professional services". It could have concluded that the insurances were acquired as a result of a misconception of material facts, that there were no previous losses and that the insured did not know of any potential claims. These facts enabled the insurer to declare the insurance invalid due to standard fraud, misrepresentation or concealment terms or to cancel the insurance from the outset as it was acquired as a result of fraud or material misstatement as each fact in the application was agreed by both to be essential.

Courts have found that claims made do not impair public order and serve a useful function of enabling insurers to more closely control the risks they wish to insure. [ Scarborough v. Travelers Insurance Company 718 F. 2d 702 (5th Cir. 1983); Langley v. Mutual Fire, Marine and Inland Insurance Company 512 So. 2d 752 (Ala. 1987); Zuckerman v. National Union Fire Insurance Company 495 A. 2d 395 (N.J. 1985) And Gulf Insurance Company v. Dolan, Fertig and Curtis 433 So. 2d 512 (Fla. 1983).


© 2021 – Barry Zalma

Barry Zalma, Esq., CFE, now limits his practice to serving as an insurance consultant specializing in insurance coverage, insurance claims handling, bad faith insurance and insurance fraud almost as much for insurers and policyholders.

He also acts as an arbitrator or mediator for insurance-related disputes. He practiced law in California for more than 44 years as an insurance and claims management attorney and more than 54 years in the insurance industry.

Subscribe to Excellence in Claims Handling at https://barryzalma.substack.com/welcome.

He is available at http://www.zalma.com and zalma@zalma.com. Mr. Zalma is the first recipient of the first annual Claims Magazine / ACE Legend Award. For the past 53 years, Barry Zalma has devoted his life to insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to enable insurers and their indemnity staff to become professionals in insurance claims.

Go to training available at https://claimschool.com; articles at https://zalma.substack.com, the podcast Zalma On Insurance at https://anchor.fm/barry-zalma; Follow Mr. Zalma on Twitter at https://twitter.com/bzalma ; Go to Barry Zalma videos at https://www.rumble.com/zalma; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg; Go to Insurance Claims Library-https: //zalma.com/blog/insurance-claims-library/ T the last two issues of ZIFL are available at https://zalma.com/zalmas-insurance-fraud- letter -2 / podcast now available at https://podcasts.apple.com/us/podcast/zalma-on-insurance/id1509583809?uo=4


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