MIND THE GAP: Identifying & Eliminating Insurance Coverage Gaps INS002 Speakers: Lee M. Epstein, Partner, Weisbrod Matteis & Copley PLLC Adam Roffman, Vice President, Risk Management Toll Brothers, Inc.
Learning Objectives At the end of this session, you will: Appreciate Components Involved In Evaluating Current Insurance Program Year Round/Day to Day Steps Specialized Insurance Coverage Audits Learn How To Determine Whether Your Current Insurance Program Meets Needs Be Able To Identify Coverage Gaps
Beginning At the End Actual Claims Encountered Purely accidental? Human error?
Retaining Wall Not Retaining
Crane Collapse In A Major City
Landing Challenged
Our Homes Burn Well.
Our Homes Burn Well.
You Can t Make This Up!
You Can t Make This Up!
You Can t Make This Up!
Exposing Coverage Gaps After the claim occurs Incident investigation Facts and information collected Assessments calculated, repairs made, etc. Put responsible 3 rd parties on notice The Gap realization starts The policy is re-read Opinions start to take shape Everyone stakes out their position
Examples Of Coverage Gaps Property Claims Undamaged portion of a building Forests & Tree s How clean are those windows? Golf Courses Liability Claims Horizontal Exhaustion Injured Subcontractors Construction Defect Commercial vs. Residential Work
The Starting Point The Risk Management process is only the beginning Need to think outside the box about what can happen to your organization that would prevent it from meeting its goals; either Financial, Operational or otherwise.
Input From A Variety of Areas Outside Resources Insurance Broker Risk Consultant External Auditor Industry Specialists Risk profile of outside business partners Inside Resources Enterprise Risk Committee Safety Management Committee Non-traditional sources.
An Organization Working Together Quality Assurance Architecture team Engineering team Land Development Group Manufacturing systems 3rd party inspections Internal Audit Legal Department OPs/PM Weekly Meeting notes
Communication Is Key Once you know where the gaps may lay; communicating with others is the first step towards fixing it. Safety Team Project Managers Joint Venture Partners Land Acquisition team Senior Management Audit Committee Insurance Broker
Communication Is Key Steps with your Insurance Broker Proper renewal timetables Assessing your policies each year Carrier underwriting discussions Claims management communication
Communication Is Key Steps with your Insurance Broker (continued) Internal Management Discussion Post Renewal discussion with Broker Start planning goals and objectives for next year Repeat entire cycle!
Insurance Coverage Audit Goals Ground Up Evaluation Of Current Insurance Program Determine Whether Current Insurance Program Meets Needs Identify Any Unwanted Gaps In Coverage
Insurance Coverage Audit Why Necessary Modern Insurance Programs Are Highly Complex Insurance Policies & Standard Forms Are Ever Evolving New Exclusions Added To Existing Policies New Insurance Products Introduced To Market Knowing What Coverage You Have And What Coverage Is Available Is Critically Important
Insurance Coverage Audit 3 Steps Interview Key Team Members Analyze Insurance Policies & How They Interrelate Identify Coverage Gaps
Insurance Coverage Audit Step #1 Interview Key Team Members, including in-house counsel, risk management team & other executives Evaluate the Following: Current & Potential Exposures For Ongoing & Anticipated Projects Anticipated Corporate Transactions & Potential D&O Exposures Privacy Policies & The Collection Storage & Use of Confidential Information Are Professional Services Offered Extent That Additional Status Offered To Others
Insurance Coverage Audit Step #2 Analyze Insurance Policies & How They Interrelate All Lines of Coverage Analyze How Program Interacts As A Whole Analyze How Primary & Excess Policies Fit Together Analyze Coverage Provisions Notice Duty to Defend/Defense Costs Choice of Law/Dispute Resolution Deductibles, SIR s & Retros Trigger & Allocation of Coverage
Insurance Coverage Audit Step #3 Identify Coverage Gaps Prepared By Legal Counsel Not Shared With Third-Parties, Including Brokers, In Order To Maintain Attorney-Client Privilege
Summary & Questions Be Vigilant Look For & Close Coverage Gaps Year Round Periodically Supplement Process With Specialized Insurance Coverage Audits If Coverage Gap Identified Be Proactive