Errors and omissions Insurance is universally recognized by professionals across all industries as a fundamental security component for their practices. Nevertheless, the process of filing an insurance claim can often seem like a labyrinth of uncertainty, misinformation, and apprehension. This article aims to not only demystify the intricacies of the claim process but also to convince you of its paramount importance, providing compelling guidance to policyholders when faced with adversity or threats to their practice.


Notice: The Crucial First Step - A No-Brainer


Initiating the claim process begins with presenting a notice of a claim or circumstances that are likely to become a claim to the insurance carrier. Many insured individuals are hesitant to report claims or potential claims for various reasons, including concerns about increased premiums, policy cancellations, self-representation, the belief that the issue will resolve itself, and more. While these concerns are valid, it's essential to juxtapose them with critical facts:

  • Insurance companies not only accept but actively encourage overreporting rather than underreporting. They exist to protect you.

  • Professional liability insurance aims to address problems before they escalate, preserving your practice's integrity.

  • Claims professionals have a wealth of experience dealing with similar issues, offering invaluable guidance.

  • Neglecting or downplaying a threat can result in catastrophic consequences for your practice.

  • Reporting a claim within the claims-made or extended reporting period is a prerequisite for coverage. Delaying could jeopardize everything.

  • Claims or circumstances likely to become a claim, arising in a prior policy period but reported in a subsequent policy period, may face denial. The clock is ticking.

  • Failure to report a claim or potential claim from a prior policy period can be considered misrepresentation on the application, potentially leading to policy rescission. Protect your future.

  • Witnesses and evidence can deteriorate or lose credibility over time, leaving you vulnerable.


In summary, exercising caution when providing notice of a claim or potential claim is wise, but hesitation should never prevail when there is any doubt that a problem could evolve into a future claim. If questions persist, consider utilizing your policy's Helpline/Hotline, if available.


Initial Analysis: A Critical Step Towards Peace of Mind


The initial claim investigation is pivotal in gaining a comprehensive understanding of the situation at hand. Qualified and licensed claim adjusters will conduct a thorough initial analysis to devise a solid plan with the insured party. This initial analysis serves as the foundation for creating a strategy to promptly address any issues that have arisen or may arise in the future. Depending on the circumstances, this may involve hiring defense counsel with extensive malpractice defense experience or devising a strategy without engaging defense counsel. Regardless, preparation for navigating challenging circumstances is paramount from the outset.


Game Plan/Strategy: Your Shield Against Uncertainty


As claim circumstances evolve, defense counsel and claims personnel can collaborate on crafting a tailored strategy to expedite the claim or litigation process. Most insured individuals understand that leveraging the expertise of professionals in a specific field leads to above-average results. Those who opt to self-defend are in a precarious position if the claim takes an unexpected turn, with no insurance policy to indemnify potential losses. Lastly, if there's ever any doubt about whether to report a potential claim or issue, recall the sage advice of Abraham Lincoln: "A man who is his own lawyer has a fool for a client."


In conclusion, the decision of whether to report a claims notice can be subjective. Nonetheless, it is crucial to be cautious of the risks associated with underreporting, as a claim can jeopardize your practice or license. The insurance mechanism is designed to aid professionals in managing and mitigating risks. If you ever find yourself questioning whether to report, don't hesitate to reach out to your agent or utilize the Helpline (if available) to discuss concerns and determine the recommended approach.