Primary Agent - March 2011 - DE Edition

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IN THIS ISSUE: ______________ Legislation: one year later Opportunities for brokers DELAWARE

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Primary Agent - March 2011 - DE Edition

Transcript of Primary Agent - March 2011 - DE Edition

INTHISISSUE:______________

Legislation: one year later

Opportunities for brokers

DELAWARE

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“No bond, no job. No job,no commission.”

We know times in the construction business are tough andthat even the best of clientsare having problems. That’swhy when your client needs abond Commonwealth Surety should bethe first call you make. With our “A” Rated Treasury Listed bonds wecan provide the bond you never thought you could get. Why shoparound, get buried with paperwork and hear excuses? If we can’t writethe bond nobody can! We specialize in bonding those “less than perfect” clients, without cash collateral or Letters of Credit, and we’ll getyou that “YES” that you want to hear in 24 hours or less. We’ve beenwriting bonds for small and midsized companies for over 20 years. No bond is too big or too small. And by the way, we’ll even write thatbond for your perfect clients. Call now and get results not excuses.TOLL FREE: 1-800-886-7760FAX TOLL FREE: 1-800-566-7761

The place for the hard-to-place Bonds

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Patient Protection and Affordable Care Act: one year later

Controversy and conflict aside, health care reform is upon us. The March 2010reform law set the wheels in motion, and a year later, implementation and itsrecourses are reality. Here, IA&B cuts through the clutter and presents keyupdates on what members – as producers and as small-business owners –need to know.

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An upside to health care reform

Health care reform has cast a dark shadow over the industry. But beyond theconcern over commission cuts and the future of producers’ role, there is abright spot: the blossoming voluntary benefits market.

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ContentsP R I M A R Y A G E N T M A G A Z I N E

Copyright 2011. All rights reserved. No material may be reproduced in whole or in part without written consent of the publisher. The information in this publication is general in nature and is not intended to serve as legal, accounting, financial,insurance, investment advisory or other professional advice as to any reader’s particular situation. Users are encouraged to consult withcompetent legal, financial, insurance, investment advisory and or other professional advisors concerning specific matters before makingany decisions and we disclaim any responsibility for any decisions or actions by readers. Statements of fact and opinion in PrimaryAgent are the responsibility of the authors alone and do not imply an opinion on the part of the officers or the members of the IA&B.Participation in IA&B events, activities and/or publications is available on a non-discriminatory basis and does not reflect IA&Bendorsement of the products and/or services.

Subscriptions: Non-member price: $2.25 per copy or $15 per year.

All communications for publications, including news, features, advertising copy, cuts, etc., must reach the editor by 1st of month two monthsprior to publication. Advertising rates furnished upon request.

Address inquiries to:Primary Agent EditorPO Box 2023Mechanicsburg, PA 17055-0763Phone (800) 998-9644 or (717) 795-9100 Fax (717) 795-8347

Periodical postage paid at Mechanicsburg, Pa. and additional entry post office.

Postmaster: Send address changes to above address.Primary Agent (ISSN 1543-3110), Permit # 638-620, Issue # 2011-3) is published monthly by IA&B Service Group Inc., a subsidiary of IA&B.

4 Chair of the Board’s Message5 Member FAQ6 State News8 Coverage Corner10 Glance at Events

19 IA&B Partners24 Technology Update28 Advertisers Index28 Classified Ads28 Last & Least

In every issue

Mission StatementPrimary Agent delivers ideas to help InsuranceAgents & Brokers’ members negotiate their uniqueposition as guardians of trust between insuranceconsumers and companies while facing thechallenges of maintaining a small business. PrimaryAgent also supports IA&B’s mission to preserve andadvocate the American Agency System.

Get social with IA&B

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Insurance for RestaurantsFamily Style, Pizza Shops, Take-Out, Fast Food, Donut Shops,

Diners, Cafes, Bagel Stores, Franchises

Brokers Surplus Agency wants to quote your restaurants!

We have a terrific BOP program that’s packed with the coverages you need.New Ventures eligible!Liquor liability coverage available!

Contact us by phone or email today!(215) 443-9900

Brokers Surplus AgencyP.O. Box 2849

Warminster, PA 18974

Dennis Marsaglia, Ext. [email protected]

Evelyn Frisch, Ext. [email protected]

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OfficersDavid Rosenkilde, CIC

Chair of the BoardReisterstown, Md.

Robert B. Hall, CPCU, CLU, ChFC, ARM, ARM-PVice Chair of the BoardWest Chester, Pa.

Kathleen M. Glattly, ChFC, CLU, CPCUImmediate Past Chair of the BoardFactoryville, Pa.

MembersJoyce M. Bailey, CIC, CRM, CPIW

Newark, Del.

Norman F. Basso, CPCUYork, Pa.

Vincent D. “Chip” Boylan Jr., CPCURockville, Md.

Henry “Butch” Bradley, Jr.Crofton, Md.

Timothy P. BurrisThompsontown, Pa.

John T. “Chip” Colwell Jr., CICCorry, Pa.

N. Lee Dotson, CIC, AAIWilmington, Del.

John L. FrankenfieldTelford, Pa.

G. Greg Gunn, CICLemoyne, Pa.

Diana M. Hornung-Momot, ACSRWilmington, Del.

Jocelyn R. Howard-Sinopoli, CIC, CISRButler, Pa.

Robert S. Klinger, LUTCFGermantown, Md.

Michael F. McGroarty Sr.Pittsburgh, Pa.

Ann Gallen Moll, CICReading, Pa.

Scott C. Rogers, CPIAYork, Pa.

Susan A. Sallada, CIC**Ft. Washington, Pa.

David B. Wasson Sr., CICState College, Pa.

James M. Watkins*Dover, Del.

King W. “Kip” White, LUTCFFallston, Md.

* IIABA National Director** PIA National Director

Board of Directors

Health care reform: here and now

This month marks a year since health care reform legislationpassed. While some of IA&B members’ fears have waned (think: a likely repeal of the burdensome 1099 provision), othershave grown as stages of implementation are phased in.

The next year will prove critical. On a national level, producergroups must push for a legislative adjustment to the MLR ruling. Meanwhile, on a state level, it’s crunch time to advocate for privately run health exchanges that involve the producercommunity.

IA&B members — whether they write health or they operate asmall business — will be affected by health care reform. It’s the jobof your association to keep you informed of the changes and,wherever possible, advocate on behalf of your best interests.

I invite you to read the latest on reform implications – including agrowth opportunity — in this edition of Primary Agent magazine.And then I encourage you to read Agent Headlines and accessiabgroup.com for further updates.

This is a time of great change, a time like no other for theindependent agent community. Make the most of yourmembership.

Until next time,Dave

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David B. Rosenkilde Sr., CIC

Chair of the Board’sM E S S A G E

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MemberFAQ

QUESTION: Do reverse mortgages have any impact on a homeowners’ policy?

ANSWER:In the last couple of years, reversemortgages have been touted to seniorsas a viable financial tool. Consequently,there has been an increase in thenumber of reverse mortgages securedby seniors, which has led to inquiriesinto the insurance ramifications.

What is a reverse mortgage?A reverse mortgage is a product thatallows an individual 62 years or olderto convert part of a home’s equity intocash without having to sell the home orrepay monthly installments. In otherwords, it allows the equity to become“liquid” without selling the home.Traditional home equity loans let youaccess money, but first, you mustqualify for the loan, and second, youmust repay the loan monthly.

There are different types of reverse mortgages.

� Single-purpose reversemortgages, offered by some stateand local government agenciesand nonprofit organizations

� Federally-insured reversemortgages, known as HomeEquity Conversion Mortgages(HECMs) and backed by the U. S.Department of Housing andUrban Development (HUD)

� Proprietary reverse mortgages,private loans backed by thecompanies that develop them

HECMs offer several payment options:

� “Term” option — fixed monthlycash advances for a specific time

� “Tenure” option — fixed monthlycash advances for as long as youlive in your home

� Line of credit that lets you draw down the loan proceeds at any time in amounts youchoose until you have used upthe line of credit

� Combination of monthlypayments and a line of credit

What about insurance?From an insurance standpoint, the mostsignificant characteristics of a reversemortgage are that the homeowner:

� Remains in the home

� Retains the title/deed to the property

As a result, the named insured on the policy is not affected. The lenderwill be added as a mortgagee, as it would under a traditional mortgage arrangement.

While reverse mortgages can be anattractive option, individuals interestedin this option should weigh the prosand cons, including upfront costs. Formore information on reversemortgages, several reliable sourceshave published material on the subject, including:

� HUD (http://www.hud.gov/offices/hsg/sfh/hecm/hecm—df.cfm)

� AARP (http://assets.aarp.org/www.aarp.org_/articles/money/financial_pdfs/hmm_hires_nocrops.pdf)

� Federal Trade Commission (http://www.ftc.gov/bcp/edu/pubs/consumer/homes/rea13.shtm)

DO YOU HAVE AQUESTION?

E-mail it to us at [email protected] use “Primary Agent FAQ” in the subject line of your message. You can also fax your question to (717) 795-8347. We look forward toanswering your questions!

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Primary Agent | March 2011

State News

What’s Trusted Choice?Trusted Choice is a member benefitcoordinated by the Big “I” nationalassociation, of which you are a member. It is a nationwide campaign that combines national advertising exposurewith coordinated, individual efforts at the local level.

The Big “I” recently voted to make theprogram mandatory — despite DAIAB’spreference for it to remain a voluntaryinitiative. This “all-in” stance means that every Big “I”/DAIAB member will be a Trusted Choice agent, effective Sept. 1, 2011.

How is Trusted Choice funded*?“All-in” means that everyone has the sameaccess to, and makes the same investmentto support, the Trusted Choice program.As a result, your 2011-12 membershipinvoice, which is due April 1, reflects asmall dues increase: $20 or $40,depending on the size of your agency.

DAIAB would have preferred for fundingto come from already-established nationaldues and recognizes that the economyand soft market make this a difficult timefor any size increase. To reduce the impacton your agency, this year’s and nextyear’s dues increase reflects a subsidy by DAIAB.

How can I learn more aboutTrusted Choice?In the coming months, DAIAB will provide additional resources for utilizingthe benefits of a national brand. Topreview member benefits, visitwww.TrustedChoice.com/agents andwww.TrustedChoice.com.

*Agencies already participating in andpaying toward Trusted Choice havereceived – or soon will receive — a pro-rated bill from the Big “I” toaccount for the “all-in” transition.

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Read frequently askedquestions – and answers – at www.iabgroup.com/TrustedChoiceDE.

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Amend yourlicense to sell cropinsuranceProducers with a property or aproperty/casualty license shouldcomplete form 2C to amend theirexisting license and add the new crop line of authority. This will ensurethat they maintain their ability to sellcrop insurance.

No fee will be charged for theamended license, but the requestshould be submitted by March 31, 2011, according to the Department of Insurance.

Read more: http://delawareinsurance.gov/departments/licensing/WebPageCropNotice.pdf

Access form 2C: http://delawareinsurance.gov/departments/licensing/New2C.pdf

DAIAB membersset sights onfederal advocacyDAIAB members once again will trek toWashington, D.C. as part of the annualBig “I” Legislative Conference. On theiragenda? Communicating independentagents’ opinions on health care reform,optional federal charter, floodinsurance and the NARAB Reform Actto a host of freshman legislators and acore group of incumbents.

Look for highlights from the April 13-14conference in Agent Headlines andfuture issues of Primary Agentmagazine.

Non-residentlicensing 101Securing (and maintaining) a non-resident license just became a biteasier. Noticing an increase inmember inquiries, DAIAB created aWeb page reviewing the process forindividuals and agencies to secure anon-resident license in various states.

The information reminds producers:

� An agency usually must firstregister the business with theSecretary of State

� A “registered agent” is oftenneeded to finalize the registration

� Knowing and monitoring eachstate’s filing and tax requirementsshould be addressed up front toavoid nasty surprises

� Licensing the individual and theagency with the Department ofInsurance is generally the easiestpart of the process

The National Insurance ProducerRegistry’s website has become agateway for non-resident licensing. A shortcut is available from IA&B’s Web page to directly access the State Matrix of Business Rules, which provides a summary of eachstate’s requirements.

Access the resource: www.iabgroup.com/de/licensing/non_resident

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Savethe date

16

CompanyAppreciation

Night

Who:DAIAB members and their

company partners

What:Annual appreciation event

Where:Hilton Wilmington/ Christiana,

Newark, Del.

When:Wednesday, March 16

6 p.m.

Join fellow DAIAB members to thank company partners for theirsupport. The cost is only $35 permember, but the payoff is great —stronger, more productive company relationships.

Register:www.iabgroup.com/meeting_de

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CoverageC O R N E R

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JERRY MILTON, CIC

Jerry M. Milton teaches

and consults on industry

issues. The legal profession

recognizes him as an

expert on insurance

coverages. He is also the

education consultant for

IA&B, working with CISR,

CIC and continuing

education programs.

Primary Agent | March 2011

“This insurance does notapply to ‘bodily injury’ or‘property damage’ expectedor intended from thestandpoint of the insured.This exclusion does not applyto ‘bodily injury’ resultingfrom the use of reasonableforce to protect persons or property.”

Sound familiar? It should.This is the first exclusionunder the Coverage A –Bodily Injury and PropertyDamage section of theCommercial General Liability(CGL) policy. This exclusion isnot unique to the CGL – it’salso included in the BusinessAuto, Personal Auto,Homeowners’ and Umbrellapolicies.

We’ve always assumed thisexclusion does not apply to“intentional acts,” but to“intentional results.” In otherwords, “I intended to do that,but I didn’t intend to hurtanyone” should be covered.However, as is the case withmost of our policies and theirexclusions, it’s not what wethink, but what the courts

say. The following are a fewexamples of how the courtshave interpreted the“intentional injury ordamage” exclusion.

Case #1:

Two fourteen year-old boyswere playing war with theirBB guns in one of the boy’sbackyard. Their playfulshootout resulted in one ofthe boys being hit in the side.He then aimed his BB gun inthe general direction ofwhere he believed the otherboy to be, fired the gun andhit him in the left eye.

The resultant liability claimagainst the boy’s parents wasdenied by theirHomeowners’ insurer,Wisconsin Physicians ServiceInsurance. The boy who shothis friend testified, “I wasintending to shoot him in thearm or leg just to cause aslight sting, a sharp pain likehe did to me. I didn’t want tocause serious injury.” Thetrial court, referring to the“intentional injury ordamage” exclusion, found in

favor of the insurancecompany.

On appeal, the WisconsinAppeal Court stated, “So longas the actor intends to inflicta personal injury, therequisite intent is establishedeven though the actor didnot intend the particularinjury that occurred.” Thejudgment of the trial courtwas affirmed in favor of theinsurance company.

Case #2:

The co-owner of a clothingstore set fire to the store andits contents, which causedsubstantial damage to ashopping store andsurrounding stores. GreatAmerican, the liability insurerof the clothing store, deniedthe claims of the propertyinsurers of the shoppingcenter and the other tenantson the basis that the loss wasnot an accident.

Both the trial court and theappeal court concluded thatthe insured did not intend todestroy the property of

INTENTIONAL ACTS VERSUS INTENTIONAL INJURY

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others and therefore the “intentionalinjury or damage” exclusion did not apply.

The case was then appealed to theLouisiana Supreme Court. The courtdetermined that the insured used fourto five gallons of gasoline to start thefire in a 25 x 82 foot space, which wasenough to destroy the entire shoppingcenter had it not been for the fastresponse of fire fighters. They foundthis amount of gasoline to beexcessive for the intent to destroy theclothing store’s merchandise andconcluded that, “…..no reasonableperson would believe that hisinsurance policy would providecoverage for his criminal act or arson.”

The judgment of the trial court, whichwas affirmed by the appeal court, wasreversed in favor of the insurancecompany and against the partiesseeking reimbursement.

Case #3:

Overwhelmed by business problems,the owner of a music store placed aconnected soldering iron on a padsoaked with cleaning fluid. He left thestore, and a fire ensued that destroyedthe building. It also damaged threeadjoining buildings and resulted inserious injury to a fireman. Theinsured store owner admitted tohaving committed arson.

It was not disputed that, with respectto damage to the adjoining buildings,the fire was not an accident and theconsequences of the insured’s actionswere predictable. Therefore theinsured’s liability insurer, FrankenmuthMutual, was not obligated to defendthe lawsuits for property damage.

However, the firefighter and his wifesued the store owner for his injuriesand loss of consortium. Both the trialcourt and the appeal court determinedthat, although the insured intended tocause property damage, he did not

intend to injure the firefighter. Basedon their decision, the insurancecompany had a duty to defend theinsured against the injury claim.

Frankenmuth Mutual appealed thisdecision to the Michigan SupremeCourt. The court concluded that,“…..the insurer has a duty to defendthe insured in this personal injury suitbecause there are no facts to suggestthat the insured intended to inflictbodily injury on anyone by setting his

business on fire and that bodily injury occasioned by the firefighterwas not the direct result of theinsured’s conduct.”

Sounds like to me the courts aresaying, “If the results of your actionsare predictable, the resultant injury or damage is excluded.”

Y’all take care!

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Date Topic Location

1-3 L&H Licensing Study Course Mechanicsburg, Pa.

8 CISR-Personal Auto Course Pittsburgh, Pa.

William T. Hold Seminar Lehigh Valley, Pa.

9 CISR-Personal Auto Course Altoona, Pa.

CISR-Agency Operations Course Lancaster, Pa.

14 CISR-Personal Residential Course* Philadelphia, Pa.

15 CISR-Personal Auto Course* Philadelphia, Pa.

10 Ways to Get Sued Seminar Baltimore, Md.

16 CISR-Agency Operations Course* Philadelphia, Pa.

William T. Hold Seminar Baltimore, Md.

CISR-Personal Auto Course Newark, Del.

16-18 J.K. Ruble Graduate Seminar Ellicott City, Md.

17 CISR-Commercial Property Course* Philadelphia, Pa.

18 CISR-Commercial Casualty Course* Philadelphia, Pa.

21 Navigating Contractual Liability and Certificates of Insurance Mechanicsburg, Pa.

22 CISR-Personal Auto Course Reading, Pa.

10 Ways to Get Sued Seminar Philadelphia, Pa.

23 CISR-Personal Auto Course York, Pa.

23-26 CIC-Personal Lines Institute Newark, Del.

28-31 CIC-Commercial Property Institute Erie, Pa.

29 CISR-Personal Auto Course Pittsburgh, Pa.

30 CISR-Personal Residential Course State College, Pa.

CISR-Commercial Property Course Altoona, Pa.

Navigating Contractual Liability and Certificates of Insurance Philadelphia, Pa.

31 Navigating Contractual Liability and Certificates of Insurance Baltimore, Md.

*CISR Marathon Week

Glance at EventsM A R C H C A L E N D A R

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Spring into CISR designation: March has it all. Personal Auto and the four otherCISR courses are available individually in various locations, or you can take them all in the samelocation during Marathon Week in suburban Philadelphia. A new William T. Hold update is alsoscheduled in two locations. For more information and to register, visit iabgroup.com/education orcall the Member Service Center at (800) 998-9644, option 0.

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trust.

acuity.com

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INDUSTRY NEWS

Controversy and conflictaside, health care reform isupon us. The March 2010reform law set the wheelsin motion, and a year later,implementation and itsrecourses are reality. Here,IA&B cuts through theclutter and presents keyupdates on what members— as producers and assmall-business owners —need to know.

Patient Protection andAffordable Care Act:one year laterWhere we’ve been, where we’re going and what it means to members

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Primary Agent | March 2011

The divisive and controversial Patient Protection andAffordable Care Act of 2010 sent shockwavesthrough the country. In fact, many political observershave cited last year’s passage of federal health care

reform as the impetus for November 2010’s historic and tide-changing elections that left an undeniable dent in theDemocratic Party’s armor.

The U.S. House of Representatives swung solidly to the right last fall as Republicans gained over 60 seats — thelargest shift in the House since the Great Depression.Republicans now hold a 49-seat majority over theirDemocratic colleagues and with it the ability to filibuster anyunfavorable legislation.

Many state legislatures switched party leadership as well, and11 new Republican governors are now at the helm, adding tothe 19 who were already in place. These leaders will play amajor role in how the law is implemented in their states.

As Congress starts a new legislative session, controversycontinues to shroud health care reform legislation. HouseRepublicans repealed the law in a largely symbolic vote,entitled “Repealing the Job-killing Health Care Law Act.” In the meantime, the Congressional Budget Office estimated that repeal of the law could add $230 billion to the deficit over the next 10 years.

Then there are the legal challenges. A federal judge inFlorida found the law’s individual mandate, requiring allAmericans to have health coverage, to be unconstitutional ina late-January ruling. This followed a Virginia judge’s similarruling in December. However, courts in two other casesupheld the mandate. Many suspect the Supreme Courtultimately will have to resolve the issue.

While the political environment may have become moreunstable, the effects of the Patient Protection and AffordableCare Act of 2010 are here to stay. Already, in the 12 monthssince its March 23, 2010 passage, several reforms have beenimplemented: tax credits for small businesses, the extensionof health care coverage to young adults and measures toexpand coverage for those with pre-existing conditions.

As additional regulations are phased in, IA&B will keepmembers apprised. The following pages highlight some ofthe already-enacted components that members, as producersand as small-business owners, need to know.

Medical loss ratiosIn late November, the U.S. Department of Health and HumanServices issued a final interim rule on medical loss ratios(MLRs) – the amount of premium dollars spent directly oncare in relation to that spent on administrative costs. (A finalinterim rule carries the full force of the law but allows forcomments and the opportunity for a revised final rule.)

The MLR ruling alreadyhas begun to hurtproducers as some

insurance companiescut commissions tobecome compliant.

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The ruling determined that, as ofJan. 1, 2011, insurancecompanies in individual or smallgroup markets must spend 80percent of premium dollars onmedical care or qualityimprovement measures. Thethreshold rises to 85 percent forthose companies in large groupmarkets. Insurance companiesalso are required to publiclyreport how they spendpremiums. Those companies notmeeting the MLR standards willbe required to provide rebates totheir consumers (individualpolicyholders or employers)starting in 2012.

The National Association ofInsurance Commissioners (NAIC)failed to recommend thatcommissions be removed fromMLR calculations in its report to

the Department of Health andHuman Services, despite thesupport of 15 commissioners atthe NAIC’s fall 2010 meeting.Therefore, the MLR ruling alsoqualified agent and brokercommissions as “non-claimscosts,” defined as those costsnot used to adjust premiums orincurred claims or to improvequality care. The producercommunity continues to arguethat commissions are passed100 percent to third parties and,therefore, are pass-through feesthat should not be included inthe administrative definitions.

The MLR ruling already hasbegun to hurt producers assome insurance companies cutcommissions to becomecompliant. For example,effective Jan. 1, 2011, Blue CrossBlue Shield of Delaware now

pays just 5 percent across theboard. They previously hadgiven 15 percent commission for first-year plans and 7 percentfor subsequent years. Expandedover the industry, these cutscould lead to job losses,business closures and anunstable insurance market overall.

Each state’s insurancecommissioner is charged withoverseeing implementation andmay request up to a three-year“adjustment” of the MLRregulation for individualmarkets, based on projecteddisruptions. IA&B has requestedsuch a deferment forPennsylvania, Maryland andDelaware. In the meantime,Congress may address the MLRformula through legislativechanges to the health care law.

INDUSTRY NEWS

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� Free preventative care and prescriptiondrug discounts available to seniors

� Establishment of a new Center forMedicare & Medicaid Innovation

� Option to provide home andcommunity-based servicesthrough Medicaid

� MLR ruling that80-85 percent of premiumdollars be spent onhealth care services

� Increase in usage ofelectronic healthrecords to streamlinebilling andinformation sharing

� Creation of a voluntarylong-term careinsurance programto provide cashbenefits to adults whobecome disabled

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IA&B continues to monitorpotential repeals of or changesto the regulation.

1099 provisionA bright spot in the battle overhealth care reformimplementation is the likelyrepeal of the 1099 provision. Theonerous mandate requires thatall businesses issue a form tovendors from whom theypurchase goods totaling $600 ormore (e.g. Internet services or acomputer) during a calendaryear. It is scheduled to takeeffect in 2012.

IA&B and its national affiliateshave advocated against themandate, citing the additionalpaperwork, record keeping andaccounting work for agents. Thearguments have found supportin Congress.

At the start of this legislativesession, Rep. Daniel Lungren (R-Calif.) introduced the “SmallBusiness Paperwork MandateElimination Act,” aimed ateliminating the Form 1099

requirement from the healthcare reform law. And, a last-minute amendment to a bill toinclude a repeal provision,sponsored by Sen. DebbieStabenow (D-Mich.), easilypassed the Senate in earlyFebruary. Several attempts.Several attempts to repeal this

requirement failed lastlegislative session due to timing(end of session), politicalposturing (both parties wantedto take credit) and cost (repealremoves $19 billion in estimatedadditional revenue). ButRepublicans campaigned on thepromise to address this issue,and Rep. Lungren’s bill alreadyhas more member support thanpast attempts. The issue hasbeen broadly supported by both parties, and PresidentObama has stated he is open tothe amendment.

Health exchangesThe health care reform bill calls for each state to set up an exchange, or marketplace,that would allow qualifyingindividuals and small businesses(fewer than 100 employees)

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� Additional funding for state Medicaid programs that cover preventive services

� Increasing Medicaid payments for primary-care doctors

� Additional funding for the Children’s Health Insurance Program (CHIP)

� Prohibition on denying coverage based on pre-existing conditions or gender

� Prohibition on annual insurance coverage limits

� Establishment of operational healthinsurance exchanges in the states

� Increased small-business tax credit

� Increased accessto Medicaid

_______________________________

The onerous [1099] mandaterequires that all businesses

issue a form to vendors fromwhom they purchase goods

totaling $600 or more.

_______________________________

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to purchase health insurance.The exchange is intended toprovide a “one-stop-shop” forinsurance coverage.

_______________________________

IA&B continues tocommunicate with the

insurance departments andstate legislatures to advocatethat the exchanges are run by a nonprofit entity andinclusive of stakeholders from small business andproducer communities.

_______________________________

As outlined by the Departmentof Health and Human Services, the exchanges will berequired to:

� Operate an informationalhotline

� Maintain a website for plan information

� Assign price and qualityrating to available plans

� Present information onplan benefit options

� Provide information onMedicaid and CHIPeligibility

Exchanges may be run as agovernmental agency or anonprofit entity. Regardless oforganizational form, theexchange must provideconsumers with options andshould offer comparison toolsbased on quality and price.States do have the option ofcreating regional exchanges orestablishing an interstate system.

The health care reform billrequires that exchanges arecreated by March 23, 2012 andoperational (that is, offeringopen enrollment) by Jan. 1, 2014.If a state fails to act, then thefederal government will step into establish an exchange by Jan.1, 2013. The federal governmenthas given the states millions infederal grant monies to plan theexchanges, but each one mustbe self-sustained by 2015.

IA&B continues to communicatewith the Pennsylvania, Marylandand Delaware insurancedepartments and legislatures toadvocate that the exchangesfollow the following principles:

� Run by a nonprofit entity,not a government agency

� Inclusive of stakeholdersfrom small business andthe producer communities

� Focused on providingcoverage for thosecurrently uninsured

� Bound by the sameregulations currentlygoverning health insuranceproducers

� Limited to providing healthinsurance and relatedproducts only

� Prohibited from directsolicitation of those alreadyserved by the privateinsurance market

Maryland is moving quickly tocreate an exchange withcompeting bills already beforethe legislature. One heavilyfavors the creation of a

government agency, while theother supports producers'concerns. Pennsylvania andDelaware are still in exploratoryphases. IA&B will continueadvocating for the preservationof producers’ vital roles.

High-risk poolsThe mandated creation of statehigh-risk insurance pools wereone of the first health carereform provisions to take effect,with enrollment beginning inAugust 2010. The pools aredesigned to cover people whohave been denied insurance dueto pre-existing conditions andhave been without coverage forat least six months. The poolswill be in effect at the state leveluntil 2014, at which pointinsurance companies will berequired to cover everyoneregardless of their medicalhistory. The reform law doesallow for the secretary of theDepartment of Health andHuman Services to capenrollment in a pool, but for nowlimitations are not expected.

States had the option of deferringto the federal government to runtheir high-risk pool. Delaware,along with 20 other states, chosethis option, while Pennsylvaniaelected to run its own high-riskpool. Maryland acted quicklyduring the 2010 legislative sessionand passed legislation to put ahigh-risk pool in place before thefederally imposed deadline. Thebill authorized the MarylandHealth Insurance Plan (MHIP),which already served Marylanderswho were unable to securecoverage from other providers, to

INDUSTRY NEWS

[ 16 ]

G18504_12-19.qxp:March2011 2/15/11 3:06 AM Page 16

enter into an agreement to serveas the state’s pool.

While the high risk pools wereup and running quickly, lingeringconcerns remain as to theirlong-term financial viability. TheDepartment of Health andHuman Services recommendsshifting money from states notusing all of their allocated fundsto those in need of more to solvethe problem. The health carereform law allotted $5 billion forthe pools, but several estimates,including one from theCongressional Budget Office,indicate that the actual amountneeded will be significantlyhigher due to public demand.

Looking ahead…In 2012 the new law will institutea series of changes tostandardize billing and requirehealth plans adopt andimplement rules for theelectronic exchange of healthinformation. Even further downthe line, most individuals whocan afford it will be required toobtain basic health insurancecoverage or pay a fee to helpoffset the costs of caring foruninsured Americans in 2014. Asthese and other tenets of the laware implemented, uncertaintygrows for producers, insurersand consumers.

IA&B is dedicated to continuedadvocacy at the federal and statelevel to ensure the smoothesttransition possible and thepreservation of producers’interests. Members can stayabreast of reform implementationand IA&B’s advocacy by reading

Agent Headlines and PrimaryAgent and by following IA&B on Twitter.

Note: This article was accurate asPrimary Agent went to print.Legislative updates will becommunicated via Agent Headlines.

_______________________________

Nicole Grear, government affairsassistant, and Kari Kissinger,government affairs director, pennedthis article.

[ 17 ]

Primary Agent | March 2011

G18504_12-19.qxp:March2011 2/15/11 3:06 AM Page 17

Platinum ProfileInsurance Agents & Brokers proudly

recognizes Millers Mutual Group as one

of its Platinum Partners. IA&B Platinum

Partners dedicate the highest level of

sponsorship to our organization.

FEATURED PARTNER:Millers Mutual Group

CHIEF EXECUTIVE OFFICER:Robert L. Lyon, Chairman,

President/CEO

COMPANY LOCATION:Harrisburg, Pennsylvania

A.M. BEST RATING: A- (Excellent)

At Millers Mutual, we arecommitted to developing agenuine rapport and lasting

relationship with each of our agencypartners, as we continue to build anenviable reputation for integrity,stability, and personal service thatcan’t be matched by national orlarge regional carriers.

So we are delighted to have placed so highly in IA&B’s mostrecent Carrier Satisfaction Survey,where agents ranked us among theTop 3 carriers on importantdimensions such as underwritingflexibility and low turnover of staff,providing a consistent and stablemarket, and confidence in ourmanagement team.

Strong relationships flourish whenagents know what to expect from afinancially sound company. In an era

when carriers move in and out ofmarkets unpredictably, agentsappreciate having a stable market for small to mid-sized commercialaccounts and property risks, expertly underwritten, with attentionto detail, and a decided preferencefor understanding the uniquecharacteristics of each account.Admittedly, we conduct business the old-fashioned way — we listenand we care.

Our promise is a simple one —there’s simply more for you atMillers. More support for youragency, more attentive personalservice, more strength and stability,and more across-the-boardsatisfaction. But don’t take our wordfor it: Trust the people who know usbest — the independent agents whowork with us every day.

G18504_12-19.qxp:March2011 2/15/11 3:06 AM Page 18

WHAT IS IA&BPARTNERS?The IA&B Partners

program gives company

and allied businesses

the opportunity to

demonstrate their

commitment of support

to independent agents

and receive maximum

market exposure. As an

IA&B Partner, you will

also realize the benefits

of IA&B membership to

help you succeed in

the insurance industry.

DO YOU SEEYOUR NAME?To become an IA&B Partner,

choose the sponsorship

package that matches your

commitment of support.

Contact the Member Sales

Center at (800) 998-9644,

(717) 795-9100 or visit us

online at www.iabgroup.com

to get started.

Listed below are those companies that strongly support the independent agencysystem and Insurance Agents & Brokers.

Thank you for your continued sponsorship.

PLATINUM LEVELACUITYBerkley Mid-Atlantic GroupErie Insurance GroupHarleysville InsuranceHighmark Casualty Insurance CoInsurance Agents & BrokersService Group IncMillers Mutual GroupMillville Mutual Insurance CoMutual Benefit GroupOhio CasualtyPenn National InsuranceSelective Swiss ReThe Main Street America GroupTravelersUtica National Insurance Group

GOLD LEVELAllied InsuranceMMG InsuranceProgressive

SILVER LEVELAccess Insurance Company American Mining Insurance CoCumberland Insurance GroupDonegal Insurance GroupFrederick Mutual Insurance CoHarford Mutual Insurance CoJuniata Mutual Insurance CoPSBA Insurance TrustThe Motorists Insurance GroupThe Philadelphia ContributionshipWestfield InsuranceZenith Insurance

BRONZE LEVELAegis Security Insurance Co

Agency Insurance Company

Auto-Owners Insurance Company

Briar Creek Mutual Insurance Company

Builders Insurance Group

Chubb Group of Insurance Companies

Encompass Insurance

First General Services

Foremost Insurance Group

Goodville Mutual Casualty Company

Grange Insurance Companies

Guard Insurance Group

Hanover Fire & Casualty Insurance Company

Insurance Alliance of Central PA Inc

Insurance Placement Facility of PA

Keystone Insurers Group Inc

Lebanon Mutual Insurance Company

Mercer Insurance Group

Merchants Insurance Group

Mercury Casualty

Penn Millers Insurance Company

Penn PRIME Municipal Insurance

Reamstown Mutual Insurance Company

Rockwood Casualty Insurance

State Auto Mutual Insurance Company

TAPCO Underwriters Inc

The Brethren Mutual Insurance Company

The Mutual Service Office Inc

Tuscarora Wayne Insurance Company

Primary Agent March 2011

G18504_12-19.qxp:March2011 2/15/11 3:06 AM Page 19

MARKETS

Health care reform has casta dark shadow over theindustry. But beyond theconcern over commissioncuts and the future ofproducers’ role, there is abright spot: the blossomingvoluntary benefits market.

An upside to healthcare reformIncreased need for information creates opportunity for brokers

G18504_20-23.qxp:March2011 2/15/11 3:10 AM Page 20

[ 21 ]

Primary Agent | March 2011

Employers are working overtime to sort through thedetails of the new health care reform legislation andits effect on their benefits programs. Although thelegislation creates lots of changes for employers and

the medical insurance they offer employees, experts predictthe impact on voluntary benefits to be minimal. That is goodnews for everyone, but it is an especially welcoming messagefor major medical brokers looking for new sources of revenue.

As health insurance becomes more widely available during thenext few years, voluntary benefits will still be in demand to helpemployees strengthen their financial safety nets as they facemore risks and costs. Because of its complexity, health carereform will also create a growing need for effective benefitscommunication and education at the worksite. In fact, the needfor voluntary benefits, coupled with effective benefitscommunication and education, will be stronger than ever. Youdo not want to miss out on this tremendous sales opportunityby taking a wait-and-see approach.

Many of the changes outlined in the legislation will take severalyears to implement. In the meantime, we are confident that:

Voluntary benefits will be minimally affected in the short-term.The insurance market reforms in the legislation addresscomprehensive major medical insurance coverage and notplans considered excepted benefits from the portability, accessand renewability requirements of HIPAA. Excepted benefitswould include accident, disability, specified disease andhospital indemnity coverage.

Voluntary insurance coverage still will be a very relevant partof employee benefits.Voluntary products are in demand in today’s marketplace –even for the shrinking number of employers with rich benefitplans – because they help pay expenses not covered by majormedical insurance.

Voluntary products can help employees strengthen theirfinancial safety nets as more risks and costs become theirresponsibility.

The need for benefits communication and education is growing. The shift of more benefits decision-making to employeesincreases the demand for clear information so they can makethe best choices for themselves and their families.

Even in a time of relatively high unemployment, employers stillwant to retain their best workers. Benefits communicationhelps employees understand and value their benefits package,as well as their employer’s investment in benefits.

The flexibility and cost savings offered by voluntary benefitshelp explain their rising popularity among employers andemployees in recent years. The 2009 sales of voluntary benefits

___________________________

The 2009 sales of voluntary benefits

nationwide increased 3.3 percent from 2008, and expectations are

high for the near future.

___________________________

EThe need for voluntarybenefits, coupled with

effective benefits

communicationand education, will be

stronger than ever.

G18504_20-23.qxp:March2011 2/15/11 3:10 AM Page 21

nationwide increased 3.3 percentfrom 2008, and expectations arehigh for the near future.

A recent study conducted byEastbridge Consulting Groupshowed that 20 percent ofemployers indicate they are likelyto add at least one employee-pay-all benefit in the next 18months. Another Eastbridgestudy indicated that 82 percent ofrespondents believe thatemployees will be moreenthusiastic about voluntarybenefits 12 months from now.

Partner with an expertYou will be surprised andrelieved at what the rightvoluntary benefits provider can

do for you at no cost. Instead of offering your clients thedreaded annual health insurancerate increases, you may be ableto bring them cost-savingsolutions with the potential toincrease employee satisfactionand retention.

You no longer have to be theexpert on every new productand every new trend inemployee benefits. The rightvoluntary benefits providerknows about product andenrollment trends, can providethe most desirable products andservices, has in-depthexperience in worksitemarketing and can deliverongoing solutions.

What’s more, the right voluntarybenefits partners truly arepartners. It is your decisionwhether they have an active orsilent role with your clients. Youshould feel comfortable andconfident with them so you’reable to call on their experienceand insights and feel free to usethem as a sounding board.

They should also offercomprehensive resources sothey can actively market to youraccounts and provide ongoingaccount service. You’ll find thatthe right partner is like adding askilled, professional employee toyour agency at no cost to you.

MARKETS

Frederick Mutual Insurance Company, an AM BESTA- (Excellent), VI property/casualty insurer writing inMaryland and Pennsylvania is currently looking forexperienced property/casualty insurance agents licensedto write personal and commercial lines business inMaryland and Pennsylvania. Frederick Mutual, a nichecompany, specializes in writing Small ArtisanContractors, Mainstreet BOP Business, Homeowners,Dwelling Fire and Personal Umbrella.

Established in 1843, we pride ourselves on our qualityof service and desire to partner with equally dedicatedprofessionals.

Additional background information regarding FrederickMutual is available on our website at www.fredmut.com.

57 Thomas Johnson Drive, Frederick, MD 21702-4301301-663-9522

ecurity in Your Time of Need

nparalleled Customer Service

orporate Integrity

ompetitive Pricing

ase of Doing Business

uperior Financial Strength

ound Products

SSUUCCCCEESSSS

At Frederick Mutual, we adhere to the following

Pillars of SUCCESS

[ 22 ]

G18504_20-23.qxp:March2011 2/15/11 3:10 AM Page 22

What to look for in a partnerWith more and more companiesgetting into the voluntarybenefits arena, you have morechoices than ever for finding apartner. So how do you choose?

Start by finding out if yourpotential partner has limits onaccount size. You want someonewho says yes when you call forhelp, not someone who makesyou jump through hoops or isonly interested in the bigaccounts. You want a voluntarybenefits partner that is eager tohelp you enroll accounts of anysize and shape.

Look at your potential partner’strack record. What is itspersistency rate? This measurewill tell you if the employeeskeep the products they havepurchased. The higher thepersistency rate, the better yourpartner is at initial and re-enrollments. You will also wantto see performance surveyresults on the company’senrollment team.

You do not have to go it alone.The right voluntary benefitspartner can help you maintainlong-term relationships withyour clients and provideadditional income opportunitiesthat will bring in more revenue

year after year. Take advantageof the increased interest involuntary benefits and benefitscommunication, and talk to avoluntary benefits providertoday.

_______________________________

Chris Ginakes is a public sectormanager for Colonial Life with anoffice in Daytona Beach. Thisarticle originally appeared in theOctober 2010 issue of FloridaUnderwriter magazine and wasreprinted with permission.

[ 23 ]

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Primary Agent | March 2011 TechnologyU P D A T E

[ 24 ]

JEFF YATES

Jeff Yates is Executive Director of

the Agents Council for

Technology (ACT) which is part

of the Independent Insurance

Agents & Brokers of America.

Jeff can be reached at

[email protected]. This article

reflects the views of the author

and should not be construed as

an official statement by ACT.

As agencies go paperless andcarriers stop providing paperpolicies, agencies have todecide whether to continue toretain policies locally or relyon electronic policy view toaccess the policies on thecarrier’s website. Agenciesalso are considering whetherto begin to e-mail policies toclients, rather than sendingthem paper copies. Since I getthese questions frequently, Idecided to reach out to anumber of agency consultantsand E&O risk-managementexperts to get their insights onthese questions. (Please seeacknowledgements at the endof this article for the names ofthese individuals.)

Agency retention ofpoliciesMany agencies have decidedto retain commercial linespolicies locally, even if theyhave a good download ofpolicy data and electronicpolicy view in place, becausethey find they need to refer tothese policies andendorsements frequently

when coverage and claimsissues arise. In contrast, manyagencies with a gooddownload in place havedecided not to retain personallines policies locally becausethey are able to handle thetypical client inquiries withoutreferring to the policies. Oftenthese questions relate tobilling and making a payment,and the agents are able tohandle these inquiriesefficiently by using real-timebilling inquiry and make-a-payment functionality.

Each agency is different,however, so I have provided a list of considerations toassist agencies in deciding this question:

1. How frequently does thestaff need to refer to theactual policies for the lineof business and for whatpurposes? Does theamount of usage justifythe amount of time it willtake to attach them to theclient file?

2. Is there a good downloadin place for the line ofbusiness, and is mydatabase accurate? If thereis not a good downloadfor the business, then theagency will probably wantto retain at least the decpage locally.

3. Does the agency use thedec page for policychecking and like to retainit as part of thedocumentation of thepolicy checking process?

4. Does the carrier providelinks on the dec page to allof the actual policy formsand endorsementsapplicable to that risk —not just the latest editionsof these forms — so thatthey are easy to access?

5. Has the carrier provided acontractual guarantee thatthe agency will continue tohave access to its policyinformation in the eventthe carrier or the agencyterminates the

MAINTAINING POLICIES LOCALLY IN TODAY’S AGENCY AND E-MAILING POLICIESTO CLIENTS

G18504_24-28.qxp:March2011 2/15/11 3:15 AM Page 24

[ 25 ]

relationship? This commitmentshould be for the statutory periodin which the agency must retain thisinformation (usually seven years).

6. Do the applicable state laws require the agency to retain thepolicy documents locally or isaccess to them at the carrierwebsite sufficient?

Agencies should go through the same analysis with regard to their E&S policies.

Industry opportunitySince many agencies have made thedecision to retain commercial linespolicies locally, it is incumbent oncarriers and agency managementsystem providers to make it as simpleas download for agencies to attachthese policies to their client files. One approach would be to give the agency the option to have thecarrier download PDFs of policies(new, renewal and endorsements)each evening using real-time activitynotifications and alerts. An optioncould even be given to receive the dec pages with links to the actualpolicy forms or the complete policies.Agency management systems shouldhave the capability to route thesenotifications to the appropriate person in the agency for checking and attachment to the client file. Usingthis real-time workflow would be animprovement over the e-mailing ofthese policies because of the addedsecurity and transmission directly intothe agency management system.

Since some agencies use the personallines dec pages to check policies foraccuracy and then retain them, thesame workflow should be madeavailable to agencies for personal lines.

Delivering client policieselectronicallyAgents are generally supportive ofpersonal lines carriers that give clients

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G18504_24-28.qxp:March2011 2/15/11 3:15 AM Page 25

discounts in order to go paperless andaccess their policies electronically. Inthe commercial lines and E&S markets,however, many agents are concernedabout the inefficiency and cost shiftingthat takes place when carriers stopsending the paper policies to the agentfor delivery to the client because manyinsureds still want the paper.

Electronic policies represent the futureand are more efficient in many ways(no mail time, do not need to bescanned into agency system,potentially save printing costs). Agentsshould encourage their clients to makethe transition to electronic policies inthe same way that other financialservices companies are inviting theirclients to move to electronic delivery.Carriers, in turn, should help theiragents with this transition by providingthem with electronic policies and theoption to receive paper copies forclients who are not ready to accept theelectronic model.

Many agencies like to delivercommercial lines policies to theirinsureds personally and are nowdelivering these policies on a CD as an

added value, where clients agree tothis method. Several larger agenciesprovide a secured area on theirwebsite where clients can access theirpolicies. Hopefully, technologyproviders will increasingly provideturn-key solutions for the broaderagency population so that they canprovide their clients a secured portalfor accessing their policies, as well aslinking to their carriers to makepayments and perform other self-service functions. This is an area inwhich ACT’s Consumer FunctionalityWork Group is trying to spur moreindustry action.

E-mailing policies to clientsIn this emerging paperlessenvironment, many agencies areconsidering e-mailing policies to theirinsureds. There are several issues foragencies to assess and thenincorporate into their procedureswhen considering such a change in delivery:

1. Confirm that the particular state’slaws and regulations permit the e-mailing of policies and do notrequire that the insured beprovided a physical copy.

2. Secure the advance agreement ofthe client to receive policieselectronically by e-mail.

3. Provide in the e-mail attaching thepolicy a request that the clientacknowledge receipt of the e-mailand policy by return e-mail andhave a procedure — that isconsistently followed — of followingup with the insured if he/she doesnot acknowledge receipt.

4. Include in the e-mail a disclaimerthat the insured should read thepolicy to ascertain that its limits

and coverages are appropriate forits needs and that it should contactthe agency if it would like to addany coverages or make anychanges. The notice should alsogive the insured the option to electto receive paper policies. (Thisdisclaimer should be provided inthe cover letter that accompaniesthe personal delivery of a paperpolicy or CD as well.)

5. Check the policy for accuracybefore sending as provided in theagency’s procedures.

6. Send the e-mail by secure e-mail ifthe policy contains any privatepersonal information under theapplicable state and federal privacyand data breach notification laws.Such private information mightinclude the federal employeridentification number, driverlicense numbers, etc. ACTencourages the use of TLS e-mailencryption for secure e-mail, andTLS works very well in agent-carriercommunications when both partieshave it. A proprietary secure e-mailsolution, however, will benecessary for many clientcommunications when the clientdoes not have TLS.

7. Deliver the policy to the clientpromptly after being received —whether e-mailed or deliveredpersonally — and avoid any agencybacklog in policy deliveries.

8. Document in the agencymanagement system that the policy has been sent, the stepstaken to follow up if necessary andattach the transmittal e-mail inunalterable form.

TECHNOLOGY UPDATE

[ 26 ]

G18504_24-28.qxp:March2011 2/15/11 3:15 AM Page 26

The emergence of a paperless environment is precipitatingchanges in agency workflows and is creating opportunitiesfor carriers and technology providers to provide new tools to help agencies function more efficiently in this new environment. These new tools include the use ofactivity notifications and alerts to send electronic policies to agencies and the availability of easy-to-use and cost-effective plug-ins to enable agencies to provide secure portals for their clients to access documents and toperform other services online.

Acknowledgements: Thank you to the following agencyconsultants for their insights on these issues: PatAlexander, Steve Anderson and Laura Nettles. Thank youalso to the following agency E&O risk managementexperts: Dave Hulcher, IIABA; Jim Keidel, Keidel, Weldon &Cunningham; and Sabrena Sally, Westport InsuranceCorporation. Last but not least, thanks to the ACT AgentFeedback Group for its input.

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[ 27 ]

G18504_24-28.qxp:March2011 2/15/11 3:15 AM Page 27

ACUITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11

Brokers Surplus Agency . . . . . . . . . . . . . . . .3, 27

Commonwealth Ins Co . . . . . . . . . . . . . . . . . . . .1

Frederick Mutual Ins Co . . . . . . . . . . . . . . . . . .22

Guard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Harford Mutual . . . . . . . . . . . . . . . . . . . . . . . . .25

IA&B Partners Program . . . . . . . . . . . . . . . . . . .19

IA&B Series Ad . . . . . . . . . . . . . . . . . . . . .23, IBC

Insurance Club of Pittsburgh . . . . . . . . . . . . . .27

Interstate Insurance Mngmnt. . . . . . . . . . . . .OBC

Penn National Insurance . . . . . . . . . . . . . . . . . .9

Preferred Property Program . . . . . . . . . . . . . . .25

Progressive . . . . . . . . . . . . . . . . . . . . . . . . . . . .IFC

TAPCO Underwriters . . . . . . . . . . . . . . . . . . . . .17

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care of the rest.

[ 28 ]

Keeping a fingeron the pulse of the courtsZachary Eaton sustained a broken finger when he wascaught in a skirmish at an Orono, Maine nightclub –aptly named Finger Rock Bar. While removing anunruly patron, a bouncer slammed open a door andinadvertently caught Eaton’s hand.

Eaton required medical treatment and claimed lostincome. A Superior Court Justice signed a judgment inEaton’s favor, requiring that the nightclub’s owner,Albenco, Inc., provide him with $125,000.

When Eaton attempted to collect the money fromAlbenco’s insurer, Penn-America Insurance Company,the carrier moved for a summary judgment. Penn-America pointed to the CGL exclusion for “‘bodilyinjury’ … or any other damages resulting from assaultand battery or physical altercations that occur in, on,near or away from the insured’s premises.”

Eaton argued that because intentional physical contactis required for an assault and because the bouncerdidn’t intend to assault him, the exclusion didn’t apply.The court disagreed. (For more on this argument, readthis month’s Coverage Corner.)

In the end, Eaton watched the cash slip through his fingers, as a District Court ordered in favor of Penn-America.

Source: U.S. District Court, District of Maine, CV-09-71-B-W

----------------------------------------------------------------———————-------The Last & Least column is dedicated to the industry’s oddities —from creative claims and kooky coverages, to (tasteful) jokes andstrange stories. Submit yours to [email protected], subject line: Last & Least. The editor will happily protect sources’ anonymityupon request.

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