The Importance of Underwriting to the Claims Person
Barry Zalma
Sep 20, 2023
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The insurance adjuster and claims investigator are major sources of information available to the underwriter to avoid moral hazards. The adjuster provides the underwriter with information gained at the scene of a loss that will alert the underwriter of the existence or potential for a moral hazard. Every person involved in claims must understand that he or she has an important underwriting function as probably the only person from the insurer who actually communicates directly with the insured and actually views the property that is the subject of the insurance.
The sources of information available to the underwriter are limited. At best he has the answers of the insured, and the insured agents to questions posed in an application and the information provided by a pre-risk inspection. These are seldom sufficient. The investigation and adjustment of a claim is a source of detailed information about a risk that should cause an underwriter to reevaluate the risk and if a moral hazard is revealed the underwriter can take steps to protect against the moral hazard.
The adjuster must be able to recognize and report any information that might affect the underwriter’s decision to continue to insure the insured. When evidence of a moral hazard is discovered, the underwriter should be immediately alerted. Occasionally the information contained in the application is enough to make a decision. Usually, the underwriter will request more information in order to get further details to substantiate or negate suspicions. Every source of information is important to the underwriter as he or she attempts to decide whether to insure or not insure an applicant for insurance.
The Application
Clues to moral hazard can be found with statements about previous losses, previous business experience, the person in whose name title is held, and the number of mortgagees. If an inspection by the producer or loss control engineer is required, the underwriter will also learn about poor housekeeping or poor business practices.
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Concealing a Weapon Used in a Murder is an Intentional & Criminal Act
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In Howard I. Rosenberg; Kimberly L. Rosenberg v. Chubb Indemnity Insurance Company Howard I. Rosenberg; Kimberly L. Rosenberg; Kimberly L. Rosenberg; Howard I. Rosenberg v. Hudson Insurance Company, No. 22-3275, United States Court of Appeals, Third Circuit (February 11, 2025) the Third Circuit resolved whether the insurers owed a defense for murder and acts performed to hide the fact of a murder and the murder weapon.
FACTUAL BACKGROUND
Adam Rosenberg and Christian Moore-Rouse befriended one another while they were students at the Community College of Allegheny County. On December 21, 2019, however, while at his parents’ house, Adam shot twenty-two-year-old Christian in the back of the head with a nine-millimeter Ruger SR9C handgun. Adam then dragged...
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Washington state law allows insurers to deliver insurance notices and documents electronically if the party has affirmatively consented to that method of delivery and has not withdrawn the consent. The Plaintiffs argued that the terms and conditions statement was not “conspicuous” because it was hidden behind a hyperlink included in a single line of small text. The court found that the statement was sufficiently conspicuous as it was bolded and set off from the surrounding text in bright blue text.
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CRIMINAL CONDUCT NEVER GETS BETTER
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In September 2020, Givens matched with J.C. on the dating app “Tagged.” J.C., who was 20 years old at the time, had known Givens since childhood because their mothers were best friends. After matching, J.C. and Givens saw each other daily, and J.C. began working as a prostitute under Givens’s direction.
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Von Harris was convicted of bribery, forgery, and insurance fraud. He appealed his conviction and sentence. His appeal was denied, and the Court of Appeals upheld the conviction.
In State Of Ohio v. Von Harris, 2025-Ohio-279, No. 113618, Court of Appeals of Ohio, Eighth District (January 30, 2025) the Court of Appeals affirmed the conviction.
FACTUAL BACKGROUND
On January 23, 2024, the trial court sentenced Harris. The trial court sentenced Harris to six months in the county jail on Count 15; 12 months in prison on Counts 6, 8, 11, and 13; and 24 months in prison on Counts 5 and 10, with all counts running concurrent to one another for a total of 24 months in prison. The jury found Harris guilty based on his involvement in facilitating payments to an East Cleveland ...
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To Dispute an Arbitration Finding Party Must File Dispute Within 20 Days
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EXCUSABLE NEGLECT SUFFICIENT TO DISPUTE ARBITRATION LATE
In Howard Roy Housen and Valerie Housen v. Universal Property & Casualty Insurance Company, No. 4D2023-2720, Florida Court of Appeals, Fourth District (January 22, 2025) the Housens appealed a final judgment in their breach of contract action.
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