Writing an Effective Coverage Letter - Analyzing the Facts, the Law and the Insurance Policy

Why Should You Attend:

One of the most difficult tasks of a claims handler is writing a letter to an insured about coverage. A claims handler cannot just tell an insured that the loss is not covered. Instead, they must analyze the facts and circumstances of the loss, as well as the insurance policy and applicable law to determine if the loss is covered. The claims handler must then compose the letter explaining coverage to the insured in a way the insured can understand.

This webinar will cover what a claims handler needs to know in order to look at the facts, the law, and the insurance policy to make a coverage determination and convey the determination to the insured.

Learning Objectives:

• Understand the necessity of writing a coverage letter.
• Understand how to utilize the facts, the law and the insurance policy to make a determination if more information is needed.
• Communicate to the insured the need for more information when there is insufficient information to make a coverage determination.
• Determine how state mandated language is written in the coverage letter.
• Be able to write the coverage letter.
• Address responses to letters written.

Areas Covered in the Webinar:

• The need to write a coverage letter
• How facts are presented
• How applicable law affects the coverage decision
• How to apply facts and law to language in the insurance policy
• How to handle when coverage cannot be determined
• How to write correspondence to the insured
• How to respond to insureds

Who Will Benefit:

• Claims professionals who write letters regarding coverage
• Brokerage professionals who monitor claims on behalf of their insureds
• Attorneys and paralegals who work with litigation on the subject
• Risk managers who manage claims on behalf of their employers
• Underwriters who use claims history as a factor in decision making

Instructor Profile:

Marc Jorge Estrella is an insurance professional with extensive, interdisciplinary experience in the property and casualty insurance industry. Besides writing and speaking on insurance topics, he has worked in the information technology, claims, policyholder advocacy, operations and marketing areas in both carrier and producer settings. In addition to holding a Master of Science in Insurance Management from Boston University, he holds both the Chartered Property Casualty Underwriter and Certified Insurance Data Manager Professional Designations. He received his Bachelor of Arts in Economics and Business Administration from Trinity University and currently resides in San Francisco, California.

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