The lawyers at Taylor & Blair LLP have been fighting insurance companies for our client’s rightful benefits for over 30 years. Often that means challenging the insurance company directly for wrongful denial of long-term disability, critical illness, or life insurance benefits, but sometimes insurance benefits are denied not due to the actions of the insurance company themselves, but due to the negligence of the insurance agent or insurance broker who helped you enter into your insurance policy.
What’s The Difference an Insurance Agent and an Insurance Broker?
While most people have heard the term “insurance broker” and “insurance agent”, they are not interchangeable and are two completely separate types of insurance salespersons.
An insurance broker acts independently from any one insurance company and helps to arrange the purchase and sale of insurance policies from the seller (the insurance company) to the buyer (the individual or business). Since an insurance broker is independent from any specific insurance company they can offer your insurance products from all of the insurance companies.
An insurance agent is an employee (or agent) of a specific insurance company and they try to sell you their specific insurance company’s products.
Insurance broker fees are usually a commission on the sale while an insurance agent can be paid via commission or salary.
How Can an Insurance Agent or Insurance Broker Be Negligent?
Many insurance denials are denied because the insurance company feels like the insured person or business misrepresented or lied about something when entering their insurance policy, or because the insurance claim doesn’t fit the language of coverage contained in the policy. Sometimes they are right about this but often they are wrong and an experienced insurance denial lawyer can help you get the insurance benefits you deserve.
Cases with insurance agent or insurance broker negligence are different. In these cases the insurance coverage is denied not because of something the insured individual or business said or did, but because of a mistake on the part of the insurance agent or insurance broker who filled out the insurance application with you.
What Kind of Mistakes Do Insurance Brokers and Insurance Agents Make?
There are many mistakes an insurance broker or insurance agent can make that can lead to a denial of insurance coverage. Most mistakes occur during the process of filing out the application for insurance coverage. For instance, if an insurance broker or insurance agent does not go through the application in detail and make sure the insured is asked every question on the application, understands what every question on the application is asking, and gives a full answer to every answer on the application, this can lead to situations where the insurance may get denied. Insurance applications with wrong answers, questions with answers not filled in, and with other mistakes can lead to big problems down the road. Sometimes insurance agents or insurance brokers fill out portions of the insurance application themselves without the applicant seeing the actual questions. This can lead to miscommunications that can lead to coverage denials.
Another area where insurance broker or insurance agent negligence can arise is in what coverage is being sought and if it is adequate for the purposes that lead the individual or business to seek insurance in the first place. Is the insurance being offered the right insurance for the issues raised by the individual or business seeking coverage? Is the coverage they are being offered enough for the purposes it is being sought? If an insurance broker or insurance agent were to advise a business to get business interruption coverage, but the amount of coverage would clearly not cover the losses the business would suffer should they ever need to avail themselves of the policy, there could be an action for negligence to claim the difference of what the policy pays out and what the actual damages incurred were.
If you think that your insurance denial is due to insurance broker or insurance agent negligence, contact the lawyers at Taylor & Blair LLP today. There are strict timelines in which you have to start you claim.