PHIL’S CORNER: When to Report a Claim

Phil’s Corner is a special column from OAMIC’s President & CEO Phil Fraim that is sent in our e-newsletter each month.

Has it ever crossed your mind whether you should report a matter that could potentially be the basis of a claim?  You may question the timing and whether there is even a need to report it to OAMIC, since it is uncertain if anything will actually come out of the issue.

If you have ever wondered about when to involve us, you are not alone. It is a question I have heard many times. Often that question is followed with a statement conveying the only reason you are doing so is “out of an abundance of caution.” Let me just say, there is never anything wrong with that motivation!

If we made a ledger and on one side listed all the reasons to delay reporting and on the other side all the reasons to report as early as possible, the side with reasons to delay would be blank. There are no good reasons to drag your feet, but there are many excellent reasons to report as soon as possible! If nothing comes of a “possible” claim, your deductible will not be triggered and it will not impact your claims/loss experience.

You should be cognizant of the fact that professional liability insurance for lawyers is written on a claims-made policy. The policy that responds to a claim is the one in force at the time the claim is first made and reported, and not the policy in force when the act or omission took place. If you knew or should have known about a claim’s circumstances and chose not to report it until the next policy period, it would inaccurately attempt to force the wrong policy to respond. It is possible that policy provisions, terms and conditions, limits and deductibles can change from one year to the next.

Failure to timely report can lead to missed limitations periods, adverse judgments, lost appeal opportunities and negative outcomes that could have been avoided, or at least mitigated. Policy provisions require insured lawyers to cooperate in the handling of their claims. Non-cooperation can jeopardize coverage, especially if OAMIC is prejudiced.

Reporting early, even out of the abundance of caution, provides an opportunity to gather and secure information, assist in repairing the matter, if possible, and to seek settlement prior to litigation, if liability is obvious. Sometimes we have seen similar matters, preventing re-inventing the wheel in order to resolve yours. We are your insurer and we are part of your team. Let us know as soon as possible so we can better work together.

There are several ways to get the reporting process started. We have an online claim form within our insured portal (log in here), or you can always email and call. Any first notice or report will require you to provide a brief narrative of the circumstance. You should be concise with a well-organized summary including key facts, details, dates and client’s name.

Make sure to include your side of the story so we can better understand your position and how to defend you. Provide an estimate of values or amounts being demanded if any exist. There is no need to include your whole file initially. If there is already a suit that has been filed, we will hire outside counsel and will seek your approval prior to doing so. Keep in mind; you may trust your brother-in-law explicitly, but after handling approximately 3,000 of these matters, we will have strong recommendations based upon the nature of the matter and where it is filed.

Report matters promptly. The sooner we have the information, the quicker we can get to work with you to bring about a resolution.

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