Zalma’s Insurance Fraud Letter – August 15, 2025

[Scott LeMay]

Riskateers --

There is a lesson embedded in the arrival of the ZIFL by email twice a month. The lesson is that there are still guardians at the gates when it appears that the barbarians are approaching from all sides.

Barry, The Empress of the Seven Universes and I were in San Diego recently to escape the heat of Memphis. We were talking about your Bonsai collection that we saw years ago on a short road trip up from San Diego to Culver City. We hope you and your family and your art are all doing well.

From Coronado Island,  August 1:

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

[James Brittle]

Retirement looks like it’s serving you and the Empress well, Scott. 

James R. Brittle 

205-914-8316 mobile

riskm...@yahoo.com

Sent from my iPhone

On Aug 15, 2025, at 8:48 AM, Scott LeMay <sml...@gmail.com> wrote:



Riskateers --

There is a lesson embedded in the arrival of the ZIFL by email twice a month. The lesson is that there are still guardians at the gates when it appears that the barbarians are approaching from all sides.

Barry, The Empress of the Seven Universes and I were in San Diego recently to escape the heat of Memphis. We were talking about your Bonsai collection that we saw years ago on a short road trip up from San Diego to Culver City. We hope you and your family and your art are all doing well.

From Coronado Island,  August 1:

<20250801 San Diego.jpg>

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

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[Scott LeMay]

James --

We drove through Birmingham in April. Hot and Hot Fish Club is not what it used to be. We went on to Atlanta for one of +Lang's events, and I got to walk from midtown across Piedmont Park to Ponce City Market, with fake coyotes on the way.

I hope you are doing well, and your family, and the cut dogs that +Lang admires.

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

To view this discussion, visit https://groups.google.com/d/msgid/risklist/ACDCB701-EBB4-42BF-A0B3-5F19A4234538%40yahoo.com.

[Dave Morgan]

I was talking to that there Chris Holden about this a few days ago, on
the basis that I've possibly hung up my boots now and entered the world
of retirement. He's already retired.

I was probably one of the youngest people on RiskList. I joined in the
early 90s and I was in my early 20s at that point. I'm in my mid-50s
now. I suspect that quite a lot of you lot have completed a few more
laps than I have.

How many people here are still actively working? And of those that are,
how many are actually working and how many are just doing a bit of
consultancy stuff like I am rather than doing a 9-5 thing?

Dave


> Retirement looks like it’s serving you ... well

[Dave Morgan]

I think the lesson is that Mrs Scott appears to be stealing years from
Mr Scott. Every time I see a picture of her she looks younger.

Having said that, you aren't exactly ageing all that much, Scott. But
+Lang looks five years younger every time you share a photo of her!

Dave


On 15/08/2025 14:47, Scott LeMay wrote:
> There is a lesson

[AOL! EMAIL! SERVICE!!!]

Dave, 

I finally retired last December. I turned 80 in April. I don’t need the money and I was not having fun. 

I testified in my last case. We had good facts and law and lost. The court’s and people’s opinion of insurance has changed. 

Like the fire horse I still listen for the bell. 

Tom McCloskey 

Sent from the all new AOL app for iOS

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[James Brittle]

Dave
I am still in my mid-50s as well and still working. You can attest as well as I can that the business continues to evolve and the perception of insurance has definitely changed - but it may have to do with the menagerie of talking animals that our carriers advertise with and the abominable claims service most engage.

James R. Brittle
205-914-8316 mobile
riskm...@yahoo.com

Sent from my iPhone

> On Aug 15, 2025, at 7:59 PM, Dave Morgan <da...@morganbishop.co.uk> wrote:
>
> I was talking to that there Chris Holden about this a few days ago, on the basis that I've possibly hung up my boots now and entered the world of retirement. He's already retired.

[Bill Wilson]

At 74, I still do some contract writing and a little speaking. I’ve been working on a CGL book for 4 years and making little headway. I could probably work 80 hours a week if I wanted to. I’m doing a Certificates of Insurance webinar in October. I thought I’d beaten that horse to death 20 years ago but there’s a new generation of agents, underwriters, contractors, risk managers, attorneys, etc. It’s deja vu all over again.

> On Aug 15, 2025, at 7:59 PM, Dave Morgan <da...@morganbishop.co.uk> wrote:
>

> I was talking to that there Chris Holden about this a few days ago, on the basis that I've possibly hung up my boots now and entered the world of retirement. He's already retired.

[AOL! EMAIL! SERVICE!!!]

James. 

You are correct. The claims service has definitely changed/ failed. 

In Michigan the plaintiffs attorneys are banging insurance companies many times a day on television. 

The public perception is that insurance companies are a scam. 

Tom

Sent from the all new AOL app for iOS

To view this discussion, visit https://groups.google.com/d/msgid/risklist/DD1578DA-2457-49F6-B77F-1773B26166EF%40yahoo.com.

[Scott LeMay]

Dave --

I retired at 47. Half-heartedly. Then I decided that was sub-optimal. No point in sugar-coating that. That prompted me to go on and do several more ill-advised things, and also some things that were creative, challenging, and beneficial to me and to my clients. 

Amazingly, things worked out, overall, better than I had either expected or hoped. The lesson, if any, is that the fortuitous deflections and misdirections in life are not ends to the trail. It was important to peek around the corner of the granite wall that appeared, unbidden, in front of me, and to examine and select routes to possible green pastures. It was also important to examine whether the wall was truly granite, or illusory.

And, over the years, where did I end up? At Wetherspoons by Victoria Station and years later at Pride of Paddington having beer with you. And at Barclays at Canary Wharf with Chris Holden. And at Naf-Naf Grill in downtown Chicago with Harriette Liebovitz. And at various morning coffee places with James Brittle in Birmingham, Alabama. And at a Ruble Seminar on the west side of St. Louis with Tim Wahl. And at Germantown Commissary two miles from my house for barbecue with Bill Wilson. And at a Mexican restaurant on Olvera Street in Los Angeles with Barry Zalma and his wife and daughter.

I think, overall, that I've been very lucky to have been in contact with all of you. Thank you for who you are, and for what you've done to advance professionalism and decency in a business that needs more of both.

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

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[Bill Wilson]

I made a career change after listening to a Styx song. You never know what may trigger a life-changing transition. There were several factors in play, but listening to that song was the no-going-back trigger.

On Aug 16, 2025, at 8:24 AM, Scott LeMay <sml...@gmail.com> wrote:



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[Dave Morgan]

> You can attest as well as I can that the business continues to evolve

Weirdly, not for the better. And even more weirdly, I thought tech would be a game changer, but that's not changed things for the better, either.

I'm not some dodgy old bloke saying "back in my day" and stuff like that. I worked on dot-com projects. Despite being "sort of retired" I'm currently working on a couple of AI projects.

But I genuinely thought that tech would revolutionise insurance - and yet it hasn't.

OK, there's certain stuff that's cool. Google's Street View makes it a lot easier to check a risk without having to survey it in person. And being able to check the flood potential is a game changer - unless you're in an area prone to flooding.

But as a broker, having to type the same details into a dozen different insurer portals wasn't really helping me. OK, so it saved the insurer a bit of money because they didn't have to type it into their systems, but realistically it just moved the work around.

And the portals don't let you explain the risk. You spend half an hour typing in details of the claims but aren't allowed to point out that although the claims are in the claims experience, they're from a business unit that's been closed down.

Maybe I am just a grumpy old man and the kids joining the industry love the comfort blanket of a computer system that tells them the premium so they don't have to justify why they made the decision they did.

But I think we've gone for tech to generate cost savings rather than to generate enhanced service levels. And by enhanced service levels, I don't mean chatbots.

Dave

[Dave Morgan]

> I’ve been working on a CGL book for 4 years

I've been working on a cookery book for around 25 years and although I keep telling myself now's the chance to finally get it finished, that doesn't appear to be happening as quickly as I expected ;-)

Dave

[Dave Morgan]

> You never know what may trigger a life-changing transition.

For me it was sitting in a car going nowhere on the M5 motorway for around five hours on a Friday night. Once that became a regular occurrence I decided it was game over.

I decided my last day would be 4th July. It's not just you Americans that get Independence Day ;-)

(It was either 4th July or the Glorious Twelfth, but I decided I couldn't manage an extra five weeks of commuting...)

Dave

[Effec...@aol.com]

Dave,

 

One of my clients, Kim Selby, recently published her cookbook “Everything with Love”.  She created as a gift to her children, and it pays homage to her mother who always cooked and baked for the family.  It includes many lovely photographs of the kids at different ages and also her mother and friends.  Kim’s kitchen typically is full of family and friends assisting in the meal preparation – sometimes simple and sometimes more complex.

 

I think it took her 7 years – and yes it was longer than she anticipated.  Link is below if you want to take a peek.

 

                https://www.everythingwithlove.com/

 

Cheers,

pt

 

Pauline Thomas, CRM, CIC, ARM, CISR

CA License # 0519678

Effective Risk Management
Independent Insurance and Risk Management Consultants & Litigation Support – No Insurance Sold

Phone: 949-251-1500
E-mail: Effec...@aol.com

https://www.linkedin.com/in/pauline-thomas-effectiverm

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[Dave Morgan]

Yeah, same here. I guess every time I did something daft I sort of knew
that something would happen at some point so even the troughs would turn
into peaks, but it's been a wild ride.

My first encounter from RiskList was Chris Holden. A broker had asked me
if I fancied insuring fairground rides. That was a big non-starter for
the insurer I was working for, but I met up with Chris for a beer and he
talked me through the risks. At the time, among other things he was the
RM for the biggest theme park in the UK.

So I put together a business plan. Head Office thought I was an idiot,
didn't really know how I'd got access to the RM for the biggest theme
park in the UK, but decided to let me spin the wheel. I was in my
mid-20s at the time. That account was £2.5m GWP within three years and
was profitable.

I do feel a bit guilty that I've never made it to the US and every time
I've met someone from RiskList it's been in London. Well, mostly. I
think I met Rick B in Bath because his family were having a few days
there before going to London. That was amusing because Rick asked me
whether I minded his 19yo son having a beer as the age limit in the US
is 21yo. I said he'd probably need ID because although you can drink in
the UK at 18yo, you have to prove you're old enough, but it was his call
as it's his boy. Rick's boy is not someone who'd need ID. He was a
substantial, fully-bearded gentleman.

But the problem with the US is that it's such a big place and you're
mostly scattered all over the place. And in my defence, it does take me
three hours each way to get to London so it's not like I was cheating ;-)

It's been pretty cool so far though, hasn't it? Let's see what's around
the corner of that the granite wall. And I hope that the kids that are
starting in the industry now have as much fun as we've had over the past
few decades!

Dave

[Dave Morgan]

That looks pretty cool, and the website looks amazing too.

My cookery book won't have any recipes in it, though ;-)

The idea is that it'll take a similar approach to cooking that I took to
underwriting. Just make it up as you go along...



Dave



On 16/08/2025 20:32, EffectivRM via RiskList wrote:
> “Everything with Love”

[Scott LeMay]

I'll fall back on a common refrain: "Uh, yeah, ...what Pauline said."

I think lunch with Pauline would have been memorable.

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

To view this discussion, visit https://groups.google.com/d/msgid/risklist/000801dc0ee4%24782ade80%2468809b80%24%40aol.com.

[Dave Morgan]

Definitely. Particularly as she reminds me of a property underwriter I worked with:

"No Insurance Sold"

;-)

I'm joking here, so don't take this the wrong way, Pauline, but I remember a bloke who I worked with.

I'd been to lunch and secured the liability insurance for a woodworking risk. About £80k GWP back in the mid-90s. As part of that, because we'd been told we should be supporting the property underwriters I'd made it conditional on our property underwriters being offered the chance to quote for their side of it.

The broker I'd been having a beer with said he was happy with that. The property insurance was paying £250k, the existing property insurer couldn't do the casualty side of the risk, so if we could hit that premium target, the material damage risk was ours.

This property underwriter was technically amazing. He could find absolutely every single reason to decline a risk. To be fair, this was a woodworking risk with a £25m exposure and absolutely no compartmentalisation so it'd have needed to have been shared around a bit, but that was do-able once he'd have put a lead line on it.

No dice. He wasn't playing. So I met the broker the following day, handed over the casualty insurance documentation, had a couple of beers and that was it.

Back in those days I thought property insurance was complex. But actually, it sort of isn't. I knocked broking on the head around six weeks ago, but before then I was sticking stuff into out Lloyds markets with, "Are you happy with .40% on this one?"

Actually, quite often I was sending stuff in, forgetting to attach the rating sheet with my proposed rating in it and getting "agreed" come back via email ;-)

Dave

On 17/08/2025 04:02, Scott LeMay wrote:

I think lunch with Pauline would have been memorable.

 

Pauline Thomas, CRM, CIC, ARM, CISR

[Tim Wahl]

Scott probably has more pics with all of us old Risklist members than anyone. 

I'm hoping to retire in 5 years, I will tell you I'm sure tired of this market, Missouri is leading the nation in Tornadoes, add in high winds, hail and wildfires for good measure and its a complete mess. Being in this business 30+ years, I have seen premium increases, but I've never seen coverage reductions like I'm seeing. Today, more than ever, it's essential that insureds RTFP or have agents that can RTFP! 

So many carriers are going to shitty policy forms and overseas workers, it's so sad! 

There are still some holdout carriers doing things the right way, and I think that helps the IA. I'm an IA, and I don't put customers with shitty carriers! 

Regards,

Tim Wahl

To view this discussion, visit https://groups.google.com/d/msgid/risklist/CACb1-_F0jZ2jMtzmAgc3kZBEn%3DYqOPhszA4U0-t%2BveuPOdTkZw%40mail.gmail.com.

[Bill Wilson]

That’s one of 3 books I’m also working on. It’s a cookbook for people who can’t cook or hate to cook.

On Aug 16, 2025, at 2:09 PM, Dave Morgan <da...@morganbishop.co.uk> wrote:

 > I’ve been working on a CGL book for 4 years

I've been working on a cookery book for around 25 years and although I keep telling myself now's the chance to finally get it finished, that doesn't appear to be happening as quickly as I expected ;-)

Dave

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[Richard Betterley]

Thanks for the memories of our visit in Bath. That son (our younger) is now 34, married, and owns his own home. A fine young man, we love his wife, and we couldn’t have asked for a better son (both of our sons are terrific, so it’s a tie).

Here’s a pic of Jeremy and Rachel at last year’s wedding. He's still got the beard, but also my receding hairline.

Rick Betterley

C: 774/262-3460

---

From: risk...@googlegroups.com <risk...@googlegroups.com> on behalf of Dave Morgan <da...@morganbishop.co.uk>
Sent: Saturday, August 16, 2025 10:43 PM
To: risk...@googlegroups.com <risk...@googlegroups.com>

Subject: Re: [RiskList] Zalma’s Insurance Fraud Letter – August 15, 2025

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[Effec...@aol.com]

Dave,

You might get a kick out of "Schlerman in the Kitchen" - by Gene Schlerman published in 1981 - available on E-Bay, Amazon etc. Gene does not give lists of ingredients...writes in prose - tells the reader ingredients as he tosses them around the kitchen, chopping or tossing into pots and pans, stops to take a nip or two of booze, tell a story about pets, stores or friends etc. Whether using it as a cooking guide or simply to enjoy his stories, I find Gene entertaining and suspect you might too. 😉

Out of print but available at AbeBooks, EBay, Amazon.....etc. https://www.abebooks.com/9780914842569/Schlerman-kitchen-Gene-0914842560/plp

Cheers,
Pauline

-----Original Message-----
From: risk...@googlegroups.com <risk...@googlegroups.com> On Behalf Of Dave Morgan
Sent: Saturday, August 16, 2025 7:48 PM
To: risk...@googlegroups.com

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[Effec...@aol.com]

Dave,

Funny……no offense taken.  I left the underwriting and brokerage work behind when I moved on to pure consultancy in 1986.  Though oddly, I often find myself explaining to underwriters and brokers how to underwrite or sell a policy to create a win – win for the prospective Client policyholder, broker and underwriter. Also, many discussions with claims professionals about the transaction, insurance contract provisions and applicable Insurance Code statutory regulations, that often is enlightening to them. That is on the transactional consulting side working for clients.  In litigation work I study the transaction – what is there and what is not there but typically should be - to  decipher what went wrong giving rise to the litigation.  Often it is a series of missteps by all parties – if just one party had put a brake on the train and done the right thing it could have put the transaction on another track and not ended up in litigation.

 

And the beat goes on…….

 

Pauline Thomas, CRM, CIC, ARM, CISR

CA License # 0519678

Effective Risk Management

Independent Insurance & Risk Management Consultants – No Insurance Sold

Phone 949-251-1500

Effec...@aol.com

 

From: risk...@googlegroups.com <risk...@googlegroups.com> On Behalf Of Dave Morgan

Sent: Saturday, August 16, 2025 8:27 PM
To: risk...@googlegroups.com

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[Bill Wilson]

Most of the past 37 years of my career have been spent helping agents get denied claims paid without the policyholder having to resort to litigation. Where I've been convinced coverage exists, I suspect I've been successful over 90% of the time in reversing the denial. Adjusters are often looking for a way out of denying the claim if you can provide sound, persuasive reasoning. On multiple occasions, I've had carriers insist that coverage was not intended but admit that it's reasonably arguable...they paid the claim then advised they would modify the coverage language to better express their intent. That's the way it supposed to work

- Bill

Bill Wilson, CPCU, ARM, AIM, AAM

Founder & CEO, InsuranceCommentary.com

Bi...@InsuranceCommentary.com or Insurance...@outlook.com

Com•men•tar•y … an expression of opinions or offering of explanations

 

From: EffectivRM via RiskList <risk...@googlegroups.com>

Sent: Sunday, August 17, 2025 12:26 PM
To: risk...@googlegroups.com <risk...@googlegroups.com>

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[AOL! EMAIL! SERVICE!!!]

Please be careful about who you call adjuster.  

I was taught to look for coverage. To deny when I had exhausted all options. 

Companies have evolved to two options.  A pass through that pays all

Claims and passes the cost off to rate increases. 

The other is to deny all claims, without regard to coverage. Then pay the folks who sue.  

Both are wrong

Tom

Sent from the all new AOL app for iOS

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[Effec...@aol.com]

Bill,

Agreed – a professional informative discussion often leads to a positive outcome.

 

Just last week I had a friendly tc with a claim adjuster……told him the situation was foreign to me – thus I researched before calling him.  I shared what I learned in my research as a “non-lawyer”.  During our next call the adjuster admitted his knee jerk reaction would have been no…..but after hearing what I learned he researched himself and reached the same “non-lawyer” conclusion that I did.  He sent it up the line for review and so far there has been no disagreement.  Outcome looks positive!

 

Education and knowledge thoughtfully shared can be powerful.

 

Cheers,

pt

Pauline Thomas, CRM, CIC, ARM, CISR

CA License # 0519678

Effective Risk Management
Independent Insurance and Risk Management Consultants & Litigation Support – No Insurance Sold

Phone: 949-251-1500
E-mail: Effec...@aol.com

https://www.linkedin.com/in/pauline-thomas-effectiverm

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[Dave Morgan]

Mine's a cookbook for people who can't cook written by someone who can't cook ;-)

It does sort of make sense. To me, anyway. Let's face it, I've not starved to death so far.

At the moment I'm struggling with the graphics. I've not actually written most of the words but I thought that if the graphics were in place, the words would sort of flow from that...

Dave

[Scott LeMay]

Rick --

I dislike the negative locution "receding hairline." I prefer the positive  expression, "advancing skinline."

No decision on what to do about "waistline" at this point.

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

[Richard Betterley]

😀

Rick Betterley

C: 774/262-3460

---

From: risk...@googlegroups.com <risk...@googlegroups.com> on behalf of Scott LeMay <sml...@gmail.com>
Sent: Monday, August 18, 2025 12:37:43 PM

To: risk...@googlegroups.com <risk...@googlegroups.com>
Subject: Re: [RiskList] Zalma’s Insurance Fraud Letter – August 15, 2025

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[Bill Wilson]

At least he didn't refer to himself as a skinhead.

The late John Eubank always referred to the top of his head as a solar panel for a sex machine...while his wife Barbara laughed uproariously. 

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[Effec...@aol.com]

Bill…..

You were reading my mind…..it is precisely what I was thinking as I read the exchange.

 

pt

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[Bill Wilson]

The skinhead comment or sex machine comment? 😄 

From: EffectivRM via RiskList <risk...@googlegroups.com>

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[Effec...@aol.com]

Sex machine……

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[James Brittle]

Tom

You must still be close to the business these days. 

I did a presentation to my State RIMS chapter earlier this year on “Is AI the End of Underwriting” and during my research asked every insurer that visited my office what they knew about their company and it’s AI efforts. Responses were all over the map including one Carrier that was still transitioning from their DOS based system to one that was using AI to write reservation of rights letters. Interestingly, most of it was trying to be utilized for efficiency gains, and not improved underwriting results, but most said it was freeing them to underwrite more in depth and push back on Carrier predictive analytics as well. So a mix of good and really bad tasks overall. Certainly not the death of underwriting, however

James R. Brittle 

205-914-8316 mobile

riskm...@yahoo.com

Sent from my iPhone

On Aug 17, 2025, at 1:50 PM, 'AOL! EMAIL! SERVICE!!!' via RiskList <risk...@googlegroups.com> wrote:

 Please be careful about who you call adjuster.  

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[Scott LeMay]

Tom --

You nailed to the wall two examples of egregious behavior I've experienced with claims handling. Here's one example I've had that you mentioned (Case 1), and another approach that I think is egregious (Case 2):

Case 1: There is an insurance company in Tennessee that fifteen years ago or so existed primarily to collect premiums and never pay claims. One of their insureds bumped into my car while I was motionless in a parking lot. I happened to be in the car. It took months and months of requests for payments, copied to the Tennessee Department of Insurance, and visits to local offices of the carrier before anything as simple as payment of the claim happened. I think things broke loose when I wrote to the President of the company, and put in the CC: area the names and addresses of the (then) mayor of Memphis, and the area Director of N.A.A.C.P. Neither one of those two individuals was personally known to me, and I'm sure they knew nothing of me. Nor did either get a copy of the letter. The carrier paid quickly.

Case 2: A carrier writes the Physical Damage insurance on mobile equipment, both agricultural and industrial, for a major manufacturer. The Physical Damage insurance covers the usual exposures, and includes theft. Equipment that is insured by such a cover does end up regularly at dealerships for that same manufacturer, although the dealerships are franchises, so there is no direct relationship other than the normal business contracts under which the franchises exist. When a customer owned (or financed) piece of equipment is at a dealership for repair, and something happens that is not a legal liability exposure for the dealership, such as a break-in and theft or vandalism, or a Wind/Hail event, and for all such situations the dealership has exhibited at least ordinary care of the bailed properties, the Physical Damage carrier routinely contacts the dealership and asks them to report the claim to their package carrier to see if the carrier will pay the claim. Not all dealership insurance programs are written to cover bailed property as "Bailees Customers Coverage" to allow bailed property to be covered absent imposition of legal liability. Dealerships have been moving in the past ten years to get away from that older kind of automatic coverage for customers, and to keep everything on a Legal Liability basis these days. Still, the calls and the letters come in, and the representatives of the carrier can be very insistent on having the dealership make the claim even if the dealership doesn't believe they are legally liable. I've talked to the representative who make such calls, and I ask them, "We know we aren't legally liable for this. Do you want us to commit insurance fraud?" They don't have a good answer for that. I also ask them, "The owner of the stolen (or damaged) property hasn't notified us to make a claim. We haven't had a loss. Why should we file a claim?" They don't have a good answer for that, either.

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

To view this discussion, visit https://groups.google.com/d/msgid/risklist/1738781628.429853.1755456622118%40mail.yahoo.com.

[Scott LeMay]

Tim --

Carriers going to questionable forms is a problem. I'd like to blame A.I. for some of the forms, but I think it is real people making bad decisions about configuration of forms.

A carrier that I happily used for my clients for an  aggregated total sixty policy years went from an AAIS Commercial Output Program for Property and Inland Marine exposures. That carrier switched a couple of years ago to using only Property forms. The Property forms were intended to handle the exposures of property of others as bailments at covered  locations. They also were intended to handle care, custody, or control exposures away from covered locations for activities such as field repairs of tractors, combines, etc., out on the farms or ranches.

That change in forms came at a time when the equipment dealer market was evolving (finally) to a mindset that bailments and care, custody, or control exposures should fall most often into a Legal Liability situation, rather than the equivalent of a "Bailees Customers Coverage" situation that pays on the value of the bailment, and not on the legal liability that may attach to the event.

I saw my clients get away from the 1980's model that said, "We will pay for all losses because they are our customers," to believing that "Our customers have insurance for these situations, and if we are not legally liable, we should not have to pay." That change came slowly, but it accelerated as equipment dealerships got bigger through mergers and acquisitions.

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

To view this discussion, visit https://groups.google.com/d/msgid/risklist/1563524525.701628.1755403120068%40mail.yahoo.com.

[AOL! EMAIL! SERVICE!!!]

Scott, 

It sounds as if the standard crawl out clause was added

Tom

Sent from the all new AOL app for iOS

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[Bill Wilson]

My wife’s car was hit while parked in her parents’ back yard. Clearly negligence. Our insurer paid us less the deductible and we waited to be reimbursed…and waited and waited. The liability carrier was nonresponsive. Working for the Big I state association, I knew lots of people at the DOI. One of them made a phone call and essentially threatened to pull the agent’s license and suspend the carrier’s certificate of authority. The response was immediate and we got reimbursed within a week.

On another occasion, my father in law was severely injured in a skill saw accident and, after being stabilized at the local hospital, he was air lifted to a hospital where one of the top surgical teams in the country successfully reattached his fingers. Despite assurance that the flight was medically necessary, the health insurer refused to pay the $25K transportation charge…until I got the DOI’s L&H director involved and they quickly had a change of heart.

On Aug 20, 2025, at 1:30 AM, Scott LeMay <sml...@gmail.com> wrote:



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[Scott LeMay]

Dave --

I worked for a direct writer, and the underwriting manager was nicknamed "Dr. No." I'm willing to bet that was not original, or even unusual, in the wider worlds of underwriting.

At Sedgwick James of Oregon (prior to Sedgwick, Inc., and the Marsh acquisition) we referred to our in-house underwriting department as the "Business Prevention Department." Another old joke, perhaps.

All of this does point to shared experiences, however.

--  Scott

________________________________________________

                         Scott M. LeMay

                                   LeMay+Lang, LLC
                             Cell and Text  347.915.3629
  Independent Risk Management & Insurance Advisory Services

________________________________________________

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