Insurance Agent Versus Experienced Policyholder Attorney Viewpoints About Insurance Coverage Denials

Chip Merlin | Property Insurance Coverage Law Blog | January 13, 2019

Ed Eshoo works out of Merlin Law Group’s Chicago office and is one of the best property insurance policyholder coverage attorneys you could find. I do not think there is anybody with a national reputation as being “the expert” on the 165-line Standard Fire Insurance Policy on a national, rather than state, basis. Ed is an extreme competitor, and it shows in his daughter Emily Eshoo who is a varsity basketball player at the University of Tampa.

Ed Eshoo wrote a post last week, Ask An Allstate Insurance Agent, that had two of the foremost insurance agent educators in the country, Bill Wilson and David Thompson, write responses. It would be a real treat for an audience if we could ever get Ed, Bill, and David together on a panel discussing insurance coverage and insurance viewpoints because they are experienced, knowledgeable, passionate, and fun people. All of us are better for knowing and having a chance to read and learn from their thoughts.

Everybody in the insurance agent or insurance coverage business should buy Bill Wilson’s recent book, When Words Collide: Resolving Insurance Coverage and Claims Disputes. Bill Wilson made this statement in his work:

Unfortunately, in far too many cases, the denial of a claim is seemingly inexplicable. I’ve spent much of my career assisting independent agents in convincing claims adjusters that a loss is covered. Over the past few years, I began keeping an electronic copy of many of these inquiries where the adjuster’s (or agent’s) logic makes no sense. At last count, the number totaled 519.

I could fill another book with these bizarre rationales for and against coverage. All too often, they arise from ignorance stemming from substandard (or no) education or the failure (or inability) to read, with comprehension, what the policy forms actually say.

Bill Wilson correctly notes that most claims presented get paid by the insurance companies. I am not so certain whether all the claim value that should get paid is actually paid from my view and experience. However, the point is that most claims do get paid. Attorneys are not hired and everybody is happy, even if unaware they may not have been fully compensated.

If this is the case, I would suggest that Ed Eshoo’s experience and viewpoint (as well is mine) is based largely upon denied claims and claims where a coverage gap exists that could have been prevented with a different insurance product sold. Nobody is calling Merlin Law Group attorneys explaining and celebrating how routine or tough insurance coverage calls are made in the policyholder’s favor. Merlin Law Group attorneys are usually called to help resolve the coverage or valuation problem existing in a property insurance claim.

Merlin Law Group attorneys routinely get referrals from upset insurance agents who cannot convince ill-informed insurance claims adjusters. I would love for Ed Eshoo to spend a few weeks on the road with David Thompson since David invited him to do so—almost as a challenge. I think David Thompson and Ed Eshoo would quickly become friends. David Thompson would learn how good of a person and attorney Ed Eshoo is. From my viewpoint, putting those two smart people together would show David’s independent agents there exists another breed of policyholder lawyer they have never met. Ed Eshoo may find his reputation, legend, and his professional learning growing as well.

Differing viewpoints when professionally analyzed in a positive manner create growth. I feel gratitude to know Ed Eshoo, Bill Wilson and David Thompson. When they speak, people should listen.

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