How It Works.
1. Get in Touch
Call your personal broker first, or get in touch with the support team via chat. We support you all the way.
2. Submit your Claim
Your broker will support you through the claims process. We might ask you to send in photos and other relevant documentation to present a high-quality claim submission.
3. Meet with the Adjuster
In case your claim can’t be resolved quickly, your carrier then assigns you an adjuster to review the details of the claim and policy. The adjuster will meet with you and your Embroker advisor to discuss the full story.
4. Start your Legal Plan
When you know your carrier is defending you and covering all the legal expenses, it’s time to get in touch with your legal team and start taking action. In some cases, the carrier allows you to pick your own lawyer.
5. Track your Claim
Follow the claims process in real time on your account dashboard until it gets resolved.
You’ll need the following:
- Name and contact information of everyone involved in the loss;
- Your policy information;
- The type of loss you are reporting (Auto, Property, Workers Compensation etc.);
- When and how the loss occurred;
- Description of any injuries or damages.
You should file your claim as soon as possible. You will be able to add and update information later.
Time varies depending on the type of the loss, and how long it takes to investigate your claim.
A variety of factors – including your claim history, state, and type of insurance – make up your insurance premium. Your premium won’t change during your current policy period. If your premium is going to change, we will inform you of your new premium when it’s time to renew.
After all the facts about the loss are reviewed, and it is determined that your loss is covered by your insurance policy, a check can be issued to cover damages as estimated by your claims professional.
Damaged property and vehicles usually require an in-person inspection. A check can be issued immediately or soon after the inspection.
Your claims will be transferred directly to your bank account.
Your personal advisor will explain how you will receive your payment.
One of the most important things to remember is that startups should be contacting their insurers first because legal costs are only covered after you submit a claim to the insurance carrier and get their pre-approval for those expenses.
Therefore, the first step in the claims process is notifying your insurer of the claim. A good policy will limit knowledge of claims to company management and provide reasonable timelines for reporting so that payments aren’t denied for “late” notice.
The next step is to start putting together a claim submission. Package the plaintiff’s demand letter and any other relevant materials to present a high-quality claim submission to your insurer, who will then assign an adjuster to review the details of the claim and policy and meet with you and your broker to discuss the full story.
It’s quite common that there are multiple allegations in a single lawsuit and this is where the policy detail allocation impacts the claim process. Allocation defines the percentage of settlement and defense costs the carrier will cover in the event that a claim has some allegations that are not covered by the policy. A good policy will provide 100 percent defense costs allocation.
Once you are aware of what your insurer will be covering, the next step is to pick your legal representation. Your policy will dictate whether you will be able to pick your legal team independently or whether the insurer will either pick their own or have to approve your selection.
So if you want to be certain that you are able to choose your legal team without interference from the insurer, make sure that your broker stipulates that clause within the policy.
Assume you’re the CEO of a SaaS company. A few years into starting your business, an early investor sends you a letter in the mail demanding you return their $800K investment in your company citing that you (1) misrepresented the existence of potential key partnerships and (2) breached your contract of employment by not securing key partnerships.
The lawsuit rests on the investor’s claim that the failed partnerships would have helped net a large return on investment (ROI) after the sale of intellectual property and was both the main driver for their investment in the company and the selection of that particular CEO.
While the lawsuit may be groundless, the time and expenses required to fight the allegations are likely going to pose a substantial distraction for the company.
In such a case, we would guide you through the claims process from claims submission to claims resolve.
Product lawsuit claims come in three basic variations: product design, manufacturing, and improper instructions:
- Product Design: An example of this claim would be a children’s dresser that tends to topple over because of a top-heavy design, for instance. The liability in this kind of situation lies in the design of the product alone, which was faulty from the start and didn’t properly consider the safety of users.
- Manufacturing: Let’s say something goes wrong on the assembly line for a new smartphone and the incorrect components are used in the construction of some phones. As a result, the affected phones tend to overheat and explode. Because the issue wasn’t technically design-related, it doesn’t affect all the phones. Still, the manufacturing issue is enough for a product lawsuit.
- Improper Instructions: If a drug company releases a medication that can have dangerous side effects if taken in combination with another common drug or substance, the company must include a warning to that effect on the label. Failure to do so can lead to product lawsuits.
In terms of the types of professional liability claims you could face, negligence and misrepresentation are broad terms, meaning that claims that are filed as such can vary greatly in scope. Just about any business situation in which a business is accused of either breaching its duty and causing financial loss in any way to their clients can be considered negligence.
Errors such as misfiling paperwork, miscommunicating details, or forgetting about a deadline can all be considered negligence. Malpractice claims are different because they can sometimes be left completely up to the client’s interpretation. Even if you believe that you have performed your duties flawlessly, the client might think otherwise.
Accountants, lawyers, and other people who perform professional services that involve opinions and advice leave themselves open to malpractice claims if their work has not managed to meet a client’s expectations.
Regardless of what type of professional liability claim a business faces and how hard it might be to escape, the legal expenses are almost always significant. This is why having insurance is so important because defense costs can be very significant no matter what. Even if you do win the claim, if you don’t have insurance, you have to pay your legal team from your own pocket.