To Report a Claim
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Claim Service Commitment
- Policy to Pay Claims Efficiently and Fairly
- What is a Claim?
- CNA's Response
- Who Pays For Your Defense?
- Who Will Handle Your Claim At CNA?
- What Is a Reservation of Rights Letter?
- Dependability Is One of CNA's Greatest Assets
Policy to Pay Claims Efficiently and Fairly
An insurance policy is much more than a piece of paper---it's a commitment to deliver the
claims service that stands behind the policy. CNA is committed to:
- Provide timely coverage analysis.
- Make prompt assignments to defense counsel.
- Continuously consult with you and your defense counsel on the issues of defense, strategy, settlement, and claim resolution.
What is a Claim?
Before we can discuss how to report a claim, you have to know exactly what it is you need to report. That's why it is important to understand the definition of a claim. A claim is defined in the policy as:
| a) | any written or oral demand for money or other remedy upon you arising out of an actual or alleged wrongful employment practice; |
| b) | the service of suit or the institution of any alternative dispute resolution proceeding against you arising out of an actual or alleged wrongful employment practice; or |
| c) | notice to you of any administrative, investigative, or other proceeding, including an EEOC Proceeding arising out of an actual or alleged wrongful employment practice. |
A claim could be any of the following:
- A Summons and Complaint alleging a wrongful employment practice;
- An oral or written demand for money or other remedy from you because of a wrongful employment practice;
- An oral or written threat or complaint indicating that a party is holding you responsible for a wrongful employment practice;
- Notice of a Federal, State, or local Charge alleging a wrongful employment practice;
If you are in doubt whether a claim has been made against you, it is best to report it to us. We will let you know when a claim has been made.
The way to ensure the fastest possible response from CNA in the event you receive a claim is to:
- Provide CNA with written notice as soon as you are aware of the claim.
- As soon as possible, send copies of all papers to CNA and to any other insurance carrier that may provide coverage for the claim.
- In your written notice to CNA, identify your policy number, your firm name, the telephone number and name of the individual we should
contact within your office, the date you received the claim, the claimant name and a brief description of the allegations made
against you.
Send all of the above to:
CNA
Attention: Director of Claims, CNA Pro -Accountants
CNA Plaza, Floor 26 South
333 South Wabash Avenue
Chicago, Illinois 60685
Facsimile: 312-755-7215
- Refrain from signing or accepting any release from any party without obtaining approval from your CNA Claim professional.
- Avoid discussing, commenting upon or taking issue with any information you receive regarding judicial or administrative proceedings.
- Be sure you do not admit liability, consent to any arbitration or judgment, or agree to any settlement without CNA's prior written consent.
- Be prepared to spend a substantial amount of time with counsel and your CNA claim professional to aid in the investigation, defense, strategy, and settlement of your claim.
CNA's Response
After CNA receives your notice of a claim, you can expect us to take the following action:
- Assign your case to an employment practices liability claim professional who is experienced in handling claims in the territory in which your are located.
- Acknowledge receipt of your notice of a claim, inform you that we have created a claim file and provide you a claim file number for future reference, and
introduce you to the claim professional assigned to your case. We try to do this within the first 24 hours after we receive your notice so you know we are here for you.
- Review your insurance policy, advise you as to coverage issues that may be presented by the allegations made against you, and if necessary, issue a Reservation of
Rights letter explaining the coverage afforded to the claim.
- Appoint qualified and experienced defense counsel to represent you, if necessary.
- Review counsel's investigation as long as the claim is pending, communicating directly with counsel and you as needed. Counsel is always instructed to keep you informed
throughout the claim process directly.
- Consult with defense counsel to consider the defense, strategy, and resolution of the claim and advise you as to our recommendations.
Who Pays For Your Defense?
Read your policy carefully. In most instances, the insurance policy provides for your defense subject to a deductible requirement that you are obligated to pay. However, state regulations often apply to the handling of deductibles and your policy will specifically delineate how your financial obligation applies.
In some instances, your defense costs reduce the policy limit of liability. In this case you will be advised as to the remaining amount of your limits on an ongoing basis throughout the defense of the claim.
Whatever your financial responsibility, you will be advised by us of how it applies, or may apply, in the event of a claim. Once you have satisfied your financial responsibility, the insurance policy pays for your defense.
Who Will Handle Your Claim At CNA?
Your employment practices liability claim will be handled in a centralized unit at CNA's Home Office in Chicago, Illinois by claim professionals who only handle claims against accounting professionals just like you. Our staff has been extensively trained in proper claim procedures and the handling of litigation management. We follow and analyze trends in claims and in the legal environment to assure we are up to date in all the legal defenses. CNA assigns claim professionals by territory, so they are experienced in handling claims and litigation in your specific jurisdiction.
What Is a Reservation of Rights Letter?
A Reservation of Rights letter is not a denial of coverage under the policy. Whether there will be coverage for a particular claim frequently depends on the facts proven by the plaintiff.
A plaintiff may make allegations, which, if proven, would bar coverage under certain policy provisions. On the other hand, if those allegations are not proven, such provisions may not bar coverage. Other policy provisions may apply simply by virtue of the nature of the allegations against you. Thus, coverage sometimes is obvious for some allegations and not for others.
Proper insurance guidelines, many established by state regulations or laws, require that an insurer advise their insured as soon as possible of any coverage issues. The Reservation of Rights letter is the vehicle used to provide you with that advice. The letter will indicate what allegations made might, if proven, preclude coverage under the policy, provide you with the policy language potentially impacted and indicate what rights you have to protect yourself. The letter will also point out that the activities we undertake as your insurer in connection with the claim should not be construed as a relinquishment of any rights provided by the policy contract. So, the Reservation of Rights letter is protection for us and for you! We can continue to evaluate and investigate the claim and you are alerted to any coverage issues which may be associated with your claim in the future. We refer to this process as "handling the claim under a reservation of rights."
What you should understand is that we are not agreeing with or supporting the plaintiff's allegations by issuing a Reservation of Rights letter. The plaintiff must prove the allegations. When a claim is being handled under a reservation of rights, the policy provides a defense "even if the charges of the claim are groundless, false or fraudulent."
When defense of a claim is provided under a reservation of rights, you have the right to retain personal counsel to assist in the defense. Depending on your state law, personal counsel costs are borne by you or the insurance company. We will advise you of your rights in such an instance.
Dependability Is One of CNA's Greatest Assets
Dependability and experience are CNA's greatest strengths and you can expect our staff to deliver responsive, reliable service. Substantial financial strength is another of our great assets, especially when it comes to keeping our commitments and paying claims.
CNA is a strong, stable organization with products and services you can count on now and in the future. We have earned consistently high ratings from the top insurance rating services.
If you have any questions about what to expect in the event of a claim, please contact us.
The above overview is provided for illustrative purposes only. Nothing contained in the overview should be construed as an acknowledgement by any of the CNA insurance companies that a given situation would be covered under a particular insurance policy. To determine whether a specific situation may be covered, please refer to your current policy. Only the policy can provide the actual terms, conditions, and exclusions.
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