10 ways to prevent an E&O claim from happening

Guest contributor Chris Hidalgo from Gallagher MGA writes about how important documenting every interaction with your client is for managing error and omission risk. Find a link at the end of the post for a special discount offer available only through RB Insurance.

As a life and health agent, it’s important to know your customer and know the process behind how you plan to enroll your customer. Is it a worksite enrollment, a visit to a home? Is your customer a direct mail or a call center lead? Each potential enrollment situation has its own set of criteria and potential E & O exposures.


Here are 10 tips for keeping you — and your business — safe from a claim.

  1.  Always document the outcomes of key client conversations, decisions made and coverages declined. No client interaction is irrelevant. Document every call or conversation, no matter how inconsequential the subject matter.
  2. Understand your customer, anticipate questions, have literature available and be patient.
  3.  Stay current on regulatory requirements by continuing to earn appropriate designations and attending professional development courses.
  4. Practice full disclosure and be totally up front about your track record, business practices, and affiliated advisors and companies.
  5. Assess your client’s risk tolerance. Take the time to fully understand his or her situation. Uncover and document all relevant acts.
  6. Send a written confirmation with a copy of the insured’s application. Be sure your customer knows what they purchased.
  7. Make sure clients understand what their product covers and doesn’t cover as well as all moving parts, fees and expenses and any underlying risk and guarantees. Include product brochures if possible.
  8. Don’t generalize what the product offers. Avoid using common statements like “This policy is just as good as the old one.
  9. Discuss payment terms: monthly, quarterly, annual, etc. Make sure your customer knows when to expect the payment to be processed.
  10. If a client is unhappy with you, do your best to promptly resolve their complaint before it turns into a regulator sanction or lawsuit.

Chris Hidalgo is currently the Mass Communication Specialist for Gallagher MGA, an international insurance brokerage company with an office in Lakewood Ranch, Fla. Chris has been writing articles for Gallagher MGA informing agents about the latest news in the insurance industry since 2012.  He has a bachelor’s degree in mass communications from the University of South Florida, where he interned at Bluewater Media, LLC, and served as writer, producer, videographer and teleprompter operator for Florida Focus, a newscast that aired daily throughout the Tampa Bay area on WUSF-TV. 

Click here to take advantage of MGA and RB Insurance’s exclusive E & O discount.

Take the fast-track for senior insurance sales success

We’re rolling out our fast-track appointment application just in time for the 2016 senior insurance sales season. So what is it?

It’s simple: Our fast-track application is up to 22 different appointment applications in one. We’ve gone through each of our carrier partners’ appointment processes and combined them as much as possible to substantially reduce the amount of time and toil it takes for you to build a compelling portfolio of senior insurance products.

Why complete up to 300 total pages of paperwork by yourself when you can fill out a fraction of that and let us make it happen for you? Offer your clients a choice between multiple carriers for Medicare Advantage, Medicare Supplement, Hospital Indemnity and Final Expense without getting a migraine.

We estimate our fast-track application saves agents up to six hours of time that could be better spent marketing themselves at educational or sales events or at appointments they’ve scheduled through our Medicare Sales Engine if they were looking to appoint with just our top carriers.

You will still need to go through certification for MA plans in order to be Ready To Sell, but we have worked hard to eliminate the hassles of representing new carriers so you can focus on taking care of your clients.

AHIP 2016 is here. Start planning your successful senior insurance sales season now with RB Insurance by calling (800) 997 3107 or emailing me to learn more about our most competitive carrier products available in your target markets.

Get out there and market yourself! Part One

Wondering about marketing opportunities? Well it’s time to “Get out there and market yourself! (Part One)” Here’s my first post in a series of three about different kinds of events you can be a part of to market your senior insurance business.

I’ve got a buddy who’s been a successful senior insurance advisor here in Arizona for the past 20 years who just refuses to schedule or participate in any type of educational events. He likes to say his wife’s the social worker, not him.

I’ve attempted to change his mind about how valuable this type of marketing is — and it is marketing — but he just can’t see it. I have regaled my agent friend with the example set by a successful Las Vegas agent I know who only does educational event meetings to market himself. This guy works home and office appointments gleaned from those encounters all year long. My Sin City agent friend does at least two events a week and has contacts with just about every professional, fraternal, veteran and charitable organization in the county.

His CMS-regulated business consists of about 50 percent Medicare Advantage and about 50 percent Medicare Supplements with a Part D plan. He loves presenting final expense and add-on hospital indemnity products. Not bad for an agent who’s a senior himself. He never leaves a venue until he has answered every lingering question, and he tells me he goes through more than 500 business cards a month.

Market Yourself

“What?” you say, “you can’t sell or market at an educational event?” You are absolutely correct! The Medicare Marketing Guidelines tell us specific CMS-regulated products cannot be sold or discussed at these events (Here’s a much shorter compliance cheat sheet). While CMS does not require formal registration for these events, they are regularly evaluated by Secret Shoppers.

No marketing activity is allowed at educational events like those my Las Vegas friend puts on. What does that mean? It means you cannot steer to a specific plan, hand out marketing materials, gather Scopes of Appointment or Permission To Call forms.

So how does this agent generate leads and referrals from events?

He or she makes an announcement at the end of his or her formal presentation. Something like this does the trick: “This is an educational event, so I can’t put my business cards on the table, but some of you have asked for one. I will be at the back of the room as you leave, so if you want a card just ask. If you have any other questions just give me a call — I don’t charge for advice!”

That’s all it takes to successfully market yourself at educational events.

For more detailed training on conducting compliant and profitable events, our affiliated agents can call me at 1-800-997-3107 or email me. I don’t charge for advice, either.

Next week, I’ll tell you more about informal sales events, stay tuned!

Want to get more information on how to market yourself? We love helping you out! Give us a call at 1-800-997-3107 or watch this great webinar! Sign up for the “Make Community Marketing Work for You” webinar and go even further!

Just the facts, ma’am: Get your free appointment prep sheet

The Sarge’s favorite saying can remind you to ask your prospects detailed questions as you help them find the best senior products to meet their needs. Image courtesy of Wikipedia

Free Appointment Prep Sheet

Sergeant Joe Friday of “Dragnet” fame was probably a little too brusque to succeed as an insurance agent. But the ’60s TV character did make an impact on the popular lexicon with his constant plea for “Just the facts, ma’am.” With this quip, the Sarge would direct a verbose witness to concentrate on the matter at hand.

Perhaps there’s a lesson in this for today’s agents.

Senior insurance is significantly more complex today than it was even seven or eight years ago. Successful agents have learned to navigate regulations pertaining to when, where and how they meet with prospects and still sell at least one product to make them a satisfied new client. Rookies, on the other hand, may get the feeling that grievances, complaints or allegation of misrepresentation are easier to elicit from a prospect than satisfaction with an enrollment after they’ve read through the Medicare Marketing Guidelines for the first time.

The plans agents can sell (after they jump through all of the contracting and certification hoops regulators and the industry have laid out for them) have also changed. Prior to 2007, most Medicare Advantage plans had robust provider directories. It was hard to find a plan that did not have the most popular doctors and hospitals under contract. Today we see more limited networks due to Accountable Care Organizations, reduced reimbursements to plans, quality initiatives and consolidations, which all try to manage program spending.

What you ask or say to your prospect makes all the difference, so make sure you get “just the facts, ma’am.”

When a beneficiary makes contact, most agents take care to fill out a Scope of Appointment form for CMS-regulated products like Medicare Advantage. Most agents usually start to ask their prospect questions after they’ve returned the Scope and proceed to check out every doctor, drug, dentist, etc. that the client wants to keep seeing in order to make a one-stop sale. The whole process becomes frenetic — Miss a provider or drug, and you risk getting an email from your favorite compliance department. Mistakes, omissions or a missed status can ruin your day.

It’s not a CMS violation to collect voluntarily shared, detailed information from a beneficiary prior to that appointment, and you will appear more professional to your prospect if you do so. Download RB Insurance’s Initial Contact Worksheet for free to help you confidently make a sale. From docs to drugs, our worksheet covers all the bases. Don’t forget Special Election Periods, chronic conditions for DSNP plans, possible Medicaid eligibility, LIS status and other determinations.

Use our worksheet or make one for yourself, but be prepared with “just the facts” to increase productivity and professionalism. Always follow CMS rules regarding collection of medication or medical history data from a client. Offer to take down information, but never insist on getting your prospective client’s information.

Click here to download RB Insurance’s free Appointment Prep Sheet to help you prepare for appointments this AEP.

15% off Medicare leads until May 1!

Now until May 1, we’ll send out 1,000 pieces of our guaranteed-response Medicare leads mailers for you for $380 — keep in mind that our standard price is $445 when the average cost of 1,000 pieces in our industry is $500!

As part of our Massive Response Mailer promotion, here’s a quick rundown of how we’re sharing this great value to make leads happen for you:

We start by creating our own 4.25″ x 5.5″ bifold double postcards. We have postcards for Dual-eligible, LIS, Medicare Supplement, Hospital Indemnity and Special Interest mailers available to help you reach Medicare members interested in the range of carrier products you are contracted to sell. Completely compliant, they feature a business reply card interested Medicare members can mail back with their contact information.

We don’t charge you for the mailing list you request or the business reply mail it generates, and we keep your list exclusive to you for 30 days. Responses come to our office, where we process and load your leads into your Medicare Sales Engine account.

We do all this so you can focus on starting a conversation about finding the perfect plan with your prospective clients.