Insurance Companies: Policies, Product Families and Claims Roles

The Policy and the Insurer

The NAIC explains insurance through a policy and premium relationship. The policy describes the particular product, including what it addresses and its stated terms. A claim is considered in relation to that policy, rather than the general name of the insurer.

A company can offer several product families. A home-related product, vehicle product and business product address different subjects. They are not interchangeable simply because they carry the same company logo. A customer with several policies needs to identify which one a question concerns.

Distribution and Continuing Service

A customer may reach an insurer directly or through an intermediary. The selling contact, policy-administration contact and claims contact can have different roles. An enquiry should make clear whether it concerns obtaining a quotation, an existing document or a claim already being discussed.

For example, someone may contact an agency about a change while receiving a separate message from the insurer about an existing claim. Those communications need to stay associated with the appropriate policy and enquiry. One familiar contact does not make every message part of the same task.

Quotations and Policy Documents

Insurance quotations are proposals. A coverage review examines the information identified for discussion, while policy support concerns continuing enquiries and administration. An insurance consultation can help a customer understand which product or policy a question concerns.

Comparing proposals means identifying the subject, period and features being discussed. A short product summary and a complete policy document have different purposes. Ask which document the company or intermediary is explaining and where the fuller product information can be found.

Claims Are a Separate Service Stage

A quotation enquiry is not a claim, and a claim notification is not a decision. When several organizations communicate about a claim, ask which role each has and which contact handles its status. Keep the policy and claim references distinguishable from other product enquiries.

Common Questions

Is the company name always the same as the agency name?

No. Identify the insurer named on the policy separately from the agency or broker assisting you.

Does one policy name explain every covered event?

A product name is a heading. Ask the insurer or intermediary to explain the particular policy documents and the question you have.

Which contact should receive a later enquiry?

Identify whether it concerns a quotation, policy administration or a claim. Those service stages may use different contacts.