4 Reasons that Maybe is My Favorite Insurance Word

Maybe. That’s a word that brings a whole lot of frustration with it, isn’t it? It brings back days when my sons asked about going someplace special, “Dad, are we going to Darien Lake this year?” Maybe. How about this one? “Do you think you can take some time off next month for a long weekend?” Maybe. When you hear, or read it, you have a reaction to it. Your mind flashes through all those past maybes and now you’re reaching for the antacid.

It’s still frustrating to hear or say maybe, but I’ve found that it’s one of the most useful words that exists for an insurance professional. If you’re an agent, you’re imagining the last six conversations that they had with an underwriter and if you’re an underwriter, you are imagining every conversation that you have had with your agents. It’s even more frustrating when you’re in a class and someone asks a simple question like, “Is there coverage if the insured allows their employees to drive their own vehicles on a job site and they cause an accident with a crane that’s being operated by someone else’s employee?” All eyes turn to the front of the room, looking for a brilliant response. Pens are poised to write every word. Often, the first thing that I do is smile and say, maybe. Maybe is my favorite insurance word. It communicates the complexity of insurance very simply and allows me to take a breath and filter through the question and explain why I can’t just give a straight yes or no.

Every insured is different. Many personal lines carriers are automating the underwriting of risks that fit within the guidelines of their ideal risk. Underwriters don’t often look at an application for an HO-3 or a simple personal auto policy. It’s not worth the expense to the company. However, when you begin to dig into many applications, it’s possible to find something that can cause an underwriter to take a step back and ask more questions. When you ask, “Is this risk eligible,” what you’re really doing is indicating to the underwriter that there is something that you think might not be eligible. So what’s the answer? Maybe. It all depends on the individual characteristics of the risk. What does the structure look like? What is going on at the house? What makes you ask if it is eligible? While underwriting fire departments, I received a call from an agent, who asked if her client, a new fire department, would be eligible for our program. Of course, I said, “Maybe. What else can you tell me about the department?” We wrote volunteer and professional fire departments all over the United States so it should have been a simple conversation. I found out that it was a new fire department. That’s not always a big deal. As I began to dig, this fire department would be collocated with a hotel/casino. The hotel wanted a private fire department that would be available to respond to their needs. Even though we were writing fire departments in that state, that risk didn’t qualify because it was a private department and that was not what we wanted to write. Maybe was the right answer, until we realized that no was the right answer.

Every policy is different. That may sound like a bit of a stretch, but let me explain. Policy types issued by a single company are going to be very similar. It may even be that every commercial property policy issued by a company for a class of risk is essentially identical. At one time, I was underwriting policies in two different programs for one company. The property policies for one program included an endorsement providing guaranteed replacement cost for all buildings. The other program’s policies did not include that endorsement. It would be very important to remember that distinction. For several years, a property insurer issued commercial property policies with an endorsement that deleted the additional coverage, Increased Cost of Construction, which is not common among insurers. An underwriter, who was used to how another company operated, informed an agent that this coverage was indeed included in the policy. Just because I know how one company operates and how their policies generally are written, doesn’t mean that I know how the specific policy that I’m dealing with works. One final note here, it’s important to know which policy year you are talking about because this year’s no may be next year’s yes. Maybe is a good place to start until you know which policy you’re talking about.

Every claim is different. On the surface of a claim, it may appear to be simple. However, what you see on the surface isn’t all that there is to see. There’s a fire in the kitchen of a restaurant and normally that sounds like a covered loss. However, when we don’t know all the details of the claim and how the policy reads, we don’t know for sure if it’s covered. A restaurant is often subject to certain underwriting requirements that other risks aren’t subject to. The underwriter may ask for confirmation that the restaurant has an automatic fire suppression system installed (which seems reasonable) and a current contract to have their grease hoods professionally cleaned on a regular basis (also pretty reasonable). To make sure that these requirements are kept, the underwriting guidelines may allow underwriter to attach an endorsement that states that if that fire suppression system isn’t properly maintained or if that cleaning contract is not kept up, fire is no longer a covered cause of loss. In that case, the fire in the kitchen could very easily become an excluded cause of loss because the insured failed to keep up their end of the deal. Maybe is a good answer until you know all of the details of the loss.

Every question is different. People often don’t know how much information a decision maker needs. Details that appear not to be meaningful are very important in a decision making process. Even when someone does their very best to give all the important details when they ask a question, there always seems to be more to know. Without knowing all the details, the answer of a question is not very clear. If I’m not sure how to answer the question, the best answer that I can give is maybe. To be fair to the point, if I answer a question with maybe, I’m also either asking questions in return or providing some reason for my maybe. In the end, what I’m looking for is a fair and honest answer. Often times an underwriter wants to say yes, but there is something that makes them unsure. Maybe is the best answer while we try to gather enough information to give an honest yes or no.

I would love to be able to say yes or no when someone asks me a question. No one likes to say maybe, but sometimes there isn’t a better answer. So when you ask me an insurance related question, get ready because first I’ll take a moment to consider the question, smile and most likely, I’ll say, maybe.