Should You Respond to a Reservation of Rights Letter?

An organization buys insurance to transfer certain types of risks (depending on the policies purchased). If a covered event occurs that results in a loss, you submit a claim and get paid. Simple, right? That’s how it would seem, but many experienced risk managers know it doesn’t always go that smoothly.

A recent RIMS Executive Report discusses one of the most common instances when things don’t go according to plan, and the insurer sends along some unpleasant surprises. In “A Risk Manager’s Guide to Reservation of Rights,” we learn how an insurer protest against paying a claim is commonly initiated and communicated: the dreaded reservation of rights letter.

In case you’ve never had the pleasure of receiving one, a reservation of rights letter is “a notice that the insurer has reserved its rights to either limit or deny coverage for the claim, based on the terms and conditions of the policy or information uncovered in an investigation of the claim itself.” In other words, these legal notices can become hurdles for an organization trying to realize the value of the insurance it has purchased.

Many risk managers do nothing when they receive this letter—they assume that the insurer will act in good faith and everything will work out. The authors of the RIMS Executive Report, however, strongly encourage a more active response. At the very least, the risk manager should compare the wording of the letter to the insurance policy language in question, as well as draft a response to the letter. The authors state: “Generally, there is no requirement that a policyholder respond to an insurer’s reservation of rights letter, disagreeing with the reservation or the bases thereof. However, it is highly recommended that the policyholder do so.”

A response letter might look something like this:
In some cases, a well thought-out response can save an organization a large amount of money. A good example is the common insurer-proposed reservation to recover defense costs spent on defending a policyholder if the insurer determines at a later date that it did not, in fact, have a responsibility to defend. In order to reject this reservation and the big legal bills that could come with it down the road, many jurisdictions in the United States require that the insured respond to the reservation of rights letter and specifically disagree with this detail.

According to the authors: “Receipt of a reservation of rights notice should prompt a review by risk managers…leading to an informed decision and deliberate action: whether to accept the insurer’s interpretation of the coverage and defense obligations, or respond with a reservation of its own rights. If not, unexpected and unintended consequences may result.”

The report also includes more in-depth information on obligatory communications, the use of tolling agreements and conflicts of interest that arise in these situations. In a reservation of rights situation, there can be some tricky territory to navigate. For example, insureds are almost always contractually obligated to cooperate with the insurer’s investigation and defense of claims. Failure to communicate or cooperate with these efforts can be a breach of contract and result in loss of coverage. It is important for the insured (i.e., the risk manager) to “understand its obligations in the claims management and settlement process, and the continuing obliga­tions when a reservation of rights notification is issued.”

The balancing act is that “Insureds need to continue cooperating…regardless of any coverage disputes, to preserve the continuity of claim management as well as meet the policy obligation.”

As the coordinator between functional areas and the in-house risk expert, risk professionals have an important role in all of these stages.

Food Defense Initiatives Can Safeguard Your Company

When most people think of product contamination and recalls, the first thing that comes to mind is food poisoning cases from bacteria such as e-coli and listeria. Food and drug companies, however, are experiencing malicious and intentional product tampering that can be equally deadly and dangerous. Many of us can’t forget the 1982 cyanide Tylenol crisis, Johnson & Johnson’s worst nightmare as reported cases of death from their products came pouring in, causing recalls nationwide.

The Tylenol case was long ago, but unfortunately, decades later and despite modern day advancements in packaging and processes, there is still a steady flow of cases globally, where bad actors contaminate products. This can lead to possible danger for customers, recalls, lasting reputational damage and potentially huge financial losses.

For example, in 2013, unsafe levels of the insecticide malathion was found in a Japanese frozen food company’s product after customers reported a chemical smell coming from the products and almost 3,000 incidences of sickness from consuming them. As a result, the products were recalled and the company shut down, causing its stock to plummet.

Why does it happen?
The main motive for tampering with food products is to make a statement. Bad actors aim to cause injury or economic and reputational harm to companies, especially since news of these acts can go viral, creating the negative impact on companies they hope to achieve.

As with cases of cybercrime, these companies are in a sense being “hacked” and need protection. Like with the mysterious hacker, manufacturers and retailers are facing this threat from both inside and outside the organization.

Oftentimes an employee within the company is the culprit, such as in the case of Just Bare Whole Chicken. A recall of 55,608 pounds of chicken sold nationwide went into effect last June, after black sand and soil was found in some Gold’n Plump and Just Bare branded poultry. The employee responsible was identified and terminated, but the effects of the disruption were lasting.

Taking Preventative Measures
Food companies should have a full understanding of the risks they face, the insurance available, and the regulations associated with product tampering.

Insurance: Malicious Product Tampering (MPT) insurance addresses deliberate contamination, or the threat of such contamination of products when a company or the public has a reasonable belief that the products might cause bodily injury if consumed. MPT insurance should be considered as part of a total product recall risk management solution. Many of these insurance programs provide experienced crisis management consultants to help a company manage and recover from such incidents efficiently and effectively in order to minimize loss. When putting together a risk management program, make sure to have first and third party coverage for product recall, including malicious contamination, business interruption, product extortion, product recall costs, rehabilitation expenses, replacement costs and consultant costs.

Defense initiatives: There is a difference between food safety processes, which protect food from unintentional contamination by products that are present in the production plant, and food defense initiatives, which protect from intentional tampering by unknown substances. Some people use the terms interchangeably, but food defense is key to protecting against tampering.

In 2016, the FDA issued a final rule on Mitigation Strategies to Protect Food Against Intentional Adulteration and, as part of this initiative, released the Food Defense Plan Builder program, which assists food facility owners and operators with developing personalized food defense plans. This user-friendly tool should be quite valuable to your food defense strategy.

Regulation: The Food Safety and Modernization Act aims to ensure that the U.S. food supply is safe by focusing on preventing contamination before it happens rather than simply responding to it. It requires mitigation strategies to be put in place in certain food facilities.

With these risk management strategies and the right insurance plan in place, companies can protect themselves and help mitigate their risks of food or product tampering.

International Women’s Day: Risk Management Issues to Watch

A 2013 piece on the role of women in risk management remains the most controversial article we’ve ever run in Risk Management magazine and the one that received the most comments and letters to the editor, hands down. Many of those reader comments were…let’s just say less than kind or receptive.

Today, International Women’s Day, offers the perfect opportunity to revisit that article, Woman at Work: Why Women Should Lead Risk Management, and some of our more recent coverage of pressing issues like the wage gap and gender parity at the board level.

The significance of this conversation is ever clearer, given not only the political climate and regulatory concerns, but also the simple data about the bottom line. Just last year, the Peterson Institute for International Economics and EY found that almost a third of companies globally have no women in either board or C-suite positions, 60% have no female board members, 50% have no female top executives, and less than 5% have a female CEO. After analyzing 21,980 publicly traded companies from 91 countries and a wide range of industries, their report, Is Gender Diversity Profitable? Evidence from a Global Study, found that organizations with leadership that is at least 30% female could add up to 6 percentage points to its net margin.

“The impact of having more women in senior leadership on net margin, when a third of companies studied do not, begs the question of what would be the global economic impact if more women rose in the ranks?” said Stephen R. Howe Jr., EY’s U.S. chairman and Americas managing partner. “The research demonstrates that while increasing the number of women directors and CEOs is important, growing the percentage of female leaders in the C-suite would likely benefit the bottom line even more.”

While study after study comes to similar conclusions, a recent report from EY explored why businesses need gender diversity for the innovation to thrive. Five disconnects continue to hold businesses back from achieving gender diversity on their boards, the firm found:

  1. The reality disconnect: Business leaders assume the issue is nearly solved despite little progress within their own companies.
  2. The data disconnect: Companies don’t effectively measure how well women are progressing through the workforce and into senior leadership.
  3. The pipeline disconnect: Organizations aren’t creating pipelines for future female leaders.
  4. The perception and perspective disconnect: Men and women don’t see issues the same way.
  5. The progress disconnect: Different sectors agree on the value of diversity but are making uneven progress toward gender parity.

Check out some of our previous coverage of key issues regarding women in business and risk management specifically:
Equal Work, Unequal Pay: Risks of the Gender Wage Gap
The Wage Gap in the Boardroom
Is the Insurance Industry Improving for Women?
Boards Still Lagging on Gender Parity
Preparing for New Pay Equity Requirements

Bribery and Corruption: What’s the best approach?

On Feb. 17, Samsung empire’s heir Lee Jae-yong was arrested on corruption and bribery charges connected to a nationwide political scandal in South Korea. While this is unlikely to directly impact the global tech behemoth in day-to-day matters, it is important to investigate how firms and governments can work together more successfully to combat white collar crime and corruption.

An international affair
The fight against bribery and corruption has historically been led by the United States, the first country to implement tough legislation with the Foreign Corrupt Practices Act of 1977. The federal law was enacted to address accounting transparency requirements and to make bribery of foreign government officials illegal.

Europe is not far behind with a range of legislation designed to prosecute and punish corporate crime. Other emerging market governments are finally cracking down as well, holding both domestic and foreign businesses and their senior management, to account.

Tackling bribery and corruption requires prosecutors and regulators that are properly equipped to investigate and deal with complex factual and legal issues. It also requires a judiciary that is impartial and can operate without political interference.

The United Kingdom’s Bribery Act of 2010 is a good example of tough new legislation that regulators and prosecutors can rely upon when investigating such crimes. It has extra-territorial reach both for U.K. companies operating abroad and for overseas companies with a presence in the U.K. It also introduced a new strict liability offence for companies and partnerships of failing to prevent bribery.

The law is not enough
Unfortunately however, even the best legal framework in the world is insufficient on its own.

Companies need to understand exactly how to go about preventing unlawful behavior, particularly in new and distant markets that their headquarters may not clearly understand. Ultimately, the real responsibility and accountability remains with the business to ensure compliance.

Countries with robust criminal and anti-corruption laws might be able to prosecute those individuals or businesses that commit offences within or outside the jurisdiction but the problem will continue until international businesses rigorously apply universal global standards to tackle corruption across emerging markets.

It’s Still about the culture
In short, this issue is about corporate culture. The following are fundamental steps for fine-tuning your organization’s approach to corruption:

• Develop a culture through education, where turning a blind eye to unlawful activity is not an option. Staff should feel comfortable with speaking out if they see anything potentially suspicious. Anti-bribery and corruption training needs to be repeated and made relevant to the day-to-day scenarios employees at different levels might face.

• The tone must be set at the top. For instance it can be useful to educate your firm’s directors with formal governance training, such as from the Institute of Directors (IoD) in London. This level of top-level attention to corporate compliance programs, including training, should be the norm.

• Proper dialogue needs to be established with regulators—not just a one-way stream of new laws and compliance requirements. A regulator should seek the views of those it is regulating. This two-way approach really does work.