While reviewing a prospective account, you notice discrepancies between an agent’s coverage summary (open perils with 80% coinsurance) and the actual policy (named perils with 90% coinsurance). What action is appropriate?

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Multiple Choice

While reviewing a prospective account, you notice discrepancies between an agent’s coverage summary (open perils with 80% coinsurance) and the actual policy (named perils with 90% coinsurance). What action is appropriate?

Explanation:
When you find a mismatch between what the agent’s summary states and what the policy actually provides, the priority is to protect the client with clear, proper communication. A summary showing open perils with 80% coinsurance while the policy is named perils with 90% coinsurance can create real gaps in coverage and mislead the client about what is insured and what their share of loss would be. The correct action is to address the discrepancy through the right channels: talk to the agent to verify and reconcile the terms, inform the client about the difference and its implications, and report to the insurance department or compliance as required. If you share carriers with the other agent, disclose that relationship to the relevant parties. This approach ensures accuracy, maintains the client’s trust, and upholds professional and regulatory standards. Options that ignore the issue or handle it only with the client fail to fix the underlying problem and can leave the client exposed. Publicly accusing the other agent is unprofessional and can violate conduct rules.

When you find a mismatch between what the agent’s summary states and what the policy actually provides, the priority is to protect the client with clear, proper communication. A summary showing open perils with 80% coinsurance while the policy is named perils with 90% coinsurance can create real gaps in coverage and mislead the client about what is insured and what their share of loss would be.

The correct action is to address the discrepancy through the right channels: talk to the agent to verify and reconcile the terms, inform the client about the difference and its implications, and report to the insurance department or compliance as required. If you share carriers with the other agent, disclose that relationship to the relevant parties. This approach ensures accuracy, maintains the client’s trust, and upholds professional and regulatory standards.

Options that ignore the issue or handle it only with the client fail to fix the underlying problem and can leave the client exposed. Publicly accusing the other agent is unprofessional and can violate conduct rules.

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