Glad to hear of your contribution to the industry. It's appreciated.
Regarding the couple points you mentioned, a carrier has no duty to pay a claim for which there is technically no coverage. However, if a credible argument can be made by the agent, a claim that would otherwise be declined could be paid. Not saying that is the rule, only that I've seen it happen many times. A unknowledgeable layman is ill-equipped for that scenario.
We're talking about the value an agent brings and that includes advocating for the client. When the client is direct with a market, they work with the company's representatives, so no advocate. The company rep has a duty to the company (only). The agent only has a contractual/ethical duty to the company. There's a lot of help that can be rendered to the client within and outside of those duties which would rarely be afforded by a carrier's employee.
Given your claims experience, I'm sure you've run into situations where a claimant said something that could be used as a basis to deny a claim. A seasoned agent may be able to correct that, thereby facilitating a claim payment.
Never is a strong word and I used it carefully. When someone who has no expertise talks about something to which they don't understand the ramifications of their answers or words, they can give a claims adjuster what's needed to deny a claim. No sense getting into examples, you've likely seen them in your career. Needless to say, they happen frequently and a client might not even know what they said that led to the result. Again, with no agent, they have to trust the carrier is doing what's right and have little recourse aside from internal arbitration and possibly the department of banking and insurance.
All companies are made of people and agents know more people at a carrier than a client would. Again, an agent is in a far better position to intercede.
Sure, every situation is different and anyone who takes hypotheticals and applies them to their specific situation is unwise. If I'm going to court, I want a great lawyer. If I'm getting surgery, I want an experienced doctor. It just does not make sense to do something myself, that can have truly incredible consequences if done incorrectly, unless I'm willing to thoroughly learn about it so a truly informed decision can be made. An agent simply let's you leap frog past the learning phase and place your confidence in him/her. As a bonus, if they fail, you potentially have recourse with their E&O as opposed to nothing.
This has been a great conversation and thanks for your thoughts. Perhaps it will be helpful to others in the future. At the least, it's served as meaningful consideration for the both of us.
