Disclaimer: To protect confidentiality, company names and insurance carriers are not disclosed in these case studies. The details provided are generalized to illustrate our expertise and results. Have questions? Call us at: 1-833-374-7475

Background

A cannabis multi-state operator (MSO) with $300M in topline revenue, over 300 employees, and an annual insurance spend of $4M faced a significant challenge after falling victim to a fraudulent invoice scheme. A bad actor impersonating a landlord orchestrated the fraud, resulting in financial losses exceeding $200,000. Resolving the claim proved complex due to overlapping policies and intricate coverage provisions.

Concerns

• The fraudulent loss triggered claims under multiple policies, leading to complex coverage questions.
• Overlapping provisions raised the risk of carriers limiting their liability to sub-limits, restricting the client’s recovery.
• A lack of cohesive policy management further complicated the resolution process, prolonging the claim timeline.

Our Process

1. Comprehensive Review: Conducted an exhaustive analysis of the claim, scrutinizing policy language to identify potential coverage triggers.
2. Third-Party Verification: Engaged a forensics firm to independently verify the incident, ensuring clarity and accuracy in the claim submission.
3. Carrier Collaboration: Worked closely with both carriers to navigate the interplay of overlapping policies and advocated for the most favorable coverage outcome.
4. Systemic Analysis: Used the claims process to identify and address systemic gaps in the company’s insurance program for future improvement.

Results

• Full Loss Coverage: Successfully advocated for full policy limit coverage, ensuring the entire $200K+ fraudulent loss was insured.
• Expense Coverage Maximized: Secured additional coverage for related expenses stemming from the fraudulent invoice, optimizing the policy benefits for the client.
• Premium Stability: Negotiated a flat renewal with both carriers, avoiding premium increases despite the significant claim activity.

By securing comprehensive coverage and stabilizing renewal premiums, we not only resolved a challenging claim but also strengthened the company’s insurance program for the future. This case demonstrates the importance of strategic claims advocacy and proactive policy management in mitigating risks and maximizing value.

Are you interested in strategic claims advocacy and proactive policy management? Contact Frontier Risk today for customized solutions.