Keeping with my theme of fives (see The Accounting Fives), I've decided to write about the top 5 mistakes in business income loss claims. Insurance companies view certain business income loss claims as straightforward. As such, they tend to handle these claims internally. While certainly not intentional, mistakes sometimes arise. These mistakes ultimately overstate the loss. It is true that there are some mistakes that understate the loss; however, insureds are usually quick to recognize if the business income settlement appears too low. Accordingly, mistakes that understate the loss are usually just temporary. By contrast, insureds don't often see problems with settlements in excess of their expectations. This is not because they are trying to be sneaky. Rather, insureds may believe the "overage" is just a product of the insurance policy.
Saturday, May 2, 2009
Top 5 Mistakes with Business Income Loss Claims
Tuesday, April 28, 2009
The Accounting Fives
A few months ago, I posted an article titled "Internal Controls and the Five Senses." More recently, I discussed the five methods used to project sales when performing an income loss evaluation. Two fives. A coincidence? Maybe not; as it turns out, five is quite popular in accounting. This is a strange observation since five is an odd number and accounting is all about symmetry and balance.
- Existence or occurrence - Transactions reflected in the accounting records have actually occurred and assets reflected on the balance sheet actually exist.
- Completeness - The financial statements include all material transactions.
- Rights and obligations - The company has actual rights to its assets and is obligated for the balance sheet liabilities.
- Valuation - All items are properly valued (historical cost, lower of cost or market, net realizable value, etc.).
- Presentation/disclosure - The financial statements are presented properly and include all relevant and required disclosures.
Wednesday, March 25, 2009
Business Income Claims in a Recessionary Environment
As a case in point, I was recently engaged in a case where a travel company experienced intermittent computer failures over an approximate 2-week period in December. There was a large gap between sales for December 2008 and December 2007, which was the basis for the claim. A pre-loss trend analysis revealed that sales were down between 30% and 45% in October and November 2008, relative to those months in 2007. Thus, I determined that most of the difference in December 2008 was due to the economy, not computer problems.
Saturday, November 15, 2008
The New Assurance Forensic Accounting Website...6 months after
Wednesday, June 4, 2008
New Credential For Forensic CPAs: A Good Thing
There's exciting news on the accounting front! The AICPA recently announced that it will offer a new specialized credential for CPAs beginning this fall. The new credential will be known as "Certified in Financial Forensics," or simply, CFF. The CFF joins the three other specialized credentials offered by the AICPA, which include: Accredited in Business Valuation, Certified Information Technology Professional and Personal Financial Specialist.
Unlike the traditional accountant, the forensic accountant does not have a defined set of rules to follow. Since the circumstances of each case are different, it is up to the forensic accountant to determine the steps to follow, the methodologies to employ and the most appropriate manner upon which to communicate his or her findings.
Monday, April 21, 2008
Uses and Misuses of Industry Ratios
Ratio analysis is a powerful tool for the financial statement analyst. From a company's financial statements, one can calculate a host of meaningful ratios including profitability, efficiency and leverage. While one can calculate these ratios for a given company, there are services available that compile ratios for dozens, if not thousands, of companies within a given industry. These are often referred to as "industry ratios." Most services categorize the industries consistently with the North American Industry Classification System.
Tuesday, April 15, 2008
Fraud and the Small Business
Each year, my firm analyzes a significant number of employee fraud cases involving small businesses. I've observed that employee frauds most frequently occur with moderately successful small businesses. In this context, the profile of a moderately successful business is one in which the owners enjoy an above-average living, but at the same time are not so successful to bring the need for a structured environment with layers of management.
Monday, April 14, 2008
Accounting is Life
Chad Thompson Speaks at KSU
I received my undergraduate degree from Kennesaw State University (KSU), a school well known for its excellence in accounting education. Within the Masters of Accounting program, KSU requires a Forensic Accounting class. I am very happy about this requirement, since I believe all accountants benefit from some level of forensic exposure. I'd really like to see a forensic accounting class become a requirement for sitting for the CPA exam.
Saturday, March 22, 2008
Internal Controls and the Five Senses
Large scale corporate malfeasance over the past decade was a call to action for the executive and legislative branches of our government. They responded (as only our government can) with a massive piece of legislation called the Sarbanes-Oxley act. The act contained a myriad of new laws aimed at strengthening the internal control and reporting standards for public companies. All of this came with a hefty cost to American companies, and ultimately the taxpayers to whom they pass along their costs. And just what is the cost? A study by the law firm of Foley and Lardner found the Act increased costs for publicly held companies by 130 percent!
Tuesday, February 26, 2008
80's Movie Reveals Tips for Testifying
I've discovered some wisdom within the 1989 film, Roadhouse. In this film, Patrick Swayze's character James Dalton accepts the job of cleaning up a bar gone bad. After surveying the scope of the assignment, he summons his coworkers for a meeting to discuss the plan. He tells them reaching the desired result is as simple as these three things:
- Never underestimate your opponent...expect the unexpected.
- Take it outside...never start anything in the bar.
- Be nice!
Friday, February 22, 2008
Business Income Loss Documentation
When faced with a business income loss claim, the most frequently asked question is “which documents are required?” I was recently a featured speaker at the Worley Companies' annual claims convention, and spoke on that very subject.
Most standard business income loss policies afford an element of coverage for the "likely" net income of the business during the period of restoration. What separates likely from unlikely is the quality of the documentation supporting the determination of the net income amount. All businesses prepare and maintain some level of financial/accounting documents. The range of documents prepared by businesses depends on such characteristics as the size and complexity of the business, the nature of the business, the regulatory environment and the level of financial sophistication of the owners/managers.
There are literally scores of different accounting documents. To understand documents from a practical standpoint, I have designed a category system. Thus, the multitude of business documents can fit into one of the following categories:
- Compliance
- Informational
- Corroborating
Informational documents are usually generated for internal use, meaning use by the owners/managers of the business. Since there is not a requirement to prepare such documents, information documents are subject to the record keeping practices of a given business.
Corroborating documents are those that serve to substantiate records, reports or transactions of the business. Corroborating documents are prepared by, or involve third parties.
The categories provide a way of grouping documents, and allow us to think about documents in a systematic manner. Now that we have a platform for understanding documents, we can apply that knowledge to claims with the following general rules:
1. Always obtain compliance documents.
The necessity of compliance documents is twofold. First, the business is required to prepare the documents, so they should be relatively easy to obtain. Next, compliance documents tend to have a high degree of accuracy. Since compliance documents are routinely prepared, and since these documents are often reviewed by others (IRS, CPA, bank), the probability for a material error is greatly reduced.
2. Obtain informational documents to the extent the business has them and to the extent that they will assist with the evaluation.
Informational documents are useful in a loss determination, but they are not always required. Moreover, some businesses may not have informational documents.
3. Obtain corroborating documentation when the records of the business are incomplete or believed to be inaccurate.
Corroborating documents can be difficult to obtain, as well as time consuming to evaluate. Therefore, corroborating documents are limited to those occasions when other business records need substantiation. Also, corroborating documents may be used when a business has no compliance or informational documents.
4. Consider the nature of the business.
It is important to understand the nature of the insured’s business in order to know the best information to request. If the insured’s operations are complex in nature, then it is likely that a more in-depth analysis will be required. As such, the amount of information requested should increase in order to assist with the analysis.
The nature of the insured’s business dictates the type of document that should be requested. For instance, if the business is a manufacturing company or medical practice, then production reports should be requested. Also, rent rolls should be requested for apartment complexes. In either case, it would be inappropriate to ask for a sales report. Asking for the wrong type of document can confuse the insured, and cause them to doubt that one understands the nature of the business.
5. Consider the length of the restoration period.
The length of the restoration period often dictates the amount of information requested. The longer the period of restoration, the more information should be requested to evaluate the operating history of the business and project the results of operations for a longer period of time. Because more expenses discontinue over a longer period, more documentation is required to perform an expense analysis.
Sunday, February 4, 2007
The Impact of Non-recurring Gains
Chad was interviewed in an Atlanta legal newspaper on the subject of forensic accounting. He points out a case in which he discovered a claim misrepresented by the one-time gain. Read the interview here.
Monday, January 29, 2007
Burned Out-of-Sight Inventory May Hold Clues to Financial Motive
Sometimes, there are various financial incentives for a business owner or manager to commit arson at the business facility. Financial motive to commit arson can include the desire to liquidate excess or obsolete inventory, the desire to escape debt, or the desire to promptly stop an unprofitable venture. In the case of arson-for-profit, inventory is often times an integral piece of the financial motive puzzle.
Read Chad's full article from Fire and Arson Investigator magazine here.
Saturday, January 6, 2007
Business Income Loss for Unprofitable Businesses
2. Continuing normal operating expenses, including payroll.
The readers of the policy sometimes conclude that an insured is at least entitled to recover the continuing expenses incurred during the loss period. The theory behind this argument is often the following: “since the coverage is two-pronged, the net income portion should be ignored because an unprofitable business does not have net income. Ignoring the net income portion leaves the coverage as continuing expenses.” Interpreting the policy to include only continuing expenses for an unprofitable business results in an erroneous business income loss determination. Such reasoning is also inconsistent with the wording of the policy.
From a policy standpoint, the coverage clearly states net profit or loss. Therefore, if the insured was expected to incur an operating loss during the restoration period, the business income loss calculation should begin with a negative number. Next, the policy contains the conjoining word “and” which explicitly states that the net operating loss (a negative number) should be combined with continuing expenses. Therefore, the resulting net number is less than continuing expenses alone. Thus, an insured is not entitled to recover its continuing expenses.



The above scenario showed that an unprofitable business can experience a business income loss. However, in the event that the insured is unprofitable and abated expenses exceed continuing expenses, the insured does not sustain a business income loss. An example of such a situation is shown below:



