With the nation's financial crisis taking new twists and turns every day, and the country's biggest insurance organization in distress, buyers are taking a more proactive approach to renewals–assessing carriers with much greater care, while their organization's officers and directors look over their shoulders, demanding stricter due diligence, leading risk managers say.

"In light of the financial crisis, renewal this year is definitely more tedious–more stressful than in past years," according to Scott H. Beckman, vice president of risk management and insurance for Advocate Health Care in Oak Brook, Ill. "The approach we've been taking is not just monitoring but investigating insurers."

Mr. Beckman is working on major renewals, including "our entire excess liability reinsurance program for malpractice and general liability covering all of our operations, so it probably is the singular, largest renewal and the most costly renewal for us."

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