Archives: Coverage

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Misrepresentation Results in Loss of Coverage

One of the best ways for a policyholder to lose its insurance coverage is to conceal or misrepresent material facts and circumstances about the claim.  In a recent case, the Sixth Circuit Court of Appeals affirmed summary judgment in favor of the insurance company dismissing a policyholder’s claims against its insurance carrier for not paying … Continue Reading

The Top 10 InReDisputesBlog Posts for 2019

Below are the top 10 blog posts from our Insurance & Reinsurance Disputes Blog for 2019.  These are the ones our readers viewed the most last year on our blog. The compilation is diverse as is the topic of insurance and reinsurance disputes.  Please enjoy this stroll down memory lane.  If you like these and … Continue Reading

Lawyer Not Covered for Claim By Client to Recover Disputed Legal Fees

Did you hear the one about the lawyer and client fighting over paid legal fees?  When this happens lawyers often turn to their lawyers professional liability insurance policies for coverage.  In a recent case, under Connecticut law, the Second Circuit ruled against the lawyer and found no coverage.… Continue Reading

Appellate Court Grants Summary Judgment Obligating Coverage for Underlying Copyright Actions

In a recent cryptic coverage decision, a New York state intermediate appellate court reversed an order denying summary judgment to a media policyholder and held that the insurance companies were obligated to provide insurance coverage for underlying copyright infringement actions.  Although cryptic, the decision addresses exclusions and their applicability to media insurance policies.… Continue Reading

Eleventh Circuit Finds Duty to Defend Sufficient to Rebuff Claim of Illusory Auto Insurance Coverage

Some people who lease cars apply for car insurance with lower limits for themselves and higher limits to cover the leasing company’s requirements.  This is accomplished through a Lessor Liability Endorsement.  In a recent case, a putative class action was brought against insurance companies by lessees who sought damages alleging that the coverage provided was … Continue Reading

Strict Conditions Doom Flood Insurance Claim

The National Flood Insurance Program has been controversial to say the least.  Part of the program allows commercial insurance companies to act as agents for the federal government in producing Standard Flood Insurance policies and managing claims under a write your own program (“WYO”).  The program, under its enabling law, the National Flood Insurance Act, … Continue Reading

Not an Accident When Victim is Intentionally Dragged By the Hair

When someone gets injured and sues, sometimes the defendant defaults and the claimant is left to pursue its remedies against the defendant’s insurance policy.  It’s basically a coverage suit, but brought by the claimant instead of the policyholder.  The same defenses to coverage also apply.  Paramount, however, is that the loss complained of has to … Continue Reading

Prior Publication Exclusion and the Duty to Defend

Remember my recent post on how broad the duty to defend was?  Well it’s still broad.  In a new opinion, the 4th Circuit Court of Appeals, under North Carolina law, reversed a district court’s order on a motion on the pleadings that had dismissed a policyholder’s complaint based on application of the “prior publication” exclusion.  … Continue Reading

Faulty Excavation Support Not Covered By Contractor Controlled Insurance Plan

Construction projects are often subject to myriad claims.  Subcontractors can cause damage to third-parties and their property, the project can be delayed by municipal inspections or citations, workers can get injured, and property can be damaged by fire, collapse or weather.  To organize construction projects, sometimes insurance is purchased through a plan.  A contractor controlled … Continue Reading

Claims of False Advertising and Unfair Competition Are Not Disparagement or Defamation

Most commercial general liability policies include coverage for personal and advertising injury claims by third parties.  In a recent case, the Third Circuit Court of Appeals addressed the issue of whether claims of false advertising and unfair competition brought against a competitor entitled the policyholder to a defense under its personal and advertising injury coverage.… Continue Reading

How Specific Does a Specific Litigation Exclusion Have to Be?

Insurance policies often have general exclusions for known losses or prior acts.  The reason for this is that most insurance is for fortuitous risks–risks that will take place in the future; not risks that already have taken place.  For large policyholders that have ongoing litigation, it is not uncommon for a new carrier to craft … Continue Reading

Untimely Notice Causes Loss of Directors and Officers Coverage

Claims-made and reported policies typically contain, as a condition precedent, fairly strict notice requirements.  The entire point of a claims-made policy is to restrict the policy to claims made during the policy period and reported during the policy period or any extended reporting period.  Giving notice early and often is a mantra that is often … Continue Reading

When Seeking Coverage for Trademark Infringement Policy Exclusions Matter

In a recent case, the 4th Circuit Court of Appeals affirmed the dismissal of a coverage dispute based on unambiguous exclusions barring coverage.  Nothing dramatically unique here, but it serves as a good example of the need to read and understand the insurance policy and all of its exclusions.  … Continue Reading

Arbitration of Insurance Coverage Disputes

Coverage disputes between insurance carriers and policyholders are ripe for resolution through arbitration.  ARIAS•U.S. is working on a project to create an arbitration pathway, including modified rules and requirements for certified arbitrators, for these types of disputes and others.  But unless the parties agree or the insurance contract contains an arbitration clause, the arbitration option … Continue Reading

Pleading Standards and Consequential Damages In Coverage Disputes

When a policyholder sues its carrier for breach of contract or bad faith, one question that arises is whether the policyholder should have to plead alleged damages with particularity, or whether the policyholder can sustain its claims with less specific allegations.  A New York appellate court recently declined to impose that higher, particularity standard.… Continue Reading

Delaware Superior Court Excludes Coverage for Directors Acting in Dual Capacity as Investors

Directors and officers (“D&O”) liability insurance generally protects directors and officers against legal expenses and personal liability for acts and omissions taken in their capacity as directors and officers of the insured company.  In a recent case, coverage was excluded where directors also acted as investors of the company.… Continue Reading

Ninth Circuit Sends Conflict Between Representations of Authorized Insurer Agent and Certificate of Insurance to Washington Supreme Court

Certificates of insurance are ubiquitous in construction projects and in many other industries.  But, as most jurisdictions hold, a certificate of insurance is not the functional equivalent of the insurance policy and cannot be used to amend, extend or alter coverage.  It is merely a piece of paper informing the recipients that insurance has been obtained.  … Continue Reading

No Coverage for a Claim of Impairment of Goodwill and Reputation Under Defamation Endorsement

When a business gets sued it looks to its various insurance policies for coverage and a defense.  But sometimes the insurance policy purchased does not fit the coverage sought.  That was the case in the Seventh Circuit where a restaurant company sought coverage for a claim brought by a television provider for damages when the … Continue Reading

Advertising Injury and Offering For Sale

Whether an activity is advertising such that it comes within the advertising injury coverage grant of a commercial general liability (CGL) policy is a difficult and complicated question.  Maybe it shouldn’t be, but the coverage grant combined with exclusions to avoid coverage for intellectual property infringement claims and coverage write-backs within exclusions makes it complicated. … Continue Reading

Coverage for Government Investigations and Warranty of No Known Claims

Obtaining insurance coverage for a government investigation is often complicated by the type of investigation and the available coverage.  Most policies that cover aspects of government investigations–directors and officers liability policies or errors and omissions policies–are written on a claims-made form and exclude claims that relate back to prior or pending claims.  Very often the … Continue Reading

What Happens When a Policyholder Settles Without Involving Its Insurer?

Nobody likes to get sued.  When a lawsuit or a demand letter comes in, the first thing that crosses the mind of the party being sued (or claimed against) is how can I resolve this quickly?  That may be a reasonable visceral reaction to the suit, but what happens when insurance is involved?… Continue Reading

Ramifications of Global Re v. Century Indemnity Evident in Second Circuit

In late 2017, the New York Court of Appeals, in Global Reinsurance Corp. of Am. v. Century Indemn. Co., 30 N.Y.3d 508 (2017), provided guidance to the Second Circuit Court of Appeals on how New York law interprets reinsurance contracts and, in particular, the stated limits in facultative certificates and whether those stated limits are … Continue Reading

Direct Claims Against Reinsurer Fail to Succeed

Direct actions against reinsurers have been on the rise for some time.  To bring a direct action, a policyholder must get over the contractual privity hurdle and find some basis to show a direct relationship or third-party beneficiary relationship.  Many policyholders try to bring these actions, but they more often than not fail at the … Continue Reading

Failure to Comply With Protective Safeguards Endorsement Results in Loss of Coverage

A Protective Safeguards Endorsement (“PSE”), as defined by my friends at IRMI, is “[a] property insurance endorsement that makes it a condition of coverage that the protective safeguards cited in the endorsement (such as an automatic sprinkler system or night watch guard) be in operation at all times except when the insurer has been notified of … Continue Reading
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