Archives: Insurance

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Is Reinsurance Information Relevant In an Insurance Coverage Case?

There are lots of cases discussing the production of reinsurance contracts and reinsurance communications in insurance coverage disputes.  Generally, the answer depends on the specific facts of the case.  Recently, in a coverage case based on headline events, a New York motion court upheld a referee’s order for production of both reinsurance contracts and reinsurance … Continue Reading

Are Repair Costs Covered Damages Under a Liability Policy?

Liability policies cover sums an insured becomes legally obligated to pay to a third-party as damages for a loss.  Typically, there is no coverage in a liability policy for expenses incurred by the insured to repair damage to the insured’s own property.  Additionally, nearly every liability policy has an owned-property exclusion.  In a recent case, … Continue Reading

The 5th Amendment and Insurance Coverage

When a property is destroyed by fire, the property owner’s property insurance likely will cover the loss all things being equal.  But if the fire was intentionally set, coverage likely will be denied.  In the case of a residential property, policies often condition coverage on occupation of the premises.  In a recent case before the … Continue Reading

Is Faulty Workmanship an “Occurrence” Under a CGL Policy?

Manufacturers often face multiple lawsuits when their products fail to perform as expected.  Sometimes, the cause of the product’s failure is the faulty workmanship of a component manufacturer.  When that is the case, the product manufacturer will seek damages from the component manufacturer for the underlying product defect claims.  The component manufacturer will then turn … Continue Reading

Ohio Supreme Court to Confront Whether Return Premium Required Before Seeking Rescission

The Ohio Supreme Court recently accepted a case that presents two issues with significant implications for insurers seeking to void policies based upon misstatements in policy applications: (1) whether “an insurance policy sufficiently warns the insured of the consequences of warranty misstatements where the policy states that it ‘may be held void ab initio,’” and (2) whether … Continue Reading

Non-Signatory Surety Bound By Arbitration Clause in Incorporated Contract

An arbitration provision in a contract typically applies only to the contracting parties.  Where, however, the contract is incorporated by reference into a second agreement, if it is broad enough, the party to the second agreement–although a non-signatory to the original agreement–may find that the arbitration provision applies to them as well.  This was the … Continue Reading

No Point in “Wining” About It — No Coverage for Missing Wine

In an interesting case about wine and wine collectors, purchasers of fine wines sought coverage for wine they ordered from a seller but never received.  Turns out the seller was running a wine Ponzi scheme and hundreds of customers never received thousands of bottles of wine ordered.  The case reached the Tenth Circuit Court of … Continue Reading

Does a Directors and Officers Insurance Policy Cover the Settlement of Criminal Charges?

Directors and Officers (“D&O”) insurance policies cover individuals and entities for a wide variety of claims for “wrongful acts.”  Many D&O policies provide coverage for claims based on criminal proceedings.  When criminal charges are settled against corporations and officers, very often the settlement includes fines, penalties, cost of investigation and other payments.  Are these payments … Continue Reading

Forum Selection Clause in Excess Policy Overrides Appraisal Clause in Primary Policy

When primary and excess polices cover the same property many assume that the excess policy will follow the form of the primary policy.  That is not always the case, which is a good reason why reading the actual terms of both policies is important.  In a recent case involving hurricane damage to a Florida development, … Continue Reading

Assigning Insurance Policies Can Get Tricky

Insurance disputes sometimes arise out of transactions.  Those of you who are involved in transactions, including transactions arising out of insolvencies, might be interested in a cautionary tale from a recent Illinois appellate court case addressing the assignment of insurance policies as part of an asset purchase agreement.  This drafting lesson may help avoid future … Continue Reading

Totality of the Circumstances and Late Notice

The defense of late notice to coverage applies differently depending on the jurisdiction.  In Illinois, whether a policyholder’s notice to its insurer was timely is determined by the totality of the circumstances.  Prejudice is just one of five non-dispositive factors. In a recent case involving an excess insurer, the Seventh Circuit addressed whether the policyholder’s … Continue Reading

Covered and Uncovered Claims — When Allocation Is Required

Plaintiffs usually don’t bring claims based on the defendant’s insurance coverage.  So it is not unusual for an insurer and policyholder to have a dispute about what claims are covered and what claims are not covered under the insurance policy and, if there are covered and uncovered claims, how to allocate the covered claims to … Continue Reading

Breach of Contract Exclusion Precludes Coverage

Liability insurance policies are meant to cover claims brought against insureds by third-parties alleging a fortuitous event that causes damages.  But most liability policies have exclusions that preclude coverage for certain events.  For example, many policies exclude coverage for property damage to property owned by the insured.  Another exclusion precludes coverage for damages resulting from … Continue Reading

Crime Coverage — Who Is an Employee and Who Is an Authorized Representative?

In a recent case, a parent company took out a crime insurance policy for itself and its subsidiaries.  When a property manager for its subsidiary stole funds through forged checks over several years, the policyholder sought a recovery under the crime insurance policy.  Unfortunately for the policyholder, there was no insurance coverage.… Continue Reading

To Match or Not to Match, That Is the Question

After Hurricane Sandy, I found some shingles missing off my roof.  My contractor said the entire roof should be replaced.  My insurer would only pay for replacing the missing shingles.  The type of shingle was readily available.  But what happens if the damage to the roof, siding, facade, floor occurs to only parts of those … Continue Reading

Interrelatedness, Prompt Notice and Prior and/or Pending Litigation Exclusion Collide

Directors and Officers (“D&O”) insurance policies have been written on a claims-made basis for decades.  Because of the nature of claim-made policies, D&O policies often have provisions addressing prior claims and the relationship between similar allegations in pending claims.  D&O policies also often have exclusions for prior and/or pending litigation.  These provisions address the circumstances … 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

The Consequences of Not Giving Notice of Disclaimer to Additional Insureds

Statutes and case law make it tough for insurance companies to disclaim coverage.  In most jurisdictions, if an insurance company receives a claim or tender it must respond quickly and with specificity to avoid losing the right to assert an exclusion or other basis to deny coverage.  Where the notice of claim comes in from … Continue Reading

Exclusion Relieves Insurer of Duty to Defend in Sex Trafficking Case

Human trafficking is a serious problem.  The current news cycle is filled with stories about human trafficking in the context of immigration and with recent criminal proceedings accusing the rich and famous of underage sex and sex trafficking.  In the mundane world of insurance, sex trafficking has become a coverage issue for insurance companies when … Continue Reading

War (Exclusions), What Is It Good For?

Back in the day, policyholders and insurers (and maybe everyone) understood what war was.  War was a military action between government forces of sovereign nations.  Today, not so much.  With the proliferation of terrorism and armed groups controlling various jurisdictions like pseudo-governments, it is often difficult to know when an attack is war or terrorism.  … Continue Reading
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