When the National Weather Service names a storm heading in your direction, you know to expect wind and water. This can create a quandary for property insurers. Is water damage from a named windstorm caused by the flood or the...more
2/28/2020
/ All-Risks Insurance ,
Denial of Insurance Coverage ,
Flood Insurance ,
Flooding ,
Hurricane Sandy ,
Insurance Claims ,
Insurance Litigation ,
Lloyds of London ,
Mass Transit ,
Natural Disasters ,
Policy Limits ,
Policy Terms ,
Property Damage ,
Property Insurance ,
Severe Weather ,
Water Damage
Florida’s offer of judgment statute, Florida Statutes section 768.79, is a common technique for any litigator who wants to place additional risk on the plaintiff. The statute provides that if a defendant in a civil suit files...more
Coverage disputes often come down to the interplay between endorsements and the body of the policy. But this tension is not limited to terms addressing coverage. It can also extend to areas such as dispute resolution. ...more
A federal court has found no coverage for a $42 million whistleblower settlement due to the insured’s failure to timely report the claim to its carrier. PAMC, Ltd. v. National Union Fire Insurance Company of Pittsburgh, Pa.,...more
2/26/2019
/ Department of Justice (DOJ) ,
False Claims Act (FCA) ,
Health Insurance ,
Insurance Claims ,
Medicaid ,
Medicare ,
National Union ,
Qui Tam ,
Settlement Agreements ,
Statute of Limitations ,
Whistleblowers
Third-party liability policies often include aggregation clauses. As the name suggests, these clauses aggregate “related claims” or “interrelated wrongful acts” into one claim or occurrence....more
12/4/2018
/ Aggregation Rules ,
Denial of Insurance Coverage ,
Insurance Claims ,
Insurance Litigation ,
Investigations ,
Occurrence ,
Policy Terms ,
Professional Liability Insurance ,
Securities and Exchange Commission (SEC) ,
Third-Party Liability ,
Wrongful Acts
Insurance carriers and policyholders often argue about the scope of policy provisions. Generally, policyholders take an expansive view of insuring agreements, while carriers often construe them more narrowly. But not all...more
Claims under the Telephone Consumer Protection Act (TCPA) present numerous issues for insurance companies and policyholders. Because TCPA claims lend themselves to class action suits, the potential exposure can be...more
11/8/2017
/ Basketball ,
Class Action ,
Denial of Insurance Coverage ,
Insurance Industry ,
Insurance Litigation ,
Invasion of Privacy ,
Policy Exclusions ,
Policy Terms ,
Sports ,
TCPA ,
Text Messages
Claims-made policies often cover acts that occur before a policy period, so long as they result in a covered claim during the policy period. This is a fundamental difference between claims-made and occurrence policies. But...more
Willful misconduct is uninsurable. It is a fundamental principle of insurance, and it makes sense to both the lay and the lawyerly. But few states go as far as to codify this principle in the insurance code. California is an...more
4/3/2017
/ AIG ,
Denial of Insurance Coverage ,
False Claims Act (FCA) ,
Insurance Industry ,
Insurance Litigation ,
Liability Insurance ,
Office Depot ,
Policy Exclusions ,
Public Policy ,
Qui Tam ,
Whistleblowers ,
Willful Misconduct
The Central District of California held that Section 533 of the Insurance Code eliminated any potential for coverage for suit under the state False Claims Act.
On January 4, the U.S. District Court for the Central...more
1/24/2017
/ AIG ,
Bad Faith ,
CFCA ,
Denial of Insurance Coverage ,
Dismissal With Prejudice ,
Duty to Defend ,
False Claims Act (FCA) ,
Indemnity Insurance ,
Insurance Code ,
Insurance Industry ,
Insurance Litigation ,
Office Depot ,
Public Entities ,
Summary Judgment ,
Willful Misconduct
As this blog has reported, a line of cases deciding coverage disputes over faulty workmanship runs against (or, at least, around) a basic rule for interpreting insurance policies. Under that rule, the scope of coverage is...more
9/19/2016
/ Breach of Contract ,
Commercial General Liability Policies ,
Condominiums ,
Construction Contracts ,
Construction Defects ,
Construction Industry ,
Construction Project ,
Faulty Workmanship ,
Insurance Industry ,
NJ Supreme Court ,
Policy Exclusions ,
Popular ,
Property Damage ,
Subcontractors
A federal court has ruled that a whistleblower suit under California’s False Claims Act alleged a “willful act” that cannot be covered by liability insurance.
In Office Depot Inc. v. AIG Specialty Insurance Company, Case...more
Although the terms are often used interchangeably, there are several key differences between umbrella and excess coverage. One such distinction is that an umbrella policy can apply to multiple underlying policies. This makes...more
“Advertising injury” can be tricky. In theory, the term applies to the type of harm that can be inflicted through advertising media—defamation, disparagement, violation of privacy rights or misappropriation of intellectual...more
Many property insurance policies contain terms that prohibit assignment, but Florida law has long deemed those terms inoperative once a loss has occurred. E.g., W. Fla. Grocery Co. v. Teutonia Fire Ins. Co., 74 Fla. 220...more
Insurers don’t, as a rule, like bad faith suits. But life can play funny tricks—as when a judgment against an insured breaches a layer of excess coverage, because the primary carrier failed to settle within its policy...more
Insurers have a duty to process claims in good faith, but sometimes they farm the job out to third-party administrators (TPAs). If the TPA fouls up, many states hold that the insurer is still liable—for its own breach of...more
It is a truism that a liability insurer’s duty to defend is extremely broad—especially in states that apply the “four corners rule.” Under that rule, the insurer has a duty to defend whenever the underlying complaint alleges...more