Policy Exclusions

News & Analysis as of

New York Insurance Law: 2014 Year in Review

Introduction - Perhaps the most significant and dramatic decision of the year played out when the Court of Appeals, New York's highest court, backtracked on an earlier decision regarding the duty to defend. It first...more

10th Circuit Holds No E&O Coverage for Sexual Assault Claim

In its recent decision in Hanover Am. Ins. Co. v. Balfour, 2015 U.S. App. LEXIS 874 (10th Cir. Jan. 21, 2015), the United States Court of Appeals for the Tenth Circuit, applying Oklahoma law, had occasion to consider whether...more

Wisconsin Supreme Court: Pollution Exclusion Bars Coverage for Well Contamination Resulting from the Application of Manure and...

In Wilson Mutual Ins. Co. v. Robert Falk and Jane Falk, 2013AP691 & 2013AP776, and Preisler v. Kuettel’s Septic Serv., 2012AP2521, the Wisconsin Supreme Court sought to resolve conflicting court of appeals’ decisions on...more

TRIA’s Back . . . and There’s Going to be Trouble

Readers of a certain age may recall the Angels’ 1963 song “My Boyfriend’s Back,” which talked about a boyfriend who returned to rescue his steady girlfriend from lies and problems (“Hey-la-day-la my boyfriend’s back!”). Well,...more

Insurance Recovery Law -- January 2015

Insured v. Insured Exclusion Ambiguous When Applied to FDIC, 11th Circuit Rules - Why it matters: In the continuing split among courts considering insured v. insured exclusions, the Eleventh U.S. Circuit Court...more

Excepted Benefits: Final regulations provide guidance on dental, vision and employee assistance plans

The Departments of Labor, the Treasury, and Health and Human Services (the “Departments”) have recently published final regulations related to when limited scope dental and vision benefits and employee assistance programs...more

Illinois Court Holds No E&O Coverage for Underlying TCPA Violation

In Margulis v. BCS Ins. Co., 2014 Ill. App. LEXIS 826 (Ill. App. Ct. 1st Dist. 2014), the Appellate Court of Illinois, First District, had occasion to consider whether an insurer has a duty to defend an insurance agent under...more

Unprofessional Marketing: Illinois Appellate Court Denies Professional Liability Coverage for TCPA Violation

On November 26, 2014, an Illinois appellate court held that a professional liability insurer had no duty to defend or indemnify its insured for a class action brought under the Telephone Consumer Protection Act (TCPA) because...more

TCPA Class Action Against Insurance Agent Not Covered by Professional Liability Insurance

As class action filings under the Telephone Consumer Protection Act (TCPA) have continued to rise, so too have the number of disputes with commercial liability insurers over coverage for their insureds’ alleged TCPA...more

Indiana Court Holds Auto Exclusion Applicable to Forklift-Related Injury

In its recent decision in National Am. Ins. Co. v. Harleysville Lake State Ins. Co., 2014 U.S. Dist. LEXIS 160593 (S.D. Ind. Nov. 14, 2014), the United States District Court for the Southern District of Indiana had occasion...more

Mold Exclusion: Louisiana Federal Court Interprets Exclusion And Endorsement

Many insurance policies include exclusions that are modified by endorsement. An analysis of the specific language in both the exclusionary provision and the modifying endorsement are critical in determining whether a peril is...more

Texas Federal Court Clarifies Broad Scope of Professional Liability Policies for Lawyers

Lawyers may be surprised to learn that lawsuits brought by clients challenging something other than purely legal advice or advocacy—such as billing—may not be covered by their professional liability policies. Interpreting the...more

Texas Court Construes Professional Liability Policy to Require Defense of Law Firm in Fee Dispute

In Shamoun & Norman, LLP v. Ironshore Indemnity, Inc., Cause No. 3:14-1340, In the U.S. District Court, Northern District of Texas, the federal district court construed a professional liability policy issued by Ironshore to...more

Specialized Cyber Liability Insurance Policies Proliferate as General Liability Insurers Refuse Coverage for Data Breaches

Travelers Indemnity Company filed an action this month in the United States District Court for the District of Connecticut for a declaratory judgment that it is not obligated to defend or indemnify its policyholder, P.F....more

Texas Court Holds Professional Liability Exclusion Applicable to Well Blowout

In its recent decision in Nicklos Drilling Co. v. Ace Am. Ins. Co., 2014 U.S. Dist. LEXIS 156585 (S.D. Tex. Nov. 5, 2014), the United States District Court for the Southern District of New York had occasion to consider the...more

Fifth Circuit Addresses Contractual Liability Exclusion

In its recent decision in Crownover v. Mid-Continent Cas. Co., 2014 U.S. App. LEXIS 20737 (5th Cir. October 29, 2014), the United States Court of Appeals for the Fifth Circuit withdrew its prior ruling and held that the...more

More “Texas Justice” For Policyholder On Contractual Liability Exclusion

On October 29, the Fifth Circuit reversed itself for the second time this year in a case involving the interpretation of a contractual liability exclusion in a CGL policy. This recent decision by the Fifth Circuit in...more

Property Insurance May Mitigate Ebola-Related Losses

With cases of Ebola now in the U.S., concerns have been raised as to the safety of public places visited by a person infected with the virus. Despite assurances from health officials that it is nearly impossible to contract...more

Second Circuit Affirms a Southern District Decision Construing “Covered Location” Narrowly

In January, the Southern District rejected an insured’s $2 million claim for a generator destroyed by Superstorm Sandy. The unit was in the basement of an office building in lower Manhattan, but the contract of insurance...more

Insured v. Insured Exclusion Ambiguous, California Court Finds: Bank Ds And Os Entitled to Coverage for FDIC Suit

Why it matters - In the latest decision to weigh in on the scope of the Insured v. Insured exclusion, a California court has held that it is ambiguous as applied to suits brought by the FDIC, and therefore does not...more

Missouri Court Imposes Bad Faith Liability Despite Judicial Finding Of No Coverage For Underlying Claim

In Advantage Building, the Western District of Missouri Court of Appeals affirmed a judgment against an insurer for extra-contractual liability for bad faith failure to settle a claim within the policy limits. Interestingly,...more

Pennsylvania Court: Inaction When Damage is Known to Be Likely is Enough to Render the Loss Non-Fortuitous

On September 19th, a federal court in Pennsylvania held that a wall collapse was not fortuitous because the insureds knew that the wall was unstable and likely to fall and yet took no steps to correct the problem. ...more

As Fear of Ebola Widens, Corporate Policyholders Seek To Prevent Loss While Insurers Seek To Exclude Loss

In response to the widespread fear of Ebola, at least one insurance company is seeking to protect itself from potentially significant financial loss in the event Ebola continues to spread beyond Africa by adding...more

Financial affairs structure dodges a “related entities” exclusion

The Queensland Supreme Court recently delivered a judgement demonstrating how an exclusion intended to exclude claims from which the Insured may benefit directly or indirectly did not do its work due to the way in which the...more

Testing Texas CGL Coverage For 3rd Party Products

On Sept. 19, the Fifth Circuit certified four questions to the Texas Supreme Court regarding coverage under a commercial general liability policy in U.S. Metals Incorporated v. Liberty Mutual Group Incorporated, No. 13-20433,...more

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