Policy Exclusions

News & Analysis as of

Claim for Failure to Reimburse Reasonable Business Expenses Not Barred by EPL Policy’s Wage and Hour Exclusion

Don’t be too surprised if you see a “wage and hour” exclusion in your employment practices liability insurance policy, especially if you have employees in California. While these exclusions purport to bar coverage for claims...more

Florida Supreme Court Decides that Concurrent Causes Equal Coverage

It’s said that “defeat is an orphan,” but insurable losses often have multiple, concurrent causes. In some cases, one or more of those causes might be outside the scope of coverage, either by omission or exclusion. In Sebo v....more

Fifth Circuit affirms $34 million verdict against legal malpractice carrier — exclusion, read literally, “renders the coverage...

Readers of Law360 may recall a 2014 story about a Texas jury that rendered a $34 million dollar verdict against OneBeacon Insurance Company. According to Law360, the Jury found that OneBeacon “knowingly failed to attempt, in...more

Ohio Court Holds Software Audit Demand Is a Claim Under D&O Policy

In its recent decision in Eighth Floor Promotions v. The Cincinnati Ins. Cos., 2016 Ohio App. LEXIS 4119 (Oct. 11, 2016), the Court of Appeals of Ohio, Third Appellate District, had occasion to consider whether an audit...more

Montana Court Enforces Oil and Gas Exploration Exclusion

In its recent decision in Palmer v. Northland Cas. Co., 2016 U.S. Dist. LEXIS 138556 (D. Mont. Oct. 5, 2016), the United States District Court for the District of Montana had occasion to consider the application of an oil and...more

D&Os – Be Aware of Creditor Exclusion in Your Insurance Coverage

The U.S. Court of Appeals for the Fifth Circuit recently held that a Creditor Exclusion provision in D&O insurance coverage may result in significant limitations on the coverage provided to the D&Os, when the underlying...more

Subcontractor Exception Torpedoes Insurers’ Defense To Faulty Workmanship Claim

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

In Indiana, an Absolute Pollution Exclusion May Exclude Absolutely Nothing

A recent article in the Sports section of The Miami Herald read “Shooting coach helps Winslow.” Perhaps, but it probably didn’t help the coach much. The admonition to “eat every carrot and pea on your plate” undoubtedly...more

Do You Need Directors and Officers (D&O) Insurance for a Family-Owned Business?

Family business owners may assume that D&O insurance coverage is necessary only for publicly traded corporations and large, non-family owned private businesses. That is not the case. Individual directors and officers of a...more

“Context Matters” – Tenth Circuit Holds Mudslide Not an Explosion Under Property Policy

On August 29, 2016, the U.S. Court of Appeals for the Tenth Circuit affirmed a Colorado district court ruling that the sudden obliteration of a building in a 2013 mudslide did not constitute an “explosion” under a commercial...more

Check Your Neutral Policies: The EEOC Joins the ACLU’s Challenge to Dignity Health’s Exclusion of All Care Related to Sex...

The ACLU filed a complaint against Dignity Health, claiming that the total exclusion of care related to “sex transformation surgery” in Dignity’s employee health insurance plan is unlawful sex discrimination. Now the EEOC...more

"Assuming" the Obvious: Exclusion for “Assumption of Liability in a Contract” Does Not Apply to Breach of Professional Services

In what it described as a case of first impression, the Northern District of California ruled that a professional liability policy that excluded the insured’s “assumption of liability obligations in a contract or agreement”...more

Commercial landlords: Time to tune up your indemnity provisions

The California Court of Appeal recently issued an opinion which reminds us to take another look at the “boilerplate” indemnity provisions in commercial leases. In Morlin Asset Management LP v. Murachanian (B259800), a...more

New Jersey Supreme Court Affirms General Contractor’s Insurance Coverage for Consequential Damages Caused by a Subcontractor’s...

In an important recent decision, New Jersey joined a growing number of states holding that Insurance Services Office’s (ISO) 1986 comprehensive general liability (CGL) policy extends coverage to a property developer faced...more

Greed is Not Good: The Personal Profit Exclusion

As this blog has frequently discussed, many limitations and exclusions in liability policies address “moral hazard” situations by declining to provide insurance for bad behavior. One such exclusion is the “personal profit...more

What Community Bank Board Members Need to Know About D&O

A bank director’s responsibilities are similar to directors of other types of corporations, including the duties of loyalty and care. Federal banking regulators have strong enforcement powers to address violations of law,...more

ERISA: “Key Evidence Needed to Prove the Intoxication Exclusion”

You know that many insurance policies and ERISA-governed plans exclude from coverage disabilities “resulting from, or related to…any accident related to the voluntary influence of any drug, narcotic, intoxicant or chemical….”...more

New Jersey Supreme Court Holds CGL Policies Cover Developer/General Contractor for Damage Caused by Subcontractor’s Faulty...

The New Jersey Supreme Court recently considered whether damage caused by a subcontractor’s faulty workmanship constitutes property damage caused by an occurrence under a developer/general contractor’s commercial general...more

District Court Further Limits Application of Professional Services Exclusion

One of the most heavily-litigated exclusions in modern insurance coverage practice was the subject of a recent district court decision involving allegedly misleading marketing by for-profit colleges. Exclusions for claims or...more

Wisconsin Supreme Court Reaffirms Four-Corners Rule for Insurers’ Duty to Defend

An insurer’s decision whether to defend a lawsuit against its insured can be a critical issue involving tens of thousands, if not millions, of dollars for Wisconsin companies who are sued. The Wisconsin Supreme Court recently...more

A Recent California Federal Court Decision Restores Coverage For Some Patent-Related Lawsuits

A California district court pushed back on the restrictive interpretation of a standard intellectual property exclusion and found coverage for a policyholder’s patent related lawsuit. The United States District Court...more

Fifth Circuit Holds that National Union Fire Insurance Company of Pittsburgh, PA’s Commercial Crime Policy Does Not Cover...

Tesoro Refining & Marketing Co. v. National Union Fire Ins. Co. of Pittsburgh, PA, 2016 U.S. App. LEXIS 13838 (5th Cir. July 29, 2016). In 2003, Tesoro Refining and Marketing Company, LLC (“Tesoro”) started selling fuel to...more

Is a Rock a Landslide? Montana Supreme Court Says Yes

In a recent decision, the Montana Supreme Court upheld application of an Earth Movement exclusion to bar coverage for damage to a home when a single large boulder rolled down a hill and smashed into it. In doing so, the court...more

Warranty and indemnity insurance gaining traction in ASEAN

While the use of warranty and indemnity (W&I) insurance has become relatively commonplace in the U.S. and European M&A markets over the last decade or so, it has struggled to gain a meaningful foothold in ASEAN during the...more

Sixth Circuit Holds Coverage Unavailable for Perpetrator of Sexual Misconduct

In its recent decision in Clifford v. Church Mutual Ins. Co., 2016 Fed. Appx. 0373N (6th Cir. July 5, 2016), the United States Court of Appeals for the Sixth Circuit, applying Ohio law, had occasion to consider the coverage...more

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