Policy Exclusions

News & Analysis as of

Insurance Coverage – Auto Exclusion for “Nonrelative Resident” not Permitted

Insurance Coverage – Auto Exclusion for “Nonrelative Resident” not Permitted - Court Of Appeal, Fourth Appellate District (September 24, 2014)- Many automobile policies have exclusions against coverage for...more

“Prior or Pending Litigation” Exclusion Bars Coverage for Litigation that Was Unknown to Policyholder

Companies that do business with the federal government, or whose business transactions otherwise involve payments by the government, undoubtedly understand the exposure they face to “whistleblower” or “Qui Tam” lawsuits...more

Does Your Cyber Risk Policy Protect You In the Event of an Insider Attack or Data Breach?

Protecting a company against data breaches requires not only measures to prevent the adverse cyber event, but also adequate insurance to minimize the financial impact should such an event occur. Unlike traditional lines of...more

Cyber Voluntary Payment Defense Thwarted by Bank Fraud Regulation

Financial institutions are one of the entities most threatened by cyber crisis events. As data breaches and cyber threats become more inventive, the risks to financial institutions and their clients continue to grow. However,...more

Hacking Coverage Dispute Under Professional Liability Policy Gets the Go-Ahead from Federal Court

On October 6, 2014, a federal court denied a professional liability insurer’s motion to dismiss a coverage dispute over a $3.5 million payment the policyholder-bank made when a bank customer’s account was targeted by a...more

The Texas Supreme Court Upholds a Vacancy Condition and Refuses to Expand the Prejudice Requirement.

In Greene v. Farmers Ins. Co., 2014 Tex. LEXIS 757 (Tex. Aug. 29, 2014), the Texas Supreme Court affirmed a denial of coverage under a homeowner’s policy because the owner had vacated the home. Plaintiff purchased a Texas...more

Fifth Circuit Requests Input from the Supreme Court of Texas Regarding Interpretation of Commercial General Liability (“CGL”)...

The rule courts generally employ to interpret undefined words in insurance policies — essentially, to look to the words’ plain or ordinary meaning — sounds simple. However, many times, there is more than one meaning of such...more

Is That Covered? "Additional Insured" Coverage for Claims Brought by Employees of Named Insured

Consider this common scenario: Big Shopping Mall owns the local shopping development and leases stores to multiple tenants, including the Popular Chain Restaurant. An employee of the Popular Chain Restaurant, Bob Suzealot, ...more

Tennessee Insurance Legal News: Volume 3, Number 3

Declaratory Judgment Action Interpreting the "Land Motorized Vehicle" Exclusion - In Tennessee Farmers Mutual Insurance Co. v. Simmons, No. E2013-01419-COA-R30-CV (Tenn. Ct. App. July 15, 2014), the Tennessee Court of...more

Homeowners’ Insurance: The Devil Resides In The Details

Reading and understanding all of the language in a homeowners’ insurance policy are not formalities to be skipped over while searching for the signature line. As with any contract, the fine print can have real and lasting...more

If it Races like a Tortoise: Connecticut Deconstructs a Policyholder

In Sonson v. United Services Auto. Ass’n No. 35890 (Conn. Ct. App. Sept. 16, 2014), an automobile policyholder had to show that a “racing” exclusion did not apply, so he argued that Achilles could never overtake the tortoise...more

Do You Know the “Permissible” Exclusions in Your Auto Policy?

Barry P. Goldberg has seen almost every possible circumstance arising from automobile accidents. Many cases involve insurance coverage issues ranging from whether a policy was in effect at the time of the accident to more...more

Texas Supreme Court Orders (9/2014)

The Texas Supreme Court did not issue any opinions in its weekly orders. But the Court did accept a case on a certified question from the United States Court of Appeals for the Fifth Circuit. The Court also set the date for...more

Pennsylvania Court Holds Pending and Prior Litigation Exclusion Applicable to Unserved False Claims Complaint

In its recent decision in AmerisourceBergen Corp. v. Ace Am. Ins. Co., 2014 PA Super 198 (Pa. Super. Sept. 15, 2014), the Superior Court of Pennsylvania, an intermediate Pennsylvania court, had occasion to consider the...more

McLennan v Insurance Australia Ltd [2014] NSWCA 300

In its recent decision of McLennan v Insurance Australia Ltd [2014] NSWCA 300, the NSW Court of Appeal confirmed that a provision in an insurance policy that limits or qualifies cover is an exclusion, regardless of where or...more

TCPA Exclusion Upheld: No Ambiguity, No Duty to Defend or Indemnify for a $10 Million Judgment

In James River Insurance Company v. Med Waste Management LLC, et al., Case No. 1:13-cv-23608-KMM, (U.S. Dist. S. D. Fla., September 22, 2014), the U.S. District Court for the Southern District of Florida upheld a Telephone...more

Insurance Recovery Law - September 2014

Pollution Exclusion Doesn’t Bar Coverage for Worker Exposed to Hazardous Chemicals That Were Not “Dispersed”: Why it matters - A federal district court in Texas strictly construed a pollution exclusion in...more

Appellate Court Notes

?AC35328 - Sola v. Wal-Mart Stores, Inc. Trial court incorrectly refused to charge the jury that Walmart store had a non-delegable duty to maintain its floors in a safe condition for its patrons and could not defend a...more

Is That Covered? Insurer Refusal to Pay for Full Property Loss May Be Bad Faith

If you or your clients have ever had the experience of submitting a claim to an insurance company, you probably know how difficult it can be to get the insurance company to pay the full amount of damages. Even if the company...more

New Jersey Court Turns the Screws on the Insured, Holding That “Your Product” Exclusion Bars Coverage For Defective Product Claim

In Titanium Industries, Inc. v. Federal Ins. Co., No. A-1922-12T1, 2014 WL 4428324 (N.J. Super. Ct. App. Div. Sept. 10, 2014), the court held that the commercial general liability policy issued by defendant Federal Insurance...more

Court Holds that Privacy Violations Allegations Are Not Covered

A federal court in Washington recently issued an unpublished decision affirming that a common policy exclusion protects insurers from having to provide coverage in certain cases of alleged privacy violations. The same court...more

Business Risk Exclusions in CGL Policies Produce a Patchwork of Decisions

On July 23 and 24, 2014, respectively, intermediate appellate courts from South Carolina and Massachusetts released opinions upholding the application of the “your work” exclusion in a commercial general liability policy...more

District Courts Reviewing ERISA Cases Under the Arbitrary and Capricious Review Standard Serve Only in an Appellate Role

In McCorkle v. Metro. Life Ins. Co., 13-30745, 2014 WL 2983360 (5th Cir. 2014), the Fifth Circuit reversed the district court’s holding that MetLife’s adverse determination regarding the plaintiff’s claim for benefits due to...more

Maryland Insurer Not Permitted to Rely on Business Pursuits Exclusion to Deny Duty to Defend Where Continuity of Business Interest...

In Springer v. Erie Insurance Exchange, the Court of Appeals set out to determine whether the allegations in a complaint for defamation triggered the Business Pursuits exclusion in a homeowner’s liability insurance policy...more

Is There a Duty to Defend Pollution Claims? It’s the Complaint, Stupid

This Spring, cases from Florida and Wisconsin reaffirmed the general proposition that a liability insurer’s duty to defend must be determined from the specific claims in the underlying complaint against the insured, and not...more

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