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Denial of Insurance Coverage Professional Liability Insurance

Rivkin Radler LLP

April 2025 New York Insurance Coverage Law Update

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John H. Fisher and his P.C. represented a client in a medical malpractice action filed on February 15, 2019, alleging that the defendant medical providers failed to provide proper prenatal care to the client, causing the...more

Wiley Rein LLP

Lending Exclusion in Bankers Professional Liability Policy Bars Coverage For Claim Alleging Financing a Ponzi Scheme

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The United States District Court for the Central District of California, applying California law, has held that a lending exclusion in a bankers professional liability policy barred coverage for underlying lawsuits alleging...more

Wiley Rein LLP

Series-Qualifier Canon of Construction Determines the Effect of a Clause at the End of a Series

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The United States Court of Appeals for the Eleventh Circuit, applying New Jersey law, has held that the series-qualifier (and not the last-antecedent) canon of construction applied in an insurance coverage dispute, such that...more

Marshall Dennehey

New Jersey District Court Affirms Irrelevance of Breach of Contract Claims in Cases Involving Woerner Actions.

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Law Office of Drew J. Bauman v. Hanover Insurance Company, 2023 WL 2238552 (D.N.J. Feb. 27, 2023) - The plaintiffs had maintained a professional liability insurance policy with Hanover from October 2017 to October 2019. They...more

Robinson+Cole Data Privacy + Security Insider

Insurer Denies Coverage Under Professional Liability Policy for Lawyer’s Email Compromise

Insurance coverage for cyberattacks can be tricky for anyone to navigate, including lawyers. To illustrate this point, a case in New Jersey caught my eye that I thought would be an interesting read for our followers who are...more

Wiley Rein LLP

No Coverage for Claims Made Outside of Claims-Made Policy Period

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The United States District Court for the Northern District of Illinois, applying Illinois law, has granted a legal professional liability insurer’s motion for summary judgment, holding that its claims-made policy did not...more

Wiley Rein LLP

Notice-Prejudice Rule Does Not Apply to Claims-Made Professional Liability Policies

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The United States District Court for the District of Colorado, applying Colorado law, has held that claimants were not entitled to coverage for default judgments because the insured dentist failed to provide notice of the...more

Wiley Rein LLP

Second Circuit Affirms No Duty to Defend Claims Against Construction Firm Outside the Scope of Professional Liability Coverage

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The United States Court of Appeals for the Second Circuit, applying New York law, has held that neither of two claims against an insured construction company fell within the scope of coverage under the company’s claims-made...more

Wiley Rein LLP

New Jersey Appellate Court Holds No Coverage for Broker Malpractice Lawsuit Noticed Three Years After It Was Filed

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The Superior Court of New Jersey, Appellate Division has held that there is no coverage under an insurance broker’s claims-made professional liability policy because the policyholder reported the claim to the insurer three...more

Wiley Rein LLP

California Court Finds Insolvency Exclusion Ambiguous, Limits Application to Insolvency of Third Parties Other Than Claimant

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A California federal district court, applying California law, has held that an insolvency exclusion in a bankers’ professional liability policy did not bar coverage for a lawsuit filed by a receiver against a bank, finding...more

Wiley Rein LLP

No Coverage for Claim First Made and Reported After Policy Expired

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A Louisiana federal district court has held that a claims-made-and-reported professional liability policy did not provide coverage for a claim first made and reported years after the policy expired. Sistrunk v. Haddox, 2021...more

Wiley Rein LLP

Prior Knowledge Provisions Barred Coverage for Malpractice Claim Based on Pre-Policy Sanctions and Default Judgment

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The Montana Supreme Court has held that there was no coverage under a lawyers professional liability policy for a client’s malpractice claim because the lawyer knew of and failed to disclose, prior to the insured law firm’s...more

Wiley Rein LLP

Whether Insured Misrepresented or Concealed Information in Application is a Fact Issue for Trial

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The United States District Court for the Northern District of California has held that, in an action to rescind a professional liability policy, a triable issue of fact existed regarding whether an insured misrepresented or...more

Wiley Rein LLP

No Coverage for TPA in Claim Arising from Extracontractual Exposure to Insurer

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A federal district court has ruled that a third-party administrator’s professional liability policy does not afford coverage for a claim against the TPA arising from an excess judgment against the TPA’s...more

Wiley Rein LLP

Prior Knowledge Exclusions Apply Where Insured Received Three Letters from Potential Claimants and Issued Two Litigation Holds...

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In a case in which Wiley represented the insurer, the United States District Court for the Eastern District of Virginia, applying New York law, has held that three prior knowledge exclusions barred coverage under an...more

Wiley Rein LLP

Insurer Waived Right to Assert Policy Exclusion First Raised in Answer to Declaratory Judgment Complaint

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The U.S. District Court for the Southern District of New York, applying New York law, has concluded that an insurer waived the right to assert a policy exclusion as a coverage defense in a declaratory judgment action after...more

Carlton Fields

Years of Embezzlement Precluded From Coverage Under E&O Policy’s Commingling Exclusion

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A federal district court in North Dakota recently granted an insurer’s motion to dismiss in Campbell Property Management LLC v. Lloyd’s Syndicate 3624, finding that both prongs of a “commingling exclusion” to coverage...more

Lowenstein Sandler LLP

Fintech Company Secures Indemnity Coverage Under Professional Liability Policy for Fraudulent Funds Transfer Claim

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What You Need To Know: - Recent case law is trending favorably for policyholders to secure coverage for computer fraud claims under a wide array of insurance policies. - Because several types of policies may be...more

White and Williams LLP

Eleventh Circuit Defers to Insurer’s Definition of Professional Services

Does an Errors & Omissions (E&O) insurer have a duty to defend its insured mental healthcare provider when the policyholder was not licensed to provide such mental health counseling services? The Eleventh Circuit recently...more

Farella Braun + Martel LLP

Claims-Made Policy Note: Policy’s Use of Defined Terms May Expand or Limit Coverage Under Related Acts Provision

In an unpublished decision, the Ninth Circuit affirmed the Central District of California’s interpretation of the related acts provision in a professional liability policy, holding that related acts reported in a prior policy...more

Carlton Fields

Related Decisions: Three Recent Cases Emphasize Breadth of “Related Wrongful Acts”

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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

Bradley Arant Boult Cummings LLP

Beware of Prior Act Exclusions and Retroactive Dates When Procuring or Renewing Coverage

An 11th Circuit decision issued earlier this year serves as a reminder of the importance of carefully evaluating time-based exclusions and retroactive dates when procuring or renewing coverage. Liability policies such as...more

Goulston & Storrs PC

Eleventh Circuit Finds No Coverage for Contempt Proceedings under Lloyd's Professional Liability Insurance Policy

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In Jones, Foster, Johnston & Stubbs, P.A. v. Prosight-Syndicate 1110 at Lloyd’s, United States No. 15-12399, 2017 WL 586450 (11th Cir., February 14, 2017) the insured law firm sought to recover legal fees and costs incurred...more

Pullman & Comley, LLC

Too Soon! First Circuit Finds No Duty To Defend Before Suit Is Filed

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Can something short of the filing of a complaint trigger an insurer’s duty to defend? It’s not an idle question. Uncertainty on this issue could produce an unintended breach, and, in some jurisdictions, breach of the duty to...more

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