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 determined by a policy’s insuring clause, which may be narrowed by one or more exclusions. Exceptions to the exclusions can add back coverage that the exclusions remove, but they cannot create coverage beyond the ambit of the insuring clause. E.g., ... Keep Reading »
Declaratory Judgment
Washington Court Finds Coverage For “Collapse” Is Not Set In Stone
As this blog has documented, the language of insurance policies evolves; it changes to address new risks, and it also responds to new interpretations of old policy provisions. Even if a policyholder maintains a long-standing relationship with a single carrier, the availability of coverage might turn on whether the loss occurred in a particular policy term. Property coverage for “collapse” provides an example of this development. After a number of courts found that the ... Keep Reading »
Tenth Circuit Drills Down Into Roots Of Moral Hazard, Comes Up Dry
Moral hazard (one of this blog’s preoccupations) usually comes up in disputes over the scope of coverage under an insurance policy. (See, for example, here, here and here.) But state legislatures often address it, too—for example, by imposing limits on agreements to indemnify a party against the consequences of its own negligence. This week, in Lexington Ins. Co. v. Precision Drilling Co., No. 15-8036 (10th Cir. July 26, 2016), the U.S. Court of Appeals for the Tenth ... Keep Reading »
Step-Up, Insurer! Your Step-Down Provision Is Not Triggered
“Sometimes nothin' can be a real cool hand.” -- Frank Pierson Where an automobile policy covers someone other than the named insured, a “step-down” provision may subject the amount of available coverage to the limit on “similar coverage” that is imposed by the injured person’s own policy. Sometimes, however, that second policy does not cover a particular risk at all. Last month, in Rivera v. McCray, No. A-2337-14T1 (N.J. App. Div. May 2, 2016), a New Jersey appellate ... Keep Reading »
Ninth Circuit Leaves it to Policyholder to Pay Eddie Haskell’s Attorneys’ Fees
Eddie: Well, look, there's nothin' to be so shook about. Lumpy's insurance'll take care of it. Moral hazard lurks around the edges of many disputes about liability coverage. Everyone agrees in principle that insurance shouldn’t help bad actors benefit from their wrongdoing, but parties often clash over where the principle applies. Some courts have addressed the problem by asking if the insured has suffered an insurable “loss.” E.g., Ryerson Inc. v. Federal Ins. Co., ... Keep Reading »
None Of Your Business: Eleventh Circuit Enters A Gray Area For Contract Liability Exclusions
Businesses have responsibilities; they buy liability insurance to cover losses that arise if they fail to perform them all. Businesses also “assume” responsibilities under contracts; those responsibilities are typically excluded from coverage. Sometimes the two kinds of responsibility overlap. Last month, in Payroll Management, Inc. v. Lexington Ins. Co., No. 15-10314 (11th Cir. March 1, 2016), the U.S. Court of Appeals rejected an insured’s attempt to exploit that ... Keep Reading »
For Excess Liability Insurers, Consent-to-Settle Clauses Still Count
When a liability insurer defends its insured under a reservation, recent decisions limit the insurer’s right to enforce a policy’s consent-to-settle clause. But can the reservation affect the rights of an excess carrier? And does it matter if the carrier declines to participate in an upcoming mediation? Last month, in The Doe Run Resources Corp. v. The Fidelity & Cas. Co. of N.Y., G050689 (Cal. Ct. App. Feb. 1, 2016), a California appellate court (applying Missouri ... Keep Reading »
Coverage for Direct Physical Loss Does Not Necessarily Include “Matching” or Require “Aesthetic Uniformity”
When a property insurance policy covers a multi-story building or multi-building property, and a portion sustains damage, there is often a question regarding the extent to which undamaged property should be replaced to ensure matching and/or aesthetic uniformity throughout the property. In Great American Insurance Company of New York v. The Towers of Quayside No. 4 Condominium Association, 15-CV-20056 (S.D. Fla. Nov. 5, 2015), a District Court recently determined that ... Keep Reading »
There’s A Problem With Your Reservation: Citing Reservation of Rights, Mississippi Court Nullifies “Defense Within Limits” Provision
When liability insurers have reasonable questions about coverage, courts traditionally encourage them to defend their insureds, subject to a reservation of rights. E.g., Drawdy v. Direct Gen. Ins. Co., 586 S.E.2d 228 (Ga. 2003) (“[b]y acting in this manner, the insurer eliminates any detriment to the insured …”). But the decision to reserve can have serious, negative consequences for the insurer. In some states, a reservation is deemed to create a conflict between ... Keep Reading »
After Pit Bull Case, Questions Dog New York’s “Unfortunate Event” Test
Where an insurance policy contains a “per occurrence” limit on coverage, New York courts apply what they call the “unfortunate event” test to determine how many “occurrences” are involved in a given claim or set of claims. The test does not apply at all, however, where the policy language indicates “an intent to aggregate separate incidents into a single occurrence.” As this blog recently discussed, the U.S. Court of Appeals for the Second Circuit ruled in September ... Keep Reading »
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