On May 2, 2025, the Tenth Circuit Court of Appeals issued an opinion in AdHealth Limited v. PorterCare Adventist Health Systems affirming the lower court’s summary judgment ruling that a hospital’s excess liability insurance policies’ definition of “medical incident” unambiguously applies to the injuries of a single person, not the treatment of multiple people exposed to the same conditions. As a result, each claim for a “medical incident” must individually exceed the ... Keep Reading »
Professional Liability
Second Circuit Affirms Ruling That Prior Knowledge Exclusion Barred Coverage for Legal Malpractice Lawsuit
The Second Circuit Court of Appeals recently affirmed a lower court’s ruling, which declared that North River Insurance Co. had no duty to defend or indemnify its insured in connection with a legal malpractice lawsuit. Background In September 2019, Max Leifer and his law office applied for professional liability insurance with North River. Leifer’s application was approved, and North River issued the policy, which covered damages and defense expenses for claims ... Keep Reading »
Third Circuit Limits Pennsylvania’s “Reasonable Expectations” Doctrine
In Hemphill v. Landmark American Insurance Co., issued April 5, 2023, the Third Circuit Court of Appeals outlined limits on an insured’s use of Pennsylvania’s “reasonable expectations” doctrine — the legal theory that purports to provide coverage under a policy based on the “reasonable expectations” of the insured — and found that, among other things, the doctrine does not apply to commercial insureds. The case involved a coverage dispute for an underlying claim by an ... Keep Reading »
New Jersey Federal Court: Policyholders Must Plead Specific Policy Provisions to Maintain Suits
In Law Office of Drew J. Bauman v. Hanover Insurance Co., the U.S. District Court for the District of New Jersey affirmed that policyholders must allege, under New Jersey law, the specific provisions of the insurance policy in order to state a claim for relief under the insurance contract. In doing so, the court bolstered the growing national judicial trend of restricting policyholder coverage litigation to those involving specific allegations of a carrier’s purported ... Keep Reading »
Investment Advisory Firm’s Unlawful Copying and Distribution of Industry Publication to Firm Employees Not Covered by Professional Liability Policy
A California court recently held that an investment advisory firm’s losses stemming from its alleged copying and distribution of Oil Daily, an energy industry publication, to the firm’s advisers were not covered by investment advisory professional liability policies the firm had procured. Energy Intelligence Group Inc. is the publisher of “newsletters and other publications for the highly-specialized global energy industry,” including Oil Daily. Energy Intelligence ... Keep Reading »
Sixth Circuit Finds Unregistered Security Exclusion Bars Professional Liability Claim
In Saoud v. Everest Indemnity Insurance Co., the Sixth Circuit Court of Appeals held that an “unregistered security exclusion” barred coverage for various underlying lawsuits under a professional liability policy. The policyholder, William Saoud, was in the business of selling insurance-related products, such as annuities, life insurance, and long-term health care products. In 2017 and 2018, Saoud sold some of his clients an investment product called the 1 Global ... Keep Reading »
Arizona Federal Court Finds False Pretenses Exclusion Bars Coverage for Fraudulent Wire Transfer Under Professional Liability Policy
In Helms v. Hanover Insurance Group Inc., the U.S. District Court for the District of Arizona weighed in on the issue whether a professional liability policy provided insurance for a fraudulent wire transfer. This decision is not the first to tackle this issue, and like the other opinions issued across the country, Helms demonstrates that the answer to this somewhat thorny question depends heavily on the specific policy wording at issue. The insured plaintiffs, a ... Keep Reading »
Florida Supreme Court Permits Insurer to Maintain Subrogated Malpractice Claim Against Counsel Retained to Represent Its Insured
Long-standing Florida law recognized only two limited exceptions to the general rule prohibiting a third party from pursuing a legal malpractice claim against an attorney who was not in privity with the third party - a will drafting situation and a private placement memoranda situation. In Arch Insurance Co. v. Kubicki Draper, LLP, the Florida Supreme Court created a third exception, now allowing an insurer with a duty to defend to stand in the shoes of its insured and ... Keep Reading »
Texas Federal Court Finds Law Firm’s Alleged 40,000 Unauthorized Claims Related to Deepwater Horizon Disaster Were Not “Professional Services” Triggering Duty to Defend
The Southern District of Texas held that New York Marine and General Insurance Co. had no duty to defend its insured under a legal professional malpractice insurance policy for claims stemming from the firm's efforts to develop business in the wake of the Deepwater Horizon disaster. In the underlying litigation (the Nguyen litigation), a group of 439 Vietnamese Americans brought claims against the law firm, alleging that the firm targeted Vietnamese American fishermen ... Keep Reading »
Ninth Circuit Applies Willful Violation of Law Exclusion in Professional Liability Policy To Preclude Coverage for Wrongful Death Lawsuit Stemming From Doctor’s Unlawful Distribution of Fentanyl
In National Fire & Marine Insurance Company v. Hampton, No. 19-17235 (9th Cir. Oct. 21, 2020), the Ninth Circuit held that a doctor’s guilty plea to the unlawful distribution of a controlled substance barred insurance coverage under his professional liability policy for a subsequent wrongful death lawsuit resulting from a patient’s overdose. According to the Ninth Circuit, the doctor’s admission that he intentionally distributed fentanyl clearly implicated the ... Keep Reading »