In a majority of jurisdictions, the "notice-prejudice rule" provides that an insurer may not deny a claim on grounds of late notice without demonstrating prejudice. The rule is statutory in some states and judicially crafted in others. Most courts, however, also hold that the rule does not apply to late notice under a claims-made-and-reported policy, as opposed to an occurrence policy. In 2015, several cases have solidified this trend, and some of them actually extend ... Keep Reading »
Georgia Supreme Court: Insurer Did Not “Unreasonably” Withhold Consent to Settle
In Piedmont Office Realty Trust v. XL Specialty Insurance Co., No. S15Q0418 (Ga. Apr. 20, 2015), the Georgia Supreme Court reiterated that, in the face of a policy provision prohibiting the insured from unilaterally settling a claim, the insured may not enter into a settlement and then seek coverage or assert a bad faith claim. Piedmont, the insured, was named as a defendant in a federal securities class action. Its defense was covered under both a $10 million ... Keep Reading »
Coverage Not Limited to Schedule of Locations in Fight Over Dam Liabilities
In C. Brewer & Co., Ltd. v. Marine Indem. Ins. Co. of Am., No. SCWC-28958 (Haw. Mar. 27, 2015), the Supreme Court of Hawaii ruled that liability coverage is not limited to only those locations defined in an insurer's schedule of locations. The court found that because a causal connection could be established between the negligent decisions of a business proprietor and the liabilities stemming from those decisions elsewhere, coverage could be applied irrespective of ... Keep Reading »
Telematics and Usage-Based Insurance: Benefits, Challenges, and the Future
The NAIC's Center for Insurance Policy and Research (CIPR) released a white paper in March 2015 providing an excellent overview of the brave new world of automobile "telematics" data and their use in premium rate-making by auto insurance. Telematics allow for the measurement of actual driving habits, through remote access to a vehicle's real-time driving data. Thus, a driver's actual experience can be studied in data transmitted from, for example, the vehicle's ... Keep Reading »
Hypothetically Speaking, Mr. Insurance Commissioner, There Is No Need To Answer.
A recent case pitted two State of Florida agencies involved in insurance regulation against one another, and resulted in a decision by the appellate court that the Insurance Commissioner could not be compelled to appear as a witness at trial or in deposition to answer hypothetical questions about regulatory decisions he might have made earlier in time if he had known certain information about the financial condition of particular insurance companies. Florida Office of ... Keep Reading »
The Eleventh Circuit Holds that for Sinkhole Losses, Structural Damage ≠ Any Damage to a Structure
The land in Florida is prone to sinking and insurance companies must often scramble for solid footing on which to anchor the scope of coverage for sinkhole losses. In Hegel v. First Liberty Insurance Corporation (11th Cir. Feb. 27, 2015), the Eleventh Circuit provided some much needed guidance when it held that the plain meaning of "structural damage" in a homeowners policy cannot be simply "damage to the structure" in the context of determining coverage for a sinkhole ... Keep Reading »
Playing with House Money: Fifth Circuit Holds that Home Designs Can Constitute Advertisements
Insurers – who bear the burden of crafting unambiguous policy language defining the contours of coverage – constantly face difficulty in attempting to predict unexpected liability. And sometimes, Courts can make this job far more difficult. For example, a recent Fifth Circuit decision held that a copyright infringement exclusion did not apply to exclude coverage for a judgment against the insured in a case alleging, well, copyright infringement. In Mid-Continent ... Keep Reading »
Down in the Dumps: Court Refuses to Apply Pollution Exclusion in Landfill Seepage Case
Claims involving potential coverage for pollution liability pose unique challenges for insurers. In many cases, the polluting activity occurred decades ago and over a large span of time, with only a fraction of the activity occurring during the policy period. As a result, an issue in pollution liability cases is whether an insurer is obligated to indemnify an insured for the entire amount of damages resulting from pollution, or whether an insurer's obligation may be ... Keep Reading »
Illinois Supreme Court: Innocent Insured Doctrine? For a Lawyer? (cough)
In Illinois State Bar Assoc. Mut. Ins. Co. v. Law Office Of Tuzzolino and Terpinas, the Illinois Supreme Court held that the "innocent insured" doctrine does not protect an innocent prospective insured, if his law partner makes misrepresentations in the application for insurance that void the policy. The parties to this case were the two partners in a law firm, and a client who sued the firm for malpractice, on the one hand, and the Mutual Insurance Company on the ... Keep Reading »
Change is in the Air: New Jersey Justices Hold Their Noses While Siding with Insurer in UM Disputes
On February 18, 2015, the Supreme Court of New Jersey issued separate opinions in two first-party, uninsured motorist cases against the same auto insurer. Plaintiffs in both cases alleged that the insurer had acted in bad faith by forcing the insured to trial after losing an arbitration. The insurer won both cases, on the ground that its position each time had been "fairly debatable" as a matter of law. But New Jersey’s high court also suggested, in both cases, that ... Keep Reading »
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