Courts scrutinize a complaint’s factual allegations to decide whether the allegations trigger a duty to defend.  If the facts unambiguously exclude coverage, there is no duty to defend.  But what if the factual allegations fall within a policy exclusion, but the allegations are untrue or questionable? What if the true facts would mean the exclusion doesn’t apply? In that case, many courts have found that the insurer should base its decision on the policyholder’s version of the “true facts.”  An insurer can’t rely on the complaint’s allegations to deny coverage when the facts that the insurer knows or can ascertain show that the claim is covered. Continue Reading Allegations Versus “True Facts”: Which Govern the Duty to Defend? Bonus! A Georgia Court Clears Up What the Meaning of “Is” Is
When is a catch-all provision too broad? When “a plain-text reading of that provision would swallow a substantial portion of the coverage that the policy otherwise explicitly purports to provide,” according to the Seventh Circuit Court of Appeals. Citizens Insurance Co. of America v. Wynndalco Enterprises LLC, Case No. 22-2313.
Continue Reading “Catch-All” Can’t Catch ‘Em All: Seventh Circuit Finds Coverage for a BIPA Claim Despite Catch-All Provision in Policy’s Statutory Violation Exclusion
Insurers generally have a right to conduct a full, fair, and thorough investigation of a claim. Depending on policy language, one investigative tool available to insurers is the examination under oath, or an “EUO.” In an EUO, a representative of the policyholder is sworn-in, and an employee of or attorney for the insurer asks questions related to the claim. EUOs may be a condition precedent to coverage, meaning failure to appear and comply with a reasonable EUO request may void coverage for the claim. See, e.g., Quality Health Supply Corp. v. Nationwide Ins., No. 2021-06955, 2023 WL 3486573 (N.Y. App. Div. May 17, 2023); Raymond v. State Farm Fire & Cas. Co., 614 F. Supp. 3d 1303 (N.D. Ga. 2022).Continue Reading The ABCs of EUOs
The explosive growth of representations and warranties (R&W) insurance over the last decade is no secret. But, for many, R&W insurance remains an enigma, particularly as respects filing a claim under such policies. Indeed, even those involved in buying R&W insurance may not have experience on the claims end and, as a result, possess little…
Per- and polyfluoroalkyl Substances (“PFAS”) are a class of substances that have increasingly become the target of federal and state regulation in everything from drinking water, groundwater, site contamination, waste, air emissions, firefighting foam, personal care products, food and food packaging, and now consumer and commercial products. PFAS are widely-used chemicals that have the unique ability to repel both oil and water, which led to their application in many products including items such as stain and water-repellent fabric, chemical-and oil-resistant coatings, food packaging materials, plastics, firefighting foam, solar panels and many others. The carbon-fluorine bond is the strongest in nature, making these compounds highly persistent in the environment.Continue Reading PFAS Regulation and Insurance Coverage Implications
As businesses continue to increase their reliance on technology, they are bound to face the inevitable risks associated with online transactions and other cyber exposures. This, in turn, emphasizes the importance of having the proper insurance policies and compliance methods in place to prevent or, at least, mitigate losses that ensue from these risks. In this context, many insurance policies require that there be a “direct” loss for there to be coverage, which has spawned numerous lawsuits about what the word “direct” means. The latest court to weigh in has sided with the insured and interpreted that term broadly to essentially mean proximate causation.
Continue Reading Court Does Not Beat Around The Bush and Is Rather Direct In Rejecting Insurer’s Causation Argument In Computer Fraud Claim
While companies develop their return-to-office policies or decide to keep employees working remotely, they should be mindful of potential liability under the Worker Adjustment and Retraining Notification Act (“WARN Act”) in the event of future layoffs. A recent opinion from the Eastern District of Virginia provides a timely alert for companies to review their employment practices liability (“EPL”) coverage and understand their risk of future exposures. The court held that remote employees alleging violations under the WARN Act—a statute requiring sixty days’ notice before a “mass layoff” at a “single site of employment”—could receive class certification, despite the fact that class members physically worked at different locations. EPL policies can effectively mitigate the related risk by covering the cost of litigation, as well as the company’s resulting liability.
Continue Reading Employers Be WARNed: Remote Employees Receive Class Certification in Suit for Wrongful Termination
An amended version of the Comprehensive Insurance Disclosure Act recently went into effect in New York State. This law applies to all civil lawsuits filed in New York State Court on or after December 31, 2021. The first disclosures required by the law will be due soon and it is important for defendants to be aware of their new obligations.
Continue Reading New York’s New Insurance Disclosure Law Goes Into Effect
Most insurance policies include a period of limitation provision that limits how long policyholders have to sue their insurers for coverage under the policy. But those periods of limitation can be traps for the unwary. As with many insurance provisions, different states construe the same language differently. States not only start the clock at different times, some states pause the clock while the insurer considers whether it will provide coverage.
Continue Reading Running Out the Clock: The Period of Limitation in COVID-19 Insurance Lawsuits May Soon Come to an End
A New Mexico court recently granted judgment on the pleadings against an insurer and found coverage, reminding the insurer that different words in a policy, indeed, have different meanings.
In Power of Grace, LLC v. Weatherby, Power of Grace, a policyholder, sued its insurer, Hudson Insurance Companies, and its insurance agent, Weatherby-Eisenrich Inc. Power of Grace alleged that Weatherby and Hudson were liable for damages it might incur in an underlying wrongful death lawsuit arising from a tractor-trailer accident. …
Continue Reading Tomato-Tomato? – New Mexico Court Offers Insurer a $5 Million Reminder that Different Words Have Different Meanings