Under the Right Circumstances, an Insured Entitled to "Independent Counsel" i...NationalUnderwriter
Under the Right Circumstances, an Insured Entitled to "Independent Counsel" in California Can Retain More Than One Firm
by Carey B. Moorehead
In a case of first impression, a California district court has ruled that California law does not preclude an insured from
retaining multiple law firms as independent or Cumis counsel where the insurer is defending under reservation of
rights. The court’s ruling came in the case of Signal Products v. American Zurich Insurance Company, et al.
The Signal Products court was called upon to interpret California Civil Code §2860 in the context of cross-motions for summary judgment between American Zurich Insurance Company and its insured Signal Products, Inc., the defendant in a trademark infringement action. Zurich had agreed to defend Signal under reservation of rights and consented to Signal’s retention of independent counsel.
Under the Right Circumstances, an Insured Entitled to "Independent Counsel" i...NationalUnderwriter
Under the Right Circumstances, an Insured Entitled to "Independent Counsel" in California Can Retain More Than One Firm
by Carey B. Moorehead
In a case of first impression, a California district court has ruled that California law does not preclude an insured from
retaining multiple law firms as independent or Cumis counsel where the insurer is defending under reservation of
rights. The court’s ruling came in the case of Signal Products v. American Zurich Insurance Company, et al.
The Signal Products court was called upon to interpret California Civil Code §2860 in the context of cross-motions for summary judgment between American Zurich Insurance Company and its insured Signal Products, Inc., the defendant in a trademark infringement action. Zurich had agreed to defend Signal under reservation of rights and consented to Signal’s retention of independent counsel.
Class Actions: Insurance Related Claims
by Thomas F. Segalla
Whether prosecuting or opposing a motion for class certification, within the context of insurance related claims, there are certain principles that are critical to determining the allegations that are necessary to successfully assert such claims and the nature of any challenge to a motion to certify the punitive class. As the court noted, in the case of Deborah Mahon v. Chicago Title Insurance Co.:[1]
CCCA Spring Conference 2011: Negotiating Major Business AgreementsNow Dentons
This presentation discusses the negotiation process for major business agreements. It outlines the applicable laws that you may face, the contract process, indemnity provisions and language issues.
Supreme Court of New Jersey Confirms "Fairly Debatable" Standard for First Pa...NationalUnderwriter
Supreme Court of New Jersey Confirms "Fairly Debatable" Standard for First Party Bad Faith; Acknowledges Relevance of Actual Investigation by Frederic J. Giordano and Robert F. Pawlowski
The Supreme Court of New Jersey recently issued an important pair of decisions for policyholders with bad faith claims against their first-party insurance companies in Badiali v. New Jersey Manufacturers Insurance Group[1] and Wadeer v. New Jersey Manufacturers Insurance Company.[2] In Badiali and Wadeer, the court reiterated the narrow “fairly debatable” standard as the threshold for bad faith claims in New Jersey. But, the court also opened the door to modify this standard in the Badiali decision by recognizing the relevance of the actual claims handling in a particular case.
Thursday, October 10, 2013
4pm - 5:30pm
This program will introduce the often over-looked kingdom of people in conflict about animals. These
conflicts are not readily resolvable in Court in a way that serves anyone's purpose. Property, criminal and
civil statutes and laws bind the courts. The outcomes, in many instances, serve neither party's best
interest. In this course we will explore where conflicts arise, how people traditionally handle these
conflicts and how the ADR professional can supply his/her much-needed expertise to the parties enabling
them to arrive at a resolution that is truly party driven. The emotions surrounding a conflict involving a
pet are akin to those faced in child custody cases. There are no laws protecting the animal in a custody
disputes, they are decided using property law. It is expensive to fight a pet conflict so people often suffer in
silence with their pets or because of someone else's pet. The attendees will be able to expand their practice
in divorce, landlord tenant, med mal or contract/commercial by using ADR to resolve conflicts between
people about an animal. The need for ADR in this field is overwhelming. This program will enable the
participants to add Animal Conflicts to their quiver of services supplied to those looking for a different way
of speaking about and solving conflicts between people over animals.
Debra Vey Voda-Hamilton
Washington Court Holds Stipulated Covenant Judgment Sets Minimum Amount of Da...NationalUnderwriter
Washington Court Holds Stipulated Covenant Judgment Sets Minimum Amount of Damages in Bad Faith Case. (from FC&S Legal: The Insurance Coverage Law Information Center)
Recently, Division One of the Court of Appeals of Washington State affirmed a jury verdict awarding $13 million in damages to a passenger injured in a car accident, finding that the $4.15 million agreed amount of the covenant
judgment in the insurance bad faith case sets a floor, not a ceiling, on the damages a jury can award.
In Miller v. Kenny and Safeco Ins. Co.,[1] the Court of Appeals ruled on several additional issues on appeal including whether evidence of an insurance company’s loss reserves is properly admissible at trial.
Wisconsin Supreme Court: Pollution Exclusion Bars Coverage for Well Contamin...NationalUnderwriter
Wisconsin Supreme Court: Pollution Exclusion Bars Coverage for Well Contamination Resulting from the Application of Manure and Septage as Fertilizer
In Wilson Mutual Ins. Co. v. Robert Falk and Jane Falk,[1] and Preisler v. Kuettel’s Septic Serv.,[2] the Wisconsin Supreme Court sought to resolve conflicting court of appeals’ decisions on whether excrement (manure and septic waste, respectively) are “pollutants” under standard insurance policy exclusions when they contaminate groundwater after
being applied as fertilizer. The Wisconsin Supreme Court rejected categorically defining manure and septage as
“pollutants.” Instead, the court determined that such fertilizing excrement unambiguously falls within the applicable policy’s definition of “pollutants” once the manure and/or septage has contaminated a water supply.
Migrating Sand Triggers Separate Policy Limits for CGL Policy¹s Personal Inju...NationalUnderwriter
Migrating Sand Triggers Separate Policy Limits for CGL Policy¹s Personal Injury and Property Damage Coverages by Michael S. Levine and Matthew T. McLellan
Class Actions: Insurance Related Claims
by Thomas F. Segalla
Whether prosecuting or opposing a motion for class certification, within the context of insurance related claims, there are certain principles that are critical to determining the allegations that are necessary to successfully assert such claims and the nature of any challenge to a motion to certify the punitive class. As the court noted, in the case of Deborah Mahon v. Chicago Title Insurance Co.:[1]
CCCA Spring Conference 2011: Negotiating Major Business AgreementsNow Dentons
This presentation discusses the negotiation process for major business agreements. It outlines the applicable laws that you may face, the contract process, indemnity provisions and language issues.
Supreme Court of New Jersey Confirms "Fairly Debatable" Standard for First Pa...NationalUnderwriter
Supreme Court of New Jersey Confirms "Fairly Debatable" Standard for First Party Bad Faith; Acknowledges Relevance of Actual Investigation by Frederic J. Giordano and Robert F. Pawlowski
The Supreme Court of New Jersey recently issued an important pair of decisions for policyholders with bad faith claims against their first-party insurance companies in Badiali v. New Jersey Manufacturers Insurance Group[1] and Wadeer v. New Jersey Manufacturers Insurance Company.[2] In Badiali and Wadeer, the court reiterated the narrow “fairly debatable” standard as the threshold for bad faith claims in New Jersey. But, the court also opened the door to modify this standard in the Badiali decision by recognizing the relevance of the actual claims handling in a particular case.
Thursday, October 10, 2013
4pm - 5:30pm
This program will introduce the often over-looked kingdom of people in conflict about animals. These
conflicts are not readily resolvable in Court in a way that serves anyone's purpose. Property, criminal and
civil statutes and laws bind the courts. The outcomes, in many instances, serve neither party's best
interest. In this course we will explore where conflicts arise, how people traditionally handle these
conflicts and how the ADR professional can supply his/her much-needed expertise to the parties enabling
them to arrive at a resolution that is truly party driven. The emotions surrounding a conflict involving a
pet are akin to those faced in child custody cases. There are no laws protecting the animal in a custody
disputes, they are decided using property law. It is expensive to fight a pet conflict so people often suffer in
silence with their pets or because of someone else's pet. The attendees will be able to expand their practice
in divorce, landlord tenant, med mal or contract/commercial by using ADR to resolve conflicts between
people about an animal. The need for ADR in this field is overwhelming. This program will enable the
participants to add Animal Conflicts to their quiver of services supplied to those looking for a different way
of speaking about and solving conflicts between people over animals.
Debra Vey Voda-Hamilton
Washington Court Holds Stipulated Covenant Judgment Sets Minimum Amount of Da...NationalUnderwriter
Washington Court Holds Stipulated Covenant Judgment Sets Minimum Amount of Damages in Bad Faith Case. (from FC&S Legal: The Insurance Coverage Law Information Center)
Recently, Division One of the Court of Appeals of Washington State affirmed a jury verdict awarding $13 million in damages to a passenger injured in a car accident, finding that the $4.15 million agreed amount of the covenant
judgment in the insurance bad faith case sets a floor, not a ceiling, on the damages a jury can award.
In Miller v. Kenny and Safeco Ins. Co.,[1] the Court of Appeals ruled on several additional issues on appeal including whether evidence of an insurance company’s loss reserves is properly admissible at trial.
Wisconsin Supreme Court: Pollution Exclusion Bars Coverage for Well Contamin...NationalUnderwriter
Wisconsin Supreme Court: Pollution Exclusion Bars Coverage for Well Contamination Resulting from the Application of Manure and Septage as Fertilizer
In Wilson Mutual Ins. Co. v. Robert Falk and Jane Falk,[1] and Preisler v. Kuettel’s Septic Serv.,[2] the Wisconsin Supreme Court sought to resolve conflicting court of appeals’ decisions on whether excrement (manure and septic waste, respectively) are “pollutants” under standard insurance policy exclusions when they contaminate groundwater after
being applied as fertilizer. The Wisconsin Supreme Court rejected categorically defining manure and septage as
“pollutants.” Instead, the court determined that such fertilizing excrement unambiguously falls within the applicable policy’s definition of “pollutants” once the manure and/or septage has contaminated a water supply.
Migrating Sand Triggers Separate Policy Limits for CGL Policy¹s Personal Inju...NationalUnderwriter
Migrating Sand Triggers Separate Policy Limits for CGL Policy¹s Personal Injury and Property Damage Coverages by Michael S. Levine and Matthew T. McLellan
2017 Year in Review: Recent Midwest Legal Decisions Impacting Real Estate and...Quarles & Brady
In 2017, the Midwest (defined as Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Ohio, and Wisconsin) saw a number of statutory changes and court decisions that reshaped and framed a number of key issues every developer, design professional, owner, lender, contractor, and real estate and construction lawyer must know. Quarles & Brady lawyers discussed and took questions regarding recent decisions impacting lien claims, statute of limitation/repose, arbitration, indemnification, public improvement contracts, the current import of the economic loss doctrine, and insurance/subrogation.
Clarifying Bad Faith Jurisprudence in Virginia, Federal Court Recognizes Bad ...NationalUnderwriter
Clarifying Bad Faith Jurisprudence in Virginia, Federal Court Recognizes Bad Faith Claim Against First-Party Insurer by Michael S. Levine
In Great Am. Ins. Co. v. GRM Mgmt., LLC,[1] a federal district court denied an insurer’s motion to dismiss a bad-faith claim arising out of the insurer’s denial of its policyholder’s claim for property damage and loss of business income following the theft of rooftop air conditioning units from the policyholder’s hotel. The ruling is significant because it illustrates that Virginia law supports first-party bad-faith claims against insurers.
Clarifying Bad Faith Jurisprudence in Virginia, Federal Court Recognizes Bad-...NationalUnderwriter
Clarifying Bad Faith Jurisprudence in Virginia, Federal Court Recognizes Bad-Faith Claim Against First-Party Insurer
In Great Am. Ins. Co. v. GRM Mgmt., LLC,[1] a federal district court denied an insurer’s motion to dismiss a bad-faith claim arising out of the insurer’s denial of its policyholder’s claim for property damage and loss of business income following the theft of rooftop air conditioning units from the policyholder’s hotel. The ruling is significant because it illustrates that Virginia law supports first-party bad-faith claims against insurers.
Because of Evidence of a "Special Relationship" Between Insureds and Their Br...NationalUnderwriter
Because of Evidence of a "Special Relationship" Between Insureds and Their Broker, Insureds' Suit Against Broker Should Not Have Been Dismissed, NY's Highest Court Holds
New York’s highest court, the New York Court of Appeals, has ruled that sufficient evidence of a “special relationship” existed between insureds and their insurance broker such that a negligence lawsuit brought by the insureds against their broker should not have been dismissed at the summary judgment stage.
Malpractice Suit Against Trustee Who Failed to Inform Beneficiaries of Potent...theBurgessGroup
The successor trustees and beneficiaries of the Vitello family trust sued Kathleen King O'Brien, a Michigan lawyer, for malpractice in her handling of a policy owned by the trust when she was the trustee. O'Brien sought coverage from her malpractice insurer, Hartford Casualty. But it denies her claim because she had failed to timely notify it of the reasonably foreseeable possibility that the Vitello trust would pursue a malpractice claim against her.
Nielsen & Treas, LLC, is an established insurance defense firm in Metairie, Louisiana. In Woodson v. Allstate Insurance Company, 855 F.3d 628 (4th Cir. 2017), Nielsen & Treas, LLC, successfully represented the appellant in a case on flooding and foundation damage from 2011’s Hurricane Irene to a house in Albemarle Sound, North Carolina.
After the storm, the Woodsons filed a claim on a flood insurance policy that had been issued by Allstate Insurance Company under the federal aegis of the National Flood Insurance Program (NFIP). With engineers hired by both parties to inspect the damaged property and provide “proof of loss” documentation, Allstate issued a denial of a major part of the Woodsons' claim with regard to the foundation in February 2012. The Federal Emergency Management Agency (FEMA) agreed with Allstate and affirmed the decision.
A year later, the Woodsons improperly filed suit in state court, alleging that Allstate had breached its insurance contract and failed to act in good faith in claims handling. The NFIP Standard Flood Insurance Policy (SFIP) that was issued to the plaintiffs mandates that a policyholder must file suit in the U.S. District Court where the property is located within one year of a denial or partial denial of the claim.
Allstate claimed that the applicable statute of limitations barred the Woodsons’ case. The district court failed to address this limitations issue when it awarded the Woodsons approximately $233,000 on the breach of contract claim. This award was trebled to more than $700,000 because of the alleged bad-faith-handling claim, with nearly $64,000 more added for attorney fees. However, appellate courts from across the country have held that state-law based extra-contractual and bad faith claims are barred and preempted under federal. This is further buttressed by the fact that flood insurance carriers such as Allstate issuing NFIP flood policies have absolutely no financial incentive to not pay every dollar owed under a flood damage claim as flood carries are paid a commission by FEMA for every dollar paid on a flood claim.
On appeal, the court found that NFIP has a one-year statute of limitation on filed claims that was not met by the appellees. In addition, the National Flood Insurance Act of 1968 preempted the bad-faith-handling claim, which was argued on a matter of state law. With these factors and others under consideration, the district court judgments were reversed.
Countdown to 2021: 60 Important Supreme Court Decisions for Rhode Island Civ...Nicole Benjamin
As we countdown to 2021, we look back on the important civil decisions of the past five Rhode Island Supreme Court terms and the issues of first impression, practice pointers, and significant holdings that fill the pages of the Atlantic Reporter.
Claims-Made Policies May Cover Claims Submitted Outside the Reporting PeriodNationalUnderwriter
Claims-Made Policies May Cover Claims Submitted Outside the Reporting Period.
As a rule, liability insurance policies contain a condition requiring timely notice of a claim against the insured, so that the insurer has an opportunity to adequately investigate and defend the claim. A recurring issue is what happens when notice is not timely. Does the insured lose coverage, automatically, or only when the insurer is prejudiced by the late notice?
The answer can vary depending on what state’s law applies – in Wisconsin, this issue is seemingly answered not as much by policy language or case law but by two different statutes, Wis. Stat. §§ 631.81 and 632.26, each of which expressly states than an insured loses coverage only where the insurer is “prejudiced” by late notice.
Avoiding the Minefields of Claims-Made Insurance PoliciesL. D. Simmons
Many liability insurance policies are now issued on claims-made policy forms. As a business owner, risk manager or insurance broker, it is important to understand the difference between occurrence-based and claims-made forms and the key insurance coverage issues that arise in connection with claims made insurance. This presentation addresses these important topics.
Similar to 2019 Insurance Law Series: 2018 Insurance Coverage Case Law Year in Review (20)
2016 Year in Review: Recent Midwest Legal Decisions Impacting Real Estate and...Quarles & Brady
In 2016, the Midwest (which we will define as Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, Ohio, and Wisconsin) saw a number of statutory changes and court decisions that reshaped and framed a number of key issues every developer, design professional, owner, lender, contractor, and real estate and construction lawyer must know.
Key Bankruptcy Considerations Heading into a RecessionQuarles & Brady
As the impact of the COVID-19 pandemic continues to evolve, US businesses are already feeling the impact of a potential economic downturn. Presenters will discuss key considerations that may present themselves in the event of a recession, including modification and forbearance agreements, amendment/default scenarios, risks regarding "slow pay" and termination of key contracts, and priority rights of suppliers in bankruptcy, as well as implications of the Small Business Bankruptcy Act for potential debtors.
Action Steps for Your Employee Benefits Plan During the Coronavirus PandemicQuarles & Brady
With the enactment of two new Coronavirus-related laws, plan sponsors of retirement, health and welfare plans have several "must-do" items to consider, along with several "optional" items. Join us for this informative webinar where we will discuss the different legal considerations plan sponsors and service providers (such as third party administrators, insurance brokers and pharmacy benefit mangers) should consider for their retirement, health and welfare plans.
We will discuss:
-What coronavirus testing must be covered by health plans
Important changes to "over the counter" drugs and medicine
-Addressing layoffs and furloughs, and how to survive the benefit costs
-Best practices for distribution and loan options for those who have been affected
-Delaying, repaying and fixing 2020 required minimum distributions
-How to treat paid leave under your retirement plans
Guidance for Employers During the Evolving COVID-19 PandemicQuarles & Brady
As the impact of the COVID-19 pandemic continues to rapidly evolve, U.S. employers are wrestling with many workforce issues to ensure workforce safety and mitigate operational disruptions. Our discussion will present key considerations for employers relating to employee workplace safety, implementing policies and procedures for working remotely, handling issues of paid and unpaid leave for employees or family member care, as well as addressing travel restrictions, all within the context of FMLA, EEOC, wage and hour and other legal guidelines. A question and answer period will follow the presentation.
Guidance for Employers During the Evolving COVID-19 PandemicQuarles & Brady
As the impact of the COVID-19 pandemic continues to rapidly evolve, U.S. employers are wrestling with many workforce issues to ensure workforce safety and mitigate operational disruptions. Our discussion will present key considerations for employers relating to employee workplace safety, implementing policies and procedures for working remotely, handling issues of paid and unpaid leave for employees or family member care, as well as addressing travel restrictions, all within the context of FMLA, EEOC, wage and hour and other legal guidelines. A question and answer period will follow the presentation.
Business Law Training: Market Turmoil in D&O Insurance and Is Your Company Pr...Quarles & Brady
This lively discussion focused on the market turmoil in the current public and private D&O markets. Additionally, the professionals explained the scope of Cyber Insurance for tradition exposures, operational risk and regulatory compliance.
Understand the SECURE Act, the Repeal of the “Cadillac Tax” and Other Health ...Quarles & Brady
After stalling in the Senate for much of 2019, the long expected passage of the SECURE Act became a reality through a quiet attachment to the approved year-end spending bill. This session covered the Act's impact on important aspects of your benefit plans, along with the repeal of the so-called "Cadillac Tax" and other benefit changes included in the spending bill. Attendees were able to gain the information needed to comply with this newly passed legislation and ways to adapt their benefits to take full advantage of the law. We presented the formal legal changes as well as our perspectives on what compliance means on a practical level. Time for Q&A was planned near the end of the session.
Car Accident Injury Do I Have a Case....Knowyourright
Every year, thousands of Minnesotans are injured in car accidents. These injuries can be severe – even life-changing. Under Minnesota law, you can pursue compensation through a personal injury lawsuit.
How to Obtain Permanent Residency in the NetherlandsBridgeWest.eu
You can rely on our assistance if you are ready to apply for permanent residency. Find out more at: https://immigration-netherlands.com/obtain-a-permanent-residence-permit-in-the-netherlands/.
ALL EYES ON RAFAH BUT WHY Explain more.pdf46adnanshahzad
All eyes on Rafah: But why?. The Rafah border crossing, a crucial point between Egypt and the Gaza Strip, often finds itself at the center of global attention. As we explore the significance of Rafah, we’ll uncover why all eyes are on Rafah and the complexities surrounding this pivotal region.
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Responsibilities of the office bearers while registering multi-state cooperat...
2019 Insurance Law Series: 2018 Insurance Coverage Case Law Year in Review
1. 2018 Insurance Coverage
Case Law Year in Review
2019 Insurance Law Series – Wisconsin State Bar
March 22, 2019
Jeff Davis
Pat Nolan
Alex Shortridge
Joe Poehlmann
2. Overview
•Supreme Court rulings concerning:
•When negligent supervision leads to an intentional tort
•Application of notice requirements for UIM coverage
•Number of occurrences in a forest fire that destroys
multiple structures
•Rights of a non-breaching carrier against breaching
carrier where both are obligated to defend
2
3. Overview
•Court of Appeals sets up an interesting 2019, deciding a
number of issues to be reviewed by the Supreme Court:
• Whether the duty to defend in a D&O policy is triggered
where officer/shareholder is sued in capacity as shareholder
but not as an officer
• Availability of theft loss coverage under various policies
• Whether "knowing violation of rights of another" exclusion
requires proof of intent to avoid coverage
3
4. Talley v. Mustafa, 2018 WI 47
• Shop owner sued for negligence in supervising or hiring an employee who assaulted a customer
• Long thought to be a covered risk in WI based on Doyle, which held that a CGL policy covered
employers against this type of claim
• The Supreme Court at least partially overruled Doyle, holding that there was no occurrence
(defined as "accident") since the assault was clearly intentional and a barebones allegation that
"an employer should have trained an employee not to intentionally punch a customer in the
face" was not covered.
• Rejected argument that shop owner's alleged negligence in supervising could supply the
needed "occurrence" element
• Court noted the complaint's failure to sufficiently plead that aspect of the claim, so
hopefully this narrows the ruling's effect
• Where does Wisconsin stand now on coverage for negligent supervision leading to an
intentional tort?
4
5. Steadfast Ins. Co. v. Greenwich Ins. Co., 2019 WI 6
• Arose out of the "great flood" of 2008. Metropolitan Milwaukee
Sewage District (MMSD) MMSD faced multiple lawsuits based on
an alleged failure to properly operate and maintain a sewer
system that led to backups.
• MMSD was an additional insured under two policies issued by
Greenwich and Steadfast to two different contractors that had
operated and maintained the system at two different times.
• MMSD tendered defense to Greenwich and Steadfast. Steadfast
agreed to defend; Greenwich refused.
5
6. Steadfast Ins. Co. v. Greenwich Ins. Co. (continued)
• Steadfast sued Greenwich on a subrogation theory, claiming it
stepped into MMSD’s shoes and was entitled to full reimbursement of the
defense costs.
• Greenwich argued that its "other insurance" clause made it excess over
Steadfast, so it had no coverage or defense obligation.
• Supreme Court rejected the "other insurance" argument, finding
Greenwich in breach. However, it did not award the full defense costs on
Steadfast, but instead allocated costs on a "pro rata by limits" theory.
Court also affirmed award of attorneys fees for establishing the breach,
consistent with prior case law
6
7. Shugarts v. Mohr, 2018 WI 27
•Timeline:
• October 2010 - Mohr hits Shugarts’ squad car, severely injuring Shugarts
• January 2012 - Mohr’s insurer (Progressive) denies coverage, claiming that
Mohr acted intentionally
• June 2013 - Shugarts sues Mohr and Progressive; Progressive offers $10k
settlement and provides declarations page showing $50k limit
• October 2014 - Progressive offers $50k limit
• October 2014 - Shugarts notifies his insurer (Allstate) of underinsured
motorist (UIM) claim
• Was UIM notice late?
7
8. Shugarts v. Mohr (continued)
•Trial court and Court of Appeals agreed with Allstate that
Shugarts forfeited coverage by not providing timely notice
•Supreme Court reversed, holding duty to give notice first
arose when Progressive tendered its limits:
• UIM section required notice of “claim,” not of “accident” or
“loss”
• Under exhaustion provision, no UIM claim existed until
Progressive tendered its limits
•Broader application?
8
9. SECURA Ins. v. Lyme St. Croix Forest Co., LLC, 2018 WI 103.
•Forest fire spread from a lumber company's operations to
other properties over three days, burning 7,500 acres in
NW Wisconsin
•Lumber company had CGL policy with a $2 million
aggregate and $500,000 per occurrence limit
•Supreme Court addressed whether, under these facts, the
fire was a single occurrence or multiple occurrences.
• If the latter, then $2 million in coverage would be available for
the losses
9
10. Lyme-St. Croix Forest Co. (continued)
•The Court framed the issue as whether there was a new
occurrence each time the fire crossed a property line
causing damage to new property
• Court of Appeals: each new item of property damage
constituted new occurrence
• Supreme Court reverses
• "Cause theory" applies "where a single, uninterrupted cause results
in all of the injuries or damages" there is a single occurrence.
• Focus is on "cause" and "result" and whether they are closely linked
in "time" and "space" to equal one event.
10
11. Lyme-St. Croix Forest Co. (continued)
Case Name "Cause" "Effect" Time Space Number of
occurrences
Welter v.
Singer (1985)
Car-bicyclist
collision
Multiple discreet
bodily injuries
Minutes Single location Single
Plenco v.
Liberty Mutual
(2009)
Sale of
asbestos
containing
products
Multiple individual
injuries / deaths from
asbestos exposure
Over 20 years Multiple locations Multiple
Wilson Mutual
v. Falk (2014)
Manure
spreading
Contamination of
multiple water wells
5 months Multiple locations Multiple
Secura v. Lyme
St. Croix Forest
Co. (2018)
Forest fire Multiple instances of
real and personal
property damage
3 days Single (albeit large)
location
Single
11
12. West Bend Mutual v. Ixthus Medical Supply, 2019 WI 19
• Abbott Labs manufactured blood glucose strips for international and
domestic markets. Only the ones for domestic markets were eligible for
Medicare reimbursement. Several of Abbott's wholesalers, including
Ixthus, allegedly sold the international ones domestically, causing Abbott
to pay fraudulent reimbursement claims. Abbott sued under New York law
on 13 theories of fraud and trademark violations.
• Ixthus sought coverage from West Bend, who denied any duty to defend
(1) because there was no "advertisement" and no causation and (2) based
on the "Knowing Violation of Rights of Another" exclusion, which bars
coverage for injury "caused by or at the direction of the insured with
knowledge..."
12
13. West Bend (continued)
• The Wisconsin Supreme Court found that West Bend owed a duty to defend
• The Court affirmed the Court of Appeals ruling that the mere trade design could supply the required
“advertising” made in course of a covered offense.
• Rejected arguments that Ixthus was a distribution defendant, not an advertising defendant and that
Ixthus's acts did not cause the advertising injury: Ixthus need not be “the first, last or only entity”
alleged to advertise in order to be engaged in covered advertising activity… Further, ‘advertising
injury need not be the sole cause of harm…’”
• Affirmed that the knowing violation exclusion does not bar defense of claims where intent is not a
required element:
• The knowing violation exclusion will preclude coverage at the duty-to-defend stage only when every claim alleged in the
complaint requires the plaintiff to prove the insured acted with knowledge that its actions “would violate the rights of
another and would inflict ‘personal and advertising injury.”’ If the complaint alleges any claims that can be proven
without such a showing, the insurer will be required to provide a defense.
13
14. Leicht Transfer & Storage Co. v. Pallet Cent. Enterprises, Inc.,
2018 WI App 35.
•Policyholder suffered a $500K financial loss after a vendor
fraudulently charged it for shipping pallets that
policyholder never ordered or received
• Vendor sent fraudulent invoices to policyholder with a delivery
receipt containing forged signature of policyholder employee
• Policyholder paid vendor's fraudulent invoices based on the
signature
• Policyholder first passed charges to its customer, then
reimbursed customer after discovering the fraud
14
15. Leicht Transfer (continued)
• Leicht searches for coverage...
• Crime policy's forgery coverage. Court of Appeals: coverage applies
narrowly to fraudulent checks, draft and promissory notes, and did not
include doctored invoices as a defined "forged instrument"
• CGL policy. Court of Appeals: money reimbursed to its customers
wasn't "physical injury" to "tangible property"
• Cargo handling policy. Court of Appeals: the pallets at issue, upon
which the fraud was based, were never actually accepted for
transportation, thus defeating coverage
• Granted review by Supreme Court
15
16. Leicht Transfer (continued)
• Coverage Gap Problem:
• Typical crime policy provide coverage for theft by employees
• Typical crime policy does not cover theft losses perpetrated by
contractors or vendors
• Risk Management Solutions?
• Ensure vendor has a fidelity bond which lists your company as payee
• Obtain "agency coverage" or an "agents coverage endorsement" under
your crime policy, naming vendor as insured/employee
• Enact better internal controls
16
17. Estate of Rivera v. West Bend Mutual Ins., 2018 WI App 14.
• Rivera, while working for temporary employer (Alpine), is fatally
injured while riding in vehicle owned by Alpine
• Rivera's estate did not make a worker's compensation claim;
instead, it brought a tort claim against Alpine
• Issue: Section 102.29(6)(b)(1) bars an injured temporary
employee from filing a tort action against the borrowing
employer if the employee "makes a claim" for worker's
compensation benefits.
• Does this preclude a tort action against that employer all together, even
if no WC claim made?
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18. Estate of Rivera (continued)
• Court of appeals: No
• So long as a WC claim was never made, the injured employee may file a
tort action against the temporary employer
• WC is exclusive remedy for employee against actual employer (such
as the temp. agency), but not the borrowing employer
• Legislature and Governor: Wait!
• Immediately amended Section 102.29(6)(b)(1) to bar temporary
employees from bringing tort actions against the borrowing employer
• Now bars tort claims of temporary employee who "has the right to
make a claim" for workers comp benefits – even if not made
18
19. Blesener v. Linton, 2018 WI App 21 (unpublished).
• Duty to defend
• Homeowner completes Real Estate Condition Report (RECR) as part of
home sale in which he was alleged to have intentionally omitted known
structural defects to buyer
• Sued by buyers alleging knowledge of defects by seller which allegedly
existed since construction, for which the seller only selected the architect
and builder
• Seller tenders to Liberty Mutual, claiming that the covered "occurrence"
was not the alleged misrepresentation but instead the water damage
resulting from defective construction
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20. Blesener (continued)
• Key question: whether complaint alleges liability for an "accident" that
would qualify as a covered occurrence, or purely for the misrepresentation
• 2007 case (United Cooperative) found initial coverage where insured alleged to
have misrepresented property was also alleged to have contributed to that
property defect in the first place
• Court of appeals agreed with Liberty Mutual that the claims were based on
the misrepresentation, which was not an accident, and found no coverage
• Misrepresentations in a RECR are volitional acts, not accidents (Everson, 2005)
• Because seller wasn't involved in the construction, the only allegations he could
point to for coverage were his misrepresentations...which are not "accidents"
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21. Grigg v. Arrowcast, Inc., 2018 WI App 17
• Stock purchase agreement leads to suspicion of fraud and a
complaint against a shareholder (and executive) involved in the
transaction
• Complaint sues the shareholder "in his capacity as a shareholder
but not as an officer and director" where the underlying
complaint against the executive nevertheless included allegations
faulting his conduct as an executive
• Coverage sought under D&O policy as a "claim" alleging a
"wrongful act" defined as acts "committed by an Insured Person
in their capacity as such."
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22. Grigg v. Arrowcast (continued)
•Hudson had a duty to defend a business executive sued
"in his capacity as a shareholder but not as an officer and
director" where the complaint included allegations based
on his conduct as an executive.
•"The duty to defend is determined using the four-corners
rule"
•"[T]he duty-to-defend analysis turns on the facts pled, not
the plaintiff's theory of liability...."
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23. Coverage for Losses Caused by Phishing
• Second and Sixth Circuits both found for policyholders, ruling coverage
under computer fraud policies where email-based theft schemes caused
losses.
• Second Circuit (Medidata Solutions v. Federal Ins.): Federal must cover a $4.8 M loss
suffered when the insured was tricked into wiring money overseas when the
fraudster posed as insured's president in emails.
• Sixth Circuit (American Tooling Center v. Travelers): Travelers must cover over
$800,000 the insured lost when fraudsters posing as a vendor used fraudulent
emails to trick the company into wiring money to a sham account.
• Both panels rejected insurers' argument that the policies were designed to
only cover direct hacking into policyholders' computers.
23
24. KeySpan v. Munich Re, 96 N.E.3d 209 (N.Y. 2018)
• In long tail continuous injury cases involving multiple years, issues arise as to the amount of
coverage for a particular claim when there is coverage in some of the years but not others—the
issue in such cases is whether the insured is entitled to full coverage (or "all sums" per the policy
language) under any triggered policy or only some pro rata share. Courts are split.
• Within pro rata jurisdictions there is a further split on whether the periods encompassing the
insured's share of the loss includes periods where insurance was not "available"on the market,
e.g., post 1986 due to asbestos and absolute pollution exclusions.
• In March, 2018 New York's highest court ruled that New York would not recognize an
"unavailability exception" which will have the effect of placing an extremely large proportion of
long tail losses on the policyholder.
• Three months later New Jersey's highest court went the other way. Continental Ins. Co. v.
Honeywell, 188 A.3d 297 (N.J. 2018).
• Fortunately, this is not an issue in Wisconsin, which is an "all sums" state.
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25. Kimmelman v. Wayne Ins. Grp. (Ohio)
• National first impression: whether Bitcoin constitutes covered
property under a homeowner's policy
• Policyholder lost $16,000 in BitCoin; submitted claim as stolen property
• Wayne Ins. considered it "money," which the policy limited to $200
• Ohio trial judge: $16,000 in BitCoin stolen from insured's online
account is covered property because the IRS treats BitCoin as
"virtual currency," which is treated as property rather than
money for federal tax purposes
• Prediction: this could lead to insurers introducing policy language
curtailing coverage for bitcoin losses.
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26. Ohio Northern University v. Charles Construction (Ohio Supreme Court)
• General contractor's (Charles Construction) liability policy included
products-completed operations-hazard (PCOH) coverage, with
subcontractor exception to "your work" exclusion
• "This exclusion does not apply if the damaged work or the work out of
which the damage arises was performed on your behalf by a
subcontractor"
• Nevertheless, Court ruled no coverage (due to no "occurrence") for $6
million of damage caused by subcontractors' faulty work
• Now what?
• Ohio is distinct minority, but be wary!
• Endorsements available to modify definition of "occurrence"
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27. Berry Plastics Corp. v. IL Nat. Ins. Co. (7th Cir.)
•Berry provided faulty components that damaged
customer's products and caused customer to lose sales
•Customer won $7.2M judgment against Berry, $6.5M of
which was for customer's projected lost profits over next
10 years
•Question: Do liability policies cover economic losses (e.g.,
lost profits) caused by property damage?
•Court: Yes, but policyholder must prove causation, which
Berry failed to do
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