In Kayle Flores v. Life Insurance Company of North America1 (“Flores II”), the Ninth Circuit agreed with the insured and reversed the Central District of California’s finding that her Long-Term Disability claim was barred by res judicata. This case has a happy ending for the insured, but really underscores the importance of proceeding against a disability insurer […]

In National Casualty Company v. Georgia School Board Association – Risk Management Fund1, the Eleventh Circuit recently affirmed a Georgia rule under which irreconcilable “other insurance” clauses will not be enforced. The Eleventh Circuit found that, under Georgia law, when insurance policies’ “other insurance” clauses are “functionally the same” and cover the same risk, they […]

Federal and state courts tackled many interesting insurance-related issues this past year. Perhaps no state had a more impactful year than Illinois, which held that construction defects could constitute an occurrence, that a LEG 3 “extension” attempting to preclude coverage for faulty or defective workmanship was ambiguous as a matter of law (applying Illinois law), […]

The Tenth Circuit’s recent broad application of Oklahoma law on “interrelated acts” creates concerning precedent for policyholders seeking to maximize coverage under a professional liability policy with per claim limits. In this regard, careful pre-loss planning and policy modifications may prevent unexpected coverage gaps and avoid surprise exposure. In addition, post-loss strategic planning may prove […]

When an insurer handles a claim in violation of its duty to act in good faith, policyholders are often eager to sue the insurer for bad faith, seeking extra contractual damages. Before filing suit, however, it is critical that policyholders consider what state’s law applies to the bad faith claim. In the recent case of Scott […]

A majority of insurance policies require the insured to cooperate with the insurer. The cooperation clause generally states, “the insured agrees to Cooperate with us in the investigation, settlement or defense of the suit.” The “cooperation clause” is often an afterthought because once litigation has ensued an insured is focused on other important considerations. However, […]

Illinois joins the majority of states finding “property damage that results inadvertently from faulty work can be caused by an ‘accident’ and therefore constitute an ‘occurrence’.” The Illinois Supreme Court’s ruling in Acuity v. M/I Homes of Chicago, LLC1 (“Acuity v. M/I Homes”) is the first high court ruling in Illinois on this critical coverage issue for […]

It is well known that insurance policies universally impose a requirement that a “claim” be timely submitted. Unfortunately, this basic coverage condition is so well known that policyholders often overlook what exactly constitutes a “claim” under their insurance policy. A decision rendered by the United States District Court for the Southern District of New York […]

Builders risk claims routinely involve complicated and aggressive debate about the interplay between covered physical loss and uncovered faulty work. However, denials on this front have recently experienced a noticeable uptick in frequency, creativity, and aggressiveness. The insurer arguments concentrate in two key areas with a common theme – that any damage associated with a […]