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Litigating Insurance Disputes

Litigating Insurance Disputes

  • Author:
  • Publisher: Juris Publishing_
  • ISBN: 9781929446124
  • Published In: December 2018
  • Format: Loose-leaf + CD-ROM , 624 pages
  • Jurisdiction: U.S. ? Disclaimer:
    Countri(es) stated herein are used as reference only
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    This comprehensive single-source reference addresses all key litigation issues involving insurance disputes, including invaluable forms on CD-ROM. With coverage providing an even-handed approach Litigating Insurance Disputes is a necessary and invaluable addition to any lawyer's office library who is either an advocate for insurers or policy holders. From choice-of-law, to the advantages of seeking a declaratory judgment, to discovery and trial techniques, to case management and arbitration Litigating Insurance Disputes serves as a starting point for information on a specific topic or as a checklist of one’s general responsibilities and obligations.

  • Part I Overview of Basic Insurance Issues 

    Chapter 1: Liability Insurance: A General Introduction

        1.01 Introduction
        1.02 Obtaining Insurance - Applications
        1.02A Severability
        1.03 Binders
        1.04 Certificates of Insurance
        1.05 Automobile Insurance
        1.06 General Policy Terms in Auto Policies
        1.07 Uninsured and Underinsured Motorists Clauses
        1.08 Commercial General Liability Insurance
        1.09 Professional Liability Insurance
        1.10 Directors' and Officers' Liability Insurance
        1.11 Workers' Compensation Liability Insurance
        1.12 Layers of Insurance - Primary Insurance
        1.13 Excess Insurance
        1.14 Umbrella Insurance
        1.15 Reinsurance

        Appendix 1A Commercial General Liability Coverage Form
        Appendix 1B Specialty Errors or Omissions Liability Insurance Form
        Appendix 1C Lawyers Professional Liability Insurance Form

    Chapter 2: How to Read a Business Liability Policy

        2.01 Parts of a Liability Policy Introduction
        2.02 Declarations
        2.03 Insuring Agreement
        2.04 Definitions
        2.05 Exclusions
        2.06 Endorsements
        2.07 Conditions
        2.08 Analysis of Liability Policy - Introduction
        2.09 Declarations - Named Insured
        2.10 Policy Period and Monetary Limits of Liability
        2.11 Insuring Clause with Definitions
        2.12 Conditions
        2.13 Issues Concerning Lost Policies -  Introduction
        2.14 Secondary Evidence of Lost Policies
        2.15 Types of Secondary Evidence
        2.16 Conclusion

    Chapter 3: Rules of Liability Policy Construction

        3-01 General Rules of Construction - Policy as Contract
        3.02 Plain Meaning of Insurance Contract
        3.03 Ambiguous Policy Terms
        3.04 Centra-Insurer Doctrine
        3.05 States Applying Contra-Insurer Doctrine
        3.06 Reasonable Expectations Doctrine
        3.07 Application of Reasonable Expectations Doctrine
        3.08 States Applying Reasonable Expectations Doctrine
        3.09 Extrinsic Evidence Concerning Intentions of Parties
        3.10 Rules of Construction in Business Insurance Application of Contra-Insurer Rule
        3.11 Size and Insurance Sophistication of Business Insured
        3.12 Disputes Between Insurers
        3.13 Involvement of Brokers and Counsel
        3.14 Manuscript Policy
        3.15 Rejection of Business Insured Exception
        3.16 Renewal of Insurance Policy
        3.17 Notice of Proposed Changes in Renewal Policy
        3.18 Cancellation of Policy
        3.19 Notice
        3.20 Conclusion

        Appendix 3A States Following Contra-Insurer Doctrine
        Appendix 3B States Following Reasonable Expectations Doctrine

    Chapter 4: Insured's Duty of Notice and Cooperation

        4.01 Purpose of Notice Requirement
        4.02 Insured's Duty to Notify Insurer - Sufficiency of Notice
        4.03 To Whom Given
        4.04 By or Through Whom Given
        4.05 Timeliness of Notice
        4.06 Late Notice
        4.07 Prejudice and Late Notice
        4.08 Majority View: Prejudice Required
        4.09 Minority and Traditional View: Prejudice Not Required
        4.10 Circumstances Excusing Late Notice
        4.11 Lack of Knowledge of the Occurrence
        4.12 Reasonable Belief that a Claim Would Not Arise or be Asserted
        4.13 Lack of Knowledge of Coverage
        4.14 Other Circumstances Excusing Late Notice
        4.15 Notice Required by Other Types of Policies - Excess Insurance
        4.16 Notice by Insurer
        4.17 Claims-Made Policies
        4.18 Insured's Duty to Cooperate with the Insurer
        4.19 Insured's Failure to Cooperate Failure to Disclose Information
        4.20 Insured's Cooperation or Settlement with Claimant
        4.21 Insured's Refusal to Testify or Attend Trial
        4.22 Insurer's Waiver of Insured's Breach of Cooperation

    Chapter 5: Insurer's Duty to Defend

        5.01 Assessing Insurer's Duty to Defend - Existence of Duty in General
        5.02 Duty to Defend Determined by Allegations of Complaint Against Insured
        5.03 Insurer's Knowledge of Extrinsic Information Concerning Allegations of Complaint
        5.04 Conflicts of Interest
        5.05 Self-Insured Retention and Directors' and Officers' Duty to Defend - Self-Insured Retention
        5.06 Directors' and Officers' Policy
        5.07 Excess Insurer's Duty to Defend
        5.08 Limits of Duty to Defend - Amendment or Dismissal of Claims
        5.09 Exhaustion of Policy Limits
        5.09 A Exhaustion of Policy on Behalf of Less Than All Insurers
        5.10 Tender of Policy Limits
        5.11 Apportioning Duty to Defend Between Potentially Covered and Non-Covered Claims
        5.12 Effect of Insurer's Refusal to Defend - Waiver and Estoppel
        5.13 Theories of Recovery for Refusal to Defend
        5.14 Damages Recoverable for Breach of the Duty to Defend

    Chapter 6: Reservation of Rights and Conflicts of Interest

        6.01 Introduction
        6.02 Reservation of Rights - Legal Basis
        6.03 Types of Reservation of Rights Letters
        6.04 Non-Waiver Agreements
        6.05 Disclaimers/Declinations
        6.06 Effect of Failure to Reserve Rights - Waiver
        6.07 Estoppel
        6.08 Election of Remedies
        6.09 Excess Insurer's Reservation of Rights
        6.10 Conflicts of Interest Created by Reservation of Rights
        6.11 Intentional Act/Negligence
        6.12 Late Notice
        6.13 Permissive Use
        6.14 Punitive Damages
        6.15 Insured's Selection of Independent Counsel
        6.16 Fees of Independent Counsel

        Appendix 6A Insurers Letter to Insured, Conflict of Interest
        Appendix 6B Non-Waiver Agreement
        Appendix 6C Insurability of Punitive Damages

    Chapter 7: Number of Occurrences or Claims - Deductible and Limits

        7.01 Accident or Occurrence Giving Rise to Liability
        7.02 CGL Insurance Damage - Fortuity Requirement
        7.03 Damage Expected or Intended is Not an Occurrence
        7.04 Insured's Expectation or Intention is Based on an Objective Reasonable Person Standard
        7.05 Number of Occurrences
        7.06 Causation Analysis
        7.07 Unfortunate Event Test
        7.08 Effects Analysis
        7.09 Policy Language and Single or Multiple Occurrences
        7.10 Timing of Bodily Injury or Property Damage
        7.11 Exposure Theory
        7.12 Manifestation Theory
        7.13 Continuous Trigger Theory
        7.14 Injury-in-Fact Theory
        7.15 Special Problems Relating to Claims-Made Policies
        7.16 Definition of a Claim
        7.17 When is a Claim Made?
        7.18 Number of Claims; Related Claims
        7.19 Conclusion

        Appendix 7A Directors and Officers Insurance and Company Reimbursement Policy

    Chapter 8: Relationship of Multiple Insurers

        8.01 Primary and Excess Insurance
        8.02 Duties Owed Between Primary and Excess Insurers
        8.03 Equitable Subrogation
        8.04 Direct Independent Duty
        8.05 Triangular Reciprocity
        8.06 The Nature of the Duty
        8.07 Settlement of Claims Involving Primary and Excess Insurers
        8.08 Settlement for Less Than Primary Insurer's Limits of Liability
        8.09 Primary Insurer Insolvency and Drop Down Liability of Excess Insurers
        8.10 Cases Holding No Drop Down
        8.11 Cases Holding the Excess Insurer Must Drop Down
        8.12 Other Insurance Clauses
        8.13 Resolving Conflicts Between "Other Insurance" Clauses
        8.14 Similar "Other Insurance" Clauses
        8.15 Dissimilar " Other Insurance" Clauses
        8.16 Contribution by Equal Shares vs. Contribution by Limits
        8.17 Conclusion

    Chapter 9: Failure to Settle: Bad Faith and Extra-Contractual Liability

        9.01 Introduction
        9.02 Extent of Bad Faith Required - Negligence Standard
        9.03 Bad Faith Standard
        9.04 Circumstances Demonstrating Bad Faith or Negligence
        9.05 Amount of Consideration Given to Insured's Interest
        9.06 Bad Faith Actions under Unfair Claim Settlement Practice Statutes
        9.07 Insured's Bad Faith Refusal to Settle - Limitations to Bad Faith Actions
        9.08 Defenses to Bad Faith Actions
        9.09 Damages for Bad Faith Refusal to Settle - Compensatory Damages
        9.10 Punitive Damages
        9.11 Damages for Emotional Distress
        9.12 Attorney Fees
        9.13 Conclusion

    Chapter 10: The Role of the Broker

        10.01 Introduction
        10.02 Definition of Broker
        10.03 Legal Effect of Broker's Agency Status
        10.04 Duties Owed by Broker to Insured
        10.05 Brokers Duty to Procure Insurance
        10.06 Broker's Duty to Place Insured with Solvent or Authorized Insurer
        10.07 Broker's Duty to Renew or Service the Insured's Policy
        10.08 Broker's Duty to Notify Promptly of Rejection or Cancellation
        10.09 Broker's Duty to Advise the Insured of Alternative Coverages or Higher Limits
        10.10 Duties Owed by Broker to Insurer
        10.11 Theories of Liability Asserted Against the Broker
        10.12 Negligence Theory
        10.13 Negligent Misrepresentation and Fraud
        10.14 Breach of Fiduciary Duty
        10.15 Breach of Contract
        10.16 The Insured's Duty to Read the Policy as a Defense to Broker's Misconduct
        10.17 The Broker's Right to Litigate the Issue of Coverage as a Defense to Liability
               

    Part II Litigation and Arbitration in Insurance Disputes 

    Chapter 11: Choice-of-Law Resolution in Insurance Cases

        11.01 Introduction
        11.02 Choice-of-Law Resolution
        11.03 The First Restatements Lex Loci Approach
        11.04 The Second Restatements Most Significant Relationship Test
        11.05 Governmental Interest Analysis
        11.06 Choice Influencing Considerations
        11.07 Variations in Method Application - Issue Splitting and Multiple Risk Policies - Depecage
        11.08 Multiple Risk Policies
        11.09 Federal-State Differences
        11.10 Tort-Contract Distinctions
        11.11 Conclusion

        Appendix 11A State-by-State Approach
        Appendix 11B Summary of Results: Breakdown by Rules Applied

    Chapter 12: Declaratory Judgment Litigation Issues and Strategies

        12.01 Introduction
        12.02 Statutory Basis for Declaratory Judgment Actions
        12.03 Jurisdiction, Venue, and Service of Suit Causes
        12.04 Proper Parties
        12.05 Justiciable Controversy
        12.06 Preemptive Suits and Prior Pending Actions
        12.07 Burden of Proof of Insured and Insurer in Declaratory Judgment Action
        12.08 Right to Trial by Jury in a Declaratory Judgment Action
        12.09 Attorney Fees Incurred in Declaratory Judgment Actions
        12.10 Fees Not Recoverable
        12.11 Fees Recoverable

    Chapter 13: Discovery and Case Management in Declaratory Judgment Actions

        13.01 Scope of Discovery
        13.02 Attorney-Client Privilege
        13.03 Work Product Doctrine
        13.04 Waiver of Privilege
        13.05 Protective Orders
        13.06 Reinsurance and Privilege
        13.07 Reserves Information and Privilege
        13.08 Discovery of Claims of Other Insuneds
        13.09 Case Management and Cost Sharing

        Appendix 13A Joint Defense Agreement
        Appendix 13B Sample Protective Order
        Appendix 13C Sample Case Management Order
        Appendix 13D Sample Cost Sharing Agreement

    Chapter 14: Arbitration in Insurance Disputes

        14.01 Introduction
        14.02 Arbitration Statutes
        14.03 The Arbitration Agreement - Formal Requirements
        14.04 Broad and Narrow Arbitration Clauses
        14.05 Avoiding the Arbitration Agreement for Drafting Deficiencies or Formation Defects
        14.06 Arbitration Procedure - The Demand to Arbitrate
        14.07 Appointing the Arbitration Panel
        14.08 Arbitrator Partiality
        14.09 Time Within Which Arbitrators Must Act
        14.10 Scope of Discovery
        14.11 Parties to the Arbitration
        14.12 Arbitration Award - Form and Content of the Award
        14.13 Effect of the Award
        14.14 Grounds for Vacating the Award
        14.15 Appealing the Award

        Appendix 14A Sample Arbitration Clauses
        Appendix 14B Sample Arbitrator Disclosure Statement

                Part III Special Litigation Problems 

    Chapter 15: Litigating Directors and Officers Coverage Claims

        15.01 Introduction
        15.02 Directors' and Officers' Policies - Two-Part Claims-Made Policy
        15.03 Possible Insureds
        15.04 Wrongful Act
        15.05 Loss
        15.06 Costs Included in Limits
        15.07 Claims-Made" Fonn
        15.08 Rescission of the D&O Policy Based on Fraud or Misrepresentation
        15.09 Cancellation/Non-Renewal of Policy
        15.10 Defense Cost Reimbursement under D&O Policies
        15.11 Obligation to Reimburse Contemporaneously
        15.12 No Obligation to Reimburse Contemporaneously
        15.13 Allocation of Defense Costs
        15.14 Exclusions
        15.15 Deliberate Dishonesty Exclusion
        15.16 Insured vs. Insurer Exclusion
        15.17 Regulatory Exclusion
        15.18 Personal Profit Exclusion
        15.19 The Securities Exclusion
        15.20 Fines & Penalties

    Chapter 16: Advertising Liability Coverage

        16.01 Introduction
        16.02 Advertising Liability Clauses
        16.03 The Importance of the Nexus to Advertising Activity in Restricting Policy Coverage
        16.04 International Insurance Co. v. Florist Mutual Insurance Co,
        16.05 National Union Fire Ins, Co. v. Siliconix, Inc
        16.06 Bank of the West v. Superior Court
        16.07 A Meyers & Sons Corp. v. Zurich American Insurance Group
        16.08 Lazzara Oil Co. v. Columbia Casualty Co.
        16.09 Nexus Requirement Held to be Satisfied
        16.10 Jefferson-Pilot Fire &. Casualty Co. v. Booth, Prichard dc Dudley
        16.11 John Deere Insurance Co. v. Shamrock Industry, Inc.
        16.12 Coverage for Infringement of Trademark and Trade Dress

    Chapter 17: Litigating Environmental and Toxic Tort Coverage Claims

        17.01 Overview of Environmental Coverage Concerns
        17.02 Potentially Available Coverages - Commercial General Liability Coverage
        17.03 Environmental Impairment Liability Coverage
        17.04 Other Coverages
        17.05 Typical Environmental Coverage Issues
        17.06 Is There a "Suit" Requiring a Defense? - Potentially Responsible Party Letters
        17.07 Administrative Orders
        17.08 Are Damages Sought?
        17.09 Was There an Occurrence, and Related Issues? - Accidental, Unexpected, and Unforeseen Injury
        17.10 Known Risk
        17.11 Number of Occurrences
        17.12 Timing of Property Damages
        17.13 Potentially Applicable Exclusions: Overview
        17.14 The Standard Pollution Exclusion
        17.15 Types of Pollution Governed by the Standard Pollution Exclusion Clause
        17.16 To What Type of Pollution Does the Pollution Exclusion Apply?
        17.17 The Sudden and Accidental Exception
        17.18 Cases Holding "Sudden" Means "Unexpected"
        17.19 Cases Holding "Sudden" Has Temporal Meaning
        17.20 What Does Accidental Mean in the Sudden and Accidental Exception?
        17.21 Interplay Between "Occurrence" and the Standard Pollution Exclusion
        17.22 Cases Holding Pollution Exclusion Clause in Coextensive with Occurrence Definition
        17.23 Cases Holding Pollution Exclusion Clause Not Coextensive with Occurrence Definition
        17.24 The Absolute Pollution Exclusion
        17.25 Owned Property and Care, Custody, or Control Exclusions
        17.26 Choice of Law
        17.27 Forum Non Conveniens in Multi-Site Litigation
        17.28 Personal Injury Coverage for Environmental Claims
        17.29 Regulatory Estoppel
        17.30 Allocation

        17.31 Investigation Costs-Defense or Indemnity


    Chapter 18: Employment Liability Coverage

        18.01 Introduction
        18.02 Comprehensive General Liablility Insurance
        18.03 Review of Other Liability Insurance
        18.04 Employment Practices Liability Insurance (EPU)

        Appendix 18A Specimen Policy and Application

    Chapter 19: Fiduciary Responsibility Insurance

        19.01 Introduction
        19.02 Fiduciary Liability
        19.03 Claims-Made Policy
        19.04 Named Insured
        19.05 Wrongful Act
        19.06 Loss or Damages
        19.07 Insuring Agreement
        19.08 Deductible and Limits
        19.09 Exclusions
        19.10 Claims-Made Extension Clause
        19.11 Other Key Policy Provisions
        19.12 The FRIP Policy as Compared to Other Insurance Policy Forms
        19.13 Conclusion

    Table of Cases

    Table of Authorities

    Index

     

    CD- ROM Table Of Contents

    Part I Overview of Basic Insurance Issues

    Chapter 1: Liability Insurance: A General Introduction

    Appendix 1A Commercial General Liability Coverage Form
    Appendix 1B Specialty Errors or Omissions Liability Insurance Form
    Appendix 1C Lawyers Professional Liability Insurance Form

    Chapter 6: Reservation of Rights and Conflicts of Interest

    Appendix 6A Insurers Letter to Insured, Conflict of Interest
    Appendix 6B Non-Waiver Agreement
    Appendix 6C Insurability of Punitive Damages

    Chapter 7: Number of Occurrences or Claims - Deductible and Limits

    Appendix 7A Directors and Officers Insurance and Company Reimbursement Policy

    Part II Litigation and Arbitration in Insurance Disputes

    Chapter 13: Discovery and Case Management in Declaratory Judgment Actions

    Appendix 13A Joint Defense Agreement
    Appendix 13B Sample Protective Order
    Appendix 13C Sample Case Management Order
    Appendix 13D Sample Cost Sharing Agreement

    Chapter 14: Arbitration in Insurance Disputes

    Appendix 14A Sample Arbitration Clauses
    Appendix 14B Sample Arbitrator Disclosure Statement

    Part III Special Litigation Problems

    Chapter 18: Employment Liability Coverage

    Appendix 18A Specimen Policy and Application

  • Edward J. Zulkey is a Partner and General Counsel to the firm of Baker & McKenzie where he practices in its Chicago office. He practices primarily in the fields of liability insurance-related issues and professional liability. He is former Vice-Chair of the ABA/TIPS' Committee on Excess and Reinsurance, Co-Chair of the Legal Malpractice Subcommittee of the ABA/TIPS' Committee on Insurance Coverage Litigation and Chairman, Casualty & Excess Insurance Committee, International Association of Defense Counsel. He has written numerous articles and lectured extensively in the field of insurance coverage.

  • Praise For Litigating Insurance Disputes

    "Litigating Insurance Disputes is an important book for anyone who regularly represents the business community .. a critical book for those who do not normally practice in the field of insurance. It is well-researched, comprehensive and readable. I heartily recommend this book as a quick, but authoritative, reference source."
    - David J. Beck, 
    Beck Redden & Secrest, Houston; Former President, State Bar of Texas; Former Senior Partner, Fulbright & Jaworski

    "A timely, meticulously-researched and indispensable resource. Litigating Insurance Disputes identifies the most pressing coverage issues of the day. Whether used to survey a topic or 'kick-start' a project this work is an invaluable research tool."
    -Thomas A. Demetrio, 
    Thomas A. Demetrio, Corboy & Demetrio, Chicago; former President, Illinois Trial Lawyers Association and Chicago Bar Association

    "Ed Zulkey, a renowned national expert in insurance law, merges theory and practical knowledge into an invaluable resource. Litigating Insurance Disputes now occupies a place in my office among those works that I keep within arms reach."
    Byron Higgins, University Counsel - University of Illinois, Urbana

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