Blog: Insurance Claims

California’s complex saga of long-tail injury coverage under general liability policies took an interesting turn in the California Supreme Court’s recent decision in Truck Ins. Exch. v. Kaiser Cement.¹  In Truck, the court made it clear that Insureds can access excess policy limits without first exhausting all triggered underlying primary coverage, provided the underlying limits for the same policy period have been exhausted.

A recent decision by a federal court helps clear the path to coverage for property owners this hurricane season. The Court deemed one property policy’s flood exclusion inapplicable to bar coverage for water damage from backed-up drainage and overflow caused by excessive rainfall. The case, styled G.E.M.S. Partners LLC v. AmGUARD Ins. Co., — F.Supp. 3d —, No. CV 22-1664, 2024 WL 3568932 (D.N.J. July 29, 2024)), involved a familiar dispute between the insured and insurer following damage to covered property after a named storm’s heavy rainfall.

Despite best intentions, sometimes policyholders encounter challenges adhering to the applicable statute of limitations or their policy’s limitation of suit deadline. In complex insurance claims, identifying, comprehending, and accurately quantifying significant and long-term losses may take several years. Even when all losses are readily apparent, the insurer may invest months or years in scrutinizing the […]

Effective August 1, 2024, the NCAA will provide excess injury insurance coverage to student-athletes for athletic injuries for two years, beginning on a student-athlete’s date of separation from its member institution. The policy, with a coverage limit of $90,000 per injury and no deductible burden on the athlete, will be issued through Mutual of Omaha […]

As Florida insurers continue their attempts to narrow protections for policyholders, it is imperative – now more than ever – that insureds be well-informed and know their rights. Most recently, in Florida, insurers are attempting to weaponize the death of Senate Bill 1726 and House Bill 1287 to limit the documents disclosed to policyholders. Specifically, […]

On November 21, 2022, in the first case ever to reach a jury against the National Collegiate Athletic Association (“NCAA”), a Los Angeles County jury found the NCAA was not responsible for the death of former University of Southern California linebacker Matthew Gee. Gee played for the Trojans when the team won the Rose Bowl […]

While analyzing liability policies, courts grapple with a common issue: what constitutes a claim under a claims-made or claims-made-and-reported provision? When third-party claimants file suit, the analysis is often straightforward; the complaint itself is the claim. The analysis becomes murkier, however, when courts must determine whether a pre-suit notice—such as a demand letter—constitutes a claim. […]

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), […]

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, […]

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 […]

It is rare for the U.S. Supreme Court to grant certiorari in cases involving issues of insurance. However, the Court’s decision to grant certiorari in Great Lakes Insurance SE v. Raiders Retreat Realty Co., LLC, 143 S. Ct. 999 (2023), may substantially alter the use of choice-of-law provisions in maritime insurance policies, and possibly, insurance policies […]