Exclusion lead-in language (Based upon)

The United States District Court for the District of New Jersey, applying New Jersey law, has held that an insurer does not need to cover more than $480,000 that an insured transferred pursuant to fraudulent instructions. The court determined that the circumstances implicated an exclusion that precluded coverage for loss that arose out of the theft or misappropriation of funds. Authentic Title Servs., Inc v. Greenwich Ins. Co., 2020 WL 6739880 (D.N.J. Nov. 17, 2020).
Continue Reading No Coverage Under E&O Policy for Insured’s Loss of Funds Sent Pursuant to Fraudulent Instructions

A federal district court has ruled that a third-party administrator’s professional liability policy does not afford coverage for a claim against the TPA arising from an excess judgment against the TPA’s insurer-client.  American Claims Mgmt., Inc. v. Allied World Surplus Lines Ins. Co., 2020 WL 5257795 (S.D. Cal. Sept. 3, 2020).

Continue Reading No Coverage for TPA in Claim Arising from Extracontractual Exposure to Insurer

The Supreme Court of Mississippi held that a health care professional services exclusion applies where the damage alleged in an underlying claim would not exist but-for paramedics’ failure to provide medical attention under Mississippi law.  Gray v. Arch Spec. Ins. Co., No. 2013-CA-01124-SCT (Miss. Oct. 23, 2014)
Continue Reading Health Care Professional Services Exclusion Applies Where Injury Would Not Exist But-For Failure to Provide Medical Attention

Applying Texas law, the United States Court of Appeals for the Fifth Circuit has held that a fee dispute exclusion in a bankers liability policy did not apply to bar coverage for claims against the insured bank that involved allegations with respect to overdraft charges.  First Community Bancshares v. St. Paul Mercury Ins. Co., No. 13-50657 (5th Cir. Nov. 14, 2014)
Continue Reading Fee Dispute Exclusion in Bank E&O Policy Not Triggered by Allegations Concerning Overdraft Charges