Executive Summary Blog

Executive Summary Blog

Legal developments affecting professional liability insurers

Category Archives: Notice of Claim

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Failure of Insured to Provide Timely Notice Under Claims-Made Policy Bars Suit Against Insurer of Bankrupt Insured

Posted in Bankruptcy, Notice of Claim
The United States Court of Appeals for the Third Circuit, applying Pennsylvania law, has held that an insured’s failure to provide timely notice of a claim under a claims-made policy barred coverage for that suit.  Frazier v. Exide Techs., No. 17-2399, 2018 WL 2727396 (3d Cir. June 6, 2018).… Continue Reading

Amended Complaint Raising Different Legal Theory Is Not a Claim First Made at Time of Initial Complaint

Posted in Notice of Claim, Related Claims and associated exclusions
The Louisiana Court of Appeals has held that a claims-made policy affords coverage for a lawsuit filed before the policy period because an amended complaint alleging a new legal theory was filed during the policy period.  Billeaudeau v. Opelousas Gen. Hosp. Auth., 2018 WL 1835510 (La. Ct. App. Apr. 18, 2018).  The court also rejected… Continue Reading

No Coverage Under Claims Made and Reported Policy for Claim Reported After Policy Expiration

Posted in Notice of Claim
A Virginia federal court, applying Virginia law, has held that an insurer was entitled to summary judgment that no coverage was available under its claims made and reported policy for a claim noticed to it after the policy expired.  Gateway Residences at Exch., LLC v. Illinois Union Ins. Co., 2018 WL 1629107 (E.D. Va. Apr.… Continue Reading

No Coverage for Underlying Lawsuits Due to Insured’s Failure to Provide Notice as Soon as Practicable

Posted in Notice of Claim
The United States District Court for the Northern District of Georgia, applying Georgia law, has held that there is no coverage for multiple lawsuits under employment practices liability insurance policies where the insured failed to comply with the policies’ notice requirements.  Nat’l Cas. Co. v. Fulton Cnty., Ga., 2018 WL 1523089 (N.D. Ga. Mar. 28,… Continue Reading

Notice of Accident Constitutes Timely “Claim” Based on Insurers’ Conduct

Posted in “Claim”, Notice of Claim
The United States District Court for the Southern District of Mississippi has held that notice of an underlying accident sent to the insured’s three insurance carriers represented a timely “claim” under the claims-made general liability policies at issue in light of the insurers’ course of conduct upon receipt of the notice.  Jordan v. Maxfield &… Continue Reading

No Coverage for Criminal Investigation Where Sealed Affidavit Identifying Insured as Target of Investigation Was Not Reported During Policy Period

Posted in “Claim”, Notice of Claim
The United States District Court for the Middle District of Florida has held that an errors and omissions policy does not provide coverage for a criminal investigation of an insured individual where the affidavit identifying the individual as a target of the investigation was not unsealed or reported to the insurer until after the policy’s… Continue Reading

Lawsuit Filed by Company Against Former Officer Does Not Trigger Employment Practices Liability Coverage

Posted in Defense Costs, Notice of Claim, Wrongful Act
The United States District Court for the District of Oklahoma has held that a lawsuit filed by a company against its former president did not implicate its policy’s Employment Practices Liability coverage because the lawsuit was not filed by or on behalf of an employee, as required by the policy.  Statton v. Allied World Specialty… Continue Reading

Insured’s Late Notice of Original Discrimination Charges Bars Coverage for Related Lawsuits

Posted in Notice of Claim
In a win for Wiley Rein’s client, the United States District Court for the Eastern District of North Carolina, applying North Carolina law, has held that an insurer owed no coverage for two underlying lawsuits because the insured failed to provide notice of the EEOC charges of discrimination that arose from the same facts at… Continue Reading

No Coverage Available Where Insured Fails to Provide Notice of Potential Claim During First Policy Period and Knew About, But Failed to Disclose, Potential Claim Prior to Second Policy Period

Posted in “Claim”, Notice of Claim, Prior Knowledge/Warranty Exclusion
The United States District Court for the District of Maryland has held that where notice of a potential claim is not reported during the first policy period and the insured knew about, but failed to disclose, the potential claim prior to the second policy period, coverage is precluded under both policies.  James River Ins. Co.… Continue Reading

Court Declines to Hold Broker Accountable for Insured’s Failure to Report Known Claims in Application

Posted in Notice of Claim
A Massachusetts federal court has held that, absent special circumstances, an insurance broker does not owe a fiduciary duty of care to its client and therefore is entitled to accept its clients’ representation that all known claims had been reported in its application and has no duty to investigate whether potential claims were not reported. … Continue Reading

Coverage Barred for Claim Made During Initial Policy Period and Reported in Renewal Period

Posted in Notice of Claim
The Ninth Circuit, applying Alaska law, has held that coverage was not afforded under a company’s professional errors and omissions insurance policy for a claim made against the company during the policy period but not reported until the renewal policy period.  Alaska Interstate Constr., LLC v. Crum & Forster Specialty Ins. Co., 2017 WL 3601728… Continue Reading

No Coverage for $3.5 Million in Pre-Notice Defense Expenses Where Notice Was a Year Late

Posted in Consent to settle/incur defense costs, Defense Costs, Notice of Claim
Applying Delaware law, a federal court in New York has held that where an insured waited more than a year to report a lawsuit to its insurer and during that period incurred more $3.5 million in legal fees, the insurer had no obligation to pay pre-tender defense costs, without regard to whether the insurer could… Continue Reading

No E&O Coverage Where Insured Failed to Report Claim During Policy Period When It Was First Made

Posted in “Claim”, Notice of Claim
The Appellate Court of Illinois, applying Illinois law, has held that an insurer has no duty to defend or indemnify an insurance agent under an errors and omissions liability policy where the agent failed to provide notice of the claim during the policy period in which the claim was first made.  James River Ins. Co.… Continue Reading

“Non-Specific,” “Boiler-Plate” Notice of Potential Claim Insufficient as a Matter of Law

Posted in “Claim”, Notice of Claim
In a significant victory for Wiley Rein’s client, a Tennessee federal court has held that an insured’s “general, boiler-plate . . . broad, [and] non-specific” notice that purported to give notice of a potential claim was untimely and insufficient to provide notice of an actual claim made during the policy period and omitted from the… Continue Reading

Eighth Circuit Affirms That Notice Given During Policy Period but Seven Months After Complaint Filed is Not “As Soon As Practicable”

Posted in Notice of Claim
The United States Court of Appeals for the Eighth Circuit, applying Minnesota law, has affirmed summary judgment in favor of an insurer, holding that the condition precedent of timely notice “as soon as practicable” was not met where the insured provided notice of a lawsuit seven months after the lawsuit was filed without offering any… Continue Reading

Insured’s Failure to Provide Notice of Demand Letter Precludes Coverage for Related Lawsuit Noticed in Subsequent Policy Period

Posted in “Claim”, Notice of Claim, Related Claims and associated exclusions
A Washington federal court has held that an insured’s failure to provide notice of a demand letter to its insurer during the policy period in which the letter was received precludes coverage under a claims-made and reported policy for a related lawsuit filed during a subsequent policy period. National Union Fire Ins. Co. v. Zillow,… Continue Reading

Federal Liability Risk Retention Act Preempts Maryland’s Notice-Prejudice Statute for Non-Chartered Risk Retention Group

Posted in Notice of Claim
A Maryland federal court has held that the federal Liability Risk Retention Act (LRRA) preempts Md. Ins. Code § 19-110, Maryland’s notice prejudice statute, in circumstances where Maryland law otherwise would govern a contract issued by a non-chartered insurer.  Mora v. Lancet Indem. Risk Retention Grp., Inc., 2017 WL 818718 (D. Md. Mar. 1, 2017).… Continue Reading

Initial Inquiry Letter from Office of Disciplinary Counsel Constitutes “Disciplinary Proceeding,” Triggering Notice Obligation

Posted in “Claim”, Notice of Claim
A Louisiana appellate court, applying Louisiana law, has held that an initial inquiry letter from the Louisiana Attorney Disciplinary Board, Office of the Disciplinary Counsel received by a lawyer constituted a “Disciplinary Proceeding” under a lawyer’s professional liability policy, triggering an insured’s notice obligations under the policy. Trelles v. Continental Cas. Co., 2017 WL 658249… Continue Reading