insurance liltigation for non legal insurance professionals

.www.InsuranceCommunityUniversity.com

Insurance Litigation For Non-legal Insurance Professionals


Your Instructors TodayThe Law Offices of

15250 Ventura Blvd., 9th Floor Sherman Oaks, CA 91403(818) 205-9955 P (818) 205-9944 F

[email protected] www.Tharpe-Howell.com

Johnna Hansen, Esq. Timothy Lake, Esq.Robert Freedman, Esq.

Ms. Hansen is a Firm Partner and Trial Attorney who has handled over 100 bench and jury trials during her career.

Mr. Lake is a Firm Partner and Chair of its Insurance Coverage and Bad Faith Practice Group.


Panel Members

Tim Lake Insurance Coverage

Opinions, Litigation and Appeals

Johnna Hansen Insurance Coverage

Litigation Trial Attorney

Robert Freedman

Commercial Transactions

Litigation


Disclaimers

California Law Information Purposes ONLY Information does not constitute legal advise Contact Attorney To Discuss Specific

Matters


About Tharpe and Howell, LLC

65 Attorney Civil Litigation Firm

Representing Insureds, Self -Insureds, and Insurers

California, Nevada, Arizona, Utah And Washington

Tharpe-Howell.Com


Topics To Be Discussed

Constitutes Majority Of Appellate Opinions

Insurance Coverage Opinions

Insured V. Insurer – Breach Of Contract / Bad Faith

Insurer V. Insurer – Indemnity And Contribution

Insurer V. Insured – Subrogation


Topics To Be Discussed

Agents / Broker E&O

California Claims Handling Statutes

Risk Management Tips

7


Goals of Webinar

Insight Into Active Areas Of Insurance Coverage Litigation

How And Why Cases Develop

Touch On Important Cases And Statutes

Tips For Risk Management


Active Areas Of Insurance Coverage Litigation

Breach Of Contract – Denial Of Coverage

Bad Faith – Extra Contractual Damages

Bad Faith – Refusal To Defend And Indemnify


Active Areas Of Insurance Coverage Litigation

Declaratory Relief

Contribution

Subrogation

10


Formal Insurance Coverage LettersTender Letters: Timely And Complete

Opinion Letters: Predict How Courts Will Interpet Coverage / Analysis Of Facts, Law And Policy Terms

Opinion Letters: Use With Advice Of Counsel – Defense For Bad Faith Claims


Formal Insurance Coverage LettersReservation Of Rights Letters: Preserves

Insurer’s Rights To Deny Or Limit Coverage While Investigating / Defending Claims

Buss V. Superior Court – Allocation Between Covered And Uncovered Claims

12


California Claims Handling StatutesCalifornia Code of Regulations

Section 2695.5(e)(1): – 15 days to acknowledge claim and specify

information needed

Section 2695.5(b)(1): – 15 days to respond to communication

from claimant

Section 2695.7(b): – Insurer required to accept/ deny claim

within 40 days after receiving proof


California Claims Handling StatutesCalifornia Code of Regulations

Section 2695.7(c)(1): – If more time is required, insurer must

provide written notice and specify additional information required, and reasons for inability to make a decision; written notice must be provided every thirty (30) days until a determination is made or notice of legal action.

14


Typical Reasons For Denial Of Coverage

Insured Party / Insured Interest:

Bodily Injury, Property Damage, Advertising Injury Caused By “Occurrence”

Completed Operations Coverage

Failure To Satisfy Sir

Continuous Trigger: Montrose V. Admiral


Typical Reasons For Denial Of Coverage

Professional Liability Policies:

Claims Made And Reported Policies

E&O Claims: “Claim” During The Policy Period Against An “Insured” For Wrongful Act” In Rendering “Professional Services”

16


Bad Faith-Refusal To Defend And Indemnify Wrongful Denial Of Benefits Or Defense Duty Of Good Faith And Fair Dealing First Party – Duty To Reasonably Investigate And

Pay Benefits CGL - Duty To Investigate; Provide Defense

Upon “Potential” For Coverage CGL - Duty To Pay Damages “Actually”

Covered CGL - Duty To Achieve Reasonable Settlements

Within Policy Limits


Bad Faith-Refusal To Defend And Indemnify Tort Liability: Breach Of Duty Of Good Faith And

Fair Dealing No Bad Faith If There Is No Coverage Under The

Policy Damages: Policy Benefits, Accrued Interest,

Consequential Damages Time Limitations: (Absent Policy Limitations): 4

Years Breach Of Contract & 2 Years - Covenant Of Good Faith And Fair Dealing

18


Bad Faith Extra Contractual DamagesEconomic Losses

Emotional Distress

Attorneys’ fees Incurred To Enforce Payment Of Benefits Denied Or Delayed In Bad Faith Are Recoverable As Tort Damages: Brandt V. Superior Court

Punitive Damages


Equitable Subrogation

Insurer That Has Paid Loss “Steps Into The Shoes Of Its Insured” To Recover From Parties Legally Responsible

Policy Provisions Or Assignment

Action In Name Of Insurer Or Insured

Same Defenses May Be Asserted

Anti-Subrogation – Can Not Sue Insured For Loss


Agent & Broker E&0 Distinction Between Agent And Broker

Duty To Obtain Policy And Coverage Requested

Claims Handling Exposure

Extent Of Duty Based On Relationship And Expertise

Failure To Procure / Misrepresentations As To Coverage


Agent & Broker E&0

Two (2) Year Statute Of Limitations

Duty To Third Party Beneficiary ( Business To Business Markets, Inc. V. Zurich)

Trial Within A Trial

Damages: Insurance Benefits

22


Risk ManagementMaintain Records Of CorrespondenceDocument Requests For Coverage From

InsuredsDisclose (In Writing) Coverage

Limitations / Exclusions / SIR’s / Deductibles

Insured To Complete And Execute All Applications

Know Insured’s Business Models, Risks, And Entities


Risk Management

Confirm Coverages ObtainedConfirm Persons, Entities, & Properties

InsuredWritten Authorization / Endorsement From

Insurers For AIE’s Communicate Notice Of Claim To Proper

InsurersRequest Status Of Claim From Insurer

Every 30 Days

24


In Conclusion

Provided A General Overview Contact Us For More Information:

Offices in: California, Nevada, Arizona,

Utah and Washington

Visit us on the web! tharpe-howell.com

insurance liltigation for non legal insurance professionals

Economy & Finance

bad faith

risk management

good faith

fair dealing

opinion letters

firm partner

typical reasons

agent amp