{"id":898252,"date":"2020-11-24T15:55:19","date_gmt":"2020-11-24T22:55:19","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=898252"},"modified":"2020-11-24T15:55:22","modified_gmt":"2020-11-24T22:55:22","slug":"liability-insurance-coverage","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/liability-insurance-coverage\/","title":{"rendered":"Liability Insurance Coverage: Basic Principles"},"content":{"rendered":"\n<p>Peter Selvin | <a href=\"https:\/\/www.ecjlaw.com\/ecj-blog\/liability-insurance-coverage-basic-principles\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">Ervin Cohen &amp; Jessup<\/a><\/p>\n\n\n\n<p>There are certain core principles that must be applied in analyzing coverage under a <a href=\"https:\/\/www.myconstructionexpert.com\/blog\/california-supreme-court-rights-occurrence-ship-unintended-harm-resulting-intentional-conduct-triggers-coverage-liability-insurance-policy\/\" target=\"_blank\" rel=\"noreferrer noopener\">liability insurance policy<\/a>.<\/p>\n\n\n\n<p>This two-part article sets out those principles. It also explores some counter-intuitive situations in which such coverage may come into play.<br><br><br><strong>Insurance Liability<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Hidden opportunities to obtain coverage in liability cases<\/li><li>Sometimes counter-intuitive<\/li><li>Often obscured by jargon and complexity<\/li><li>What strategies will assist in uncovering these opportunities?<\/li><\/ul>\n\n\n\n<p><strong><u>The 8 Key Points<\/u><\/strong><\/p>\n\n\n\n<p><strong>1. Law Tilted in Favor of Policyholders<\/strong><\/p>\n\n\n\n<p>Liability insurance provides protection (i.e., indemnity) in respect to a claim, but also funding for the insured\u2019s defense to litigation. It also imposes a duty on the insurer to settle the case for its insured. The law heavily favors policyholders. In this regard, grants of coverage are construed broadly, whereas exclusions are construed narrowly. In addition, an insurer must give as much consideration to its insured as its own interests.<\/p>\n\n\n\n<p>Where the policy provides a duty to defend, there are three important features: (1) the duty to defend is extremely broad; (2) where there is a duty to defend, the carrier is obligated to defend both covered and uncovered claims; and (3) a carrier that breaches the duty to defend may face huge penalties for doing so. California courts have repeatedly found that remote facts buried within causes of action that may potentially give rise to coverage are sufficient to invoke the defense duty. Thus, California law does not require that the insured\u2019s conduct proximately cause the third-party claim in order to trigger the defense duty.<\/p>\n\n\n\n<p><strong>2. The specific causes of action in a complaint do not define or limit the scope of coverage.<\/strong><\/p>\n\n\n\n<p>The duty to defend is not limited by the causes of action that are pled by the plaintiff. \u201c\u2026That the precise causes of action pled by the third party complaint may fall outside policy coverage does not excuse the duty to defend where, under the facts alleged, reasonably inferable or otherwise known, the complaint could be fairly amended to state a covered liability.\u201d&nbsp;<em>Scottsdale Ins. Co. vs. MV Transportation<\/em>, 36 Cal.App.4th 643, 654 (2005);&nbsp;<em>Hartford Casualty vs. Swift Distribution<\/em>, 59 Cal.4th 277 (2014).<\/p>\n\n\n\n<p><strong>3. The duty to defend has surprising breadth.<\/strong><\/p>\n\n\n\n<p>Under California Civil Code \u00a7 2778(4), the duty to defend is in all liability insurance contracts unless the policy clearly and unambiguously excludes such a duty. One of the most basic cornerstones of modern insurance law is that the duty to defend is broader than the duty to indemnify<em>.&nbsp;<\/em>An insurer must provide a complete defense to its insured even where some causes of action may be outside coverage. Thus, if any claims in a third party complaint against a party insured under a CGL policy are even potentially covered by the policy, the insurer must provide its insured with a defense to all claims.<\/p>\n\n\n\n<p><strong>4. An insurer may be obligated to fund the prosecution of affirmative claims<\/strong><\/p>\n\n\n\n<p>Insurer responsibility for funding the prosecution of affirmative claims of an insured usually arises in the context of cross-complaints initiated in response to the underlying liability claim. Thus, in some instances, an insurer may be obligated to fund the prosecution of an insured\u2019s counterclaim for affirmative relief where the request for that affirmative relief is inextricably intertwined with the defense of the covered action.<\/p>\n\n\n\n<p><strong>5. Opportunities for securing coverage are enhanced by the penalties flowing from an insurer\u2019s wrongful failure to defend.<\/strong><\/p>\n\n\n\n<p><strong>Consequences of an Insurer\u2019s Wrongful Failure to Defend:<\/strong><\/p>\n\n\n\n<p><strong>Waiver of Exclusions to Coverage<\/strong>. Where the carrier wrongfully fails to defend, it will be deemed to have waived any exclusions to coverage under the policy that it otherwise would have had with respect to its obligation to indemnify. If a carrier denies the insured a defense and it is ultimately determined that a defense was owed, the carrier can be subjected to a claim of bad faith and may ultimately be required to provide indemnity even where no duty to indemnify exists<\/p>\n\n\n\n<p><strong>Waiver of Right to Reimbursement for Defense of Uncovered Claims<\/strong>. An insurer that breaches its duty to defend is liable for the costs incurred in the insured\u2019s defense and is precluded from pursuing a reimbursement claim or otherwise allocating between covered and non-covered fees and costs.<br><br><strong>Waiver of Right to Insist on \u201cPanel\u201d Rates<\/strong>. An insurer that breaches the duty to defend is precluded from arguing that Civil Code \u00a7 2860 should limit its insured\u2019s recoverable fees. &#8220;If [a] plaintiff is able to establish breach of the duty to defend, its damages are not limited by California Civil Code \u00a7 2860.&#8221;&nbsp;<em>Atmel Corp. v. St. Paul Fire &amp; Marine<\/em>, 426 F. Supp. 2d 1039, 1047 (N.D. Cal. 2005).<\/p>\n\n\n\n<p><strong>Unreasonable Delay By Carrier In Paying Defense Costs Can Constitute Breach Of The Duty To Defend As Subjecting Carrier To Claim For Bad Faith<\/strong><\/p>\n\n\n\n<p>In&nbsp;<em>Travelers lndem. Co. of Connecticut v. Centex Homes<\/em>, 2015 WL 58369 47, at *4 (N.D. Cal. 2015), the court held that &#8220;[a] failure to provide counsel or to guarantee the payment of legal fees immediately after an insurer&#8217;s duty to defend has been triggered constitutes a breach of the duty to defend, even if the insurer later reimburses the insured.&#8221; Id. at *5. In&nbsp;<em>Okada&nbsp;<\/em>the court found that the specific language in the policy required the insurer &#8220;must make contemporaneous payments for legal defense on claims covered by the policy.&#8221;&nbsp;<em>Okada v. MGIC lndem. Corp<\/em>., 283 (9th Cir. 1986).<\/p>\n\n\n\n<p><strong>Public Policy Reasons Supporting The Imposition Of Penalties on Insurers That Breach The Duty to Defend<\/strong><\/p>\n\n\n\n<p>These seemingly harsh results advance the policy of incentivizing insurers to vigorously search the underlying claim for the purpose of finding a duty to defend. \u201cIf the insured elects to proceed in tort, recovery is possible for not only all unpaid policy benefits and other contract damages, but also extra-contractual damages such as those for emotional distress, punitive damages and attorney fees\u201d.&nbsp;<em>Archdale v. American International Specialty Lines Ins. Co<\/em>., 154 Cal. App. 4th 449, 467-68, n. 19 (2007).<\/p>\n\n\n\n<p><strong>Recent Developments in Bad Faith Liability<\/strong><\/p>\n\n\n\n<p>Recent case authority suggests that an insurer may be liable for bad faith even if it offers up its full policy limits to settle a third party liability claim. In that case the Court held that notwithstanding its offer of full policy limits, the insurer was unreasonable in refusing to agree to the inclusion of language in the settlement agreement which would have preserved the insured\u2019s right, without offset, to court-ordered restitution from the tortfeasor. In those circumstances, the court allowed the insured\u2019s bad faith case to proceed.<\/p>\n\n\n\n<p><strong>6. The \u201cleverage\u201d created by the duty to settle.<\/strong><\/p>\n\n\n\n<p>Once the duty to defend attaches, the insurer also has an obligation to settle the claim within policy limits. If the carrier rejects a reasonable settlement offer from the claimant that is within policy limits, it may be liable for any judgment that is in excess of the policy limits. Importantly, in rejecting such a settlement offer, the carrier may not take into account or consider any defenses it may have to coverage for the claim. In order to establish a claim for bad faith, the insured must demonstrate that the policy obligated the insurer to indemnify the insured for the underlying loss. Liability carrier has affirmative duty to negotiate toward a settlement on behalf of its insured, even in the absence of an offer or demand by the claimant.<\/p>\n\n\n\n<p><strong>7. Amounts ostensibly paid as restitution for \u201cill gotten gains\u201d may in fact represent covered \u201cdamages\u201d.<\/strong><\/p>\n\n\n\n<p>Whether amounts paid by policyholders to fund settlements are covered under an insurer\u2019s duty to indemnify is often a contested issue. See, e.g.,&nbsp;<em>TIAA-CREF Individual &amp; Institutional Services, LLC,<\/em>&nbsp;<em>et al. v. Illinois National Insurance Company, et al<\/em>., Case No. N14C-05-178 JRJ (Delaware Superior Court, October 20, 2016) (finding that settlement amounts paid to settle class actions alleging unfair business practices did not represent uninsurable disgorgement). See also&nbsp;<em>U.S. Bank v. Indian Harbor Insurance Company<\/em>, 2014 WL 3012969 (D. Minn. 2014) (bank was entitled to coverage under its professional liability insurance for restitutionary amounts it paid in settlement of an overdraft fee overcharge class action).<\/p>\n\n\n\n<p><strong>8. Unexpected coverage opportunities in IP and commercial disputes<\/strong><\/p>\n\n\n\n<p>Utilizing coverage for \u201cpersonal injury\u201d or \u201cadvertising injury\u201d in business disputes. In lawsuits involving claims of infringement, misappropriation or the violation of the right of privacy, the key portion of a CGL policy is the \u201cpersonal injury\u201d or \u201cadvertising injury\u201d coverage found in Coverage B. That coverage section will typically contain language providing as follows:<\/p>\n\n\n\n<p>1. We will pay those sums that the insured becomes legally obligated to pay as damages because of \u201cpersonal and advertising injury\u201d to which this insurance applies. We will have the right and duty to defend any \u201csuit\u201d seeking those damages\u2026<\/p>\n\n\n\n<p>2. This insurance applies to \u201cpersonal and advertising injury\u201d caused by an offense arising out of your business but only if the offense was committed in the \u201ccoverage territory\u201d during the policy period.<\/p>\n\n\n\n<p>\u201cAccidental\u201d conduct is not required for coverage for personal or advertising injury. Coverage for personal or advertising injury does not depend on the existence of an \u201coccurrence,\u201d which typically is defined in terms of \u201caccidental\u201d conduct. Thus, coverage for personal and advertising injury is not limited to negligence and may even cover intentional torts.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Peter Selvin | Ervin Cohen &amp; Jessup There are certain core principles that must be applied in analyzing coverage under a liability insurance policy. This two-part article sets out those principles. It also explores some counter-intuitive situations in which such coverage may come into play. Insurance Liability Hidden opportunities to obtain coverage in liability cases&hellip; <a class=\"more-link\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/liability-insurance-coverage\/\">Continue reading <span class=\"screen-reader-text\">Liability Insurance Coverage: Basic Principles<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[10791,30],"tags":[9895,7777],"class_list":["post-898252","post","type-post","status-publish","format-standard","hentry","category-commercial-general-liability-policy","category-general-liability-policy","tag-advise-consult","tag-commercial-property-liability-insurance-policy","entry"],"jetpack_publicize_connections":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Liability Insurance Coverage: Basic Principles - Advise &amp; 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