{"id":904047,"date":"2025-03-05T15:56:29","date_gmt":"2025-03-05T22:56:29","guid":{"rendered":"https:\/\/www.myconstructionexpert.com\/blog\/?p=904047"},"modified":"2025-03-05T15:56:32","modified_gmt":"2025-03-05T22:56:32","slug":"insurance-coverage-conditions-to-coverage","status":"publish","type":"post","link":"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-conditions-to-coverage\/","title":{"rendered":"Conditions\u00a0to Coverage May Be More Conditional Than You Thought"},"content":{"rendered":"\n<p>Max J. Louik and Alexa L. Austin | <a href=\"https:\/\/www.policyholderperspective.com\/2025\/02\/articles\/insurance-coverage\/conditions-to-coverage-may-be-more-conditional-than-you-thought\/\" target=\"_blank\" rel=\"noreferrer noopener nofollow\">The Policyholder Perspective<\/a><\/p>\n\n\n\n<p><strong>Conditions Precedent to Coverage<\/strong><\/p>\n\n\n\n<p>Insurance policies typically are subject to certain conditions precedent to coverage.&nbsp;As the name suggests, conditions precedent to coverage are obligations placed on the insured that, in the normal case, must be complied with in order for coverage to attach.&nbsp;<\/p>\n\n\n\n<p>Take a commercial general liability (or \u201cCGL\u201d) policy, for example. An <a href=\"https:\/\/www.myconstructionexpert.com\/blog\/occurrence-vs-claims-made-policies-whats-the-difference\/\">occurrence-based CGL policy<\/a> may purport to require an insured to notify the insurer \u201cas soon as practicable\u201d of an occurrence which may result in a claim.\u00a0It may state that the insured should \u201ccooperate\u201d with the insurer in the investigation, defense and\/or settlement of that claim, and it might further state that the insured shall not settle the claim without the insurer\u2019s consent.<\/p>\n\n\n\n<p>Each of the above examples seemingly provides an \u201cescape hatch\u201d to the insurer; should the policyholder fail to comply with a condition precedent to coverage, the insurer need not pay a claim otherwise covered by the policy.&nbsp;But that isn\u2019t always the case.<\/p>\n\n\n\n<p><strong>The Futility Doctrine and Insurance Recovery<\/strong><\/p>\n\n\n\n<p>\u201cThe law does not require the doing of a futile act.\u201d&nbsp;&nbsp;<em>Ohio v. Roberts<\/em>, 448 U.S. 56, 74 (1980),&nbsp;<em>overruled on other grounds Crawford v. Washington<\/em>, 541 U.S. 36 (2004).&nbsp;The United States Supreme Court\u2019s adage is no less true in the context of insurance coverage.<\/p>\n\n\n\n<p>Consider the \u201clate notice\u201d defense.&nbsp;Where an insurer would have denied coverage for a claim irrespective of when the insured gave notice, many courts recognize that earlier notice would have been futile in such cases, and thus will not permit the insurer to deny coverage because of late notice for an otherwise covered claim. \u201cNumerous jurisdictions have held that where an insurer denies liability on some other policy or coverage ground, the insurer cannot thereafter rely on the insured\u2019s failure to give reasonable notice as a ground for avoiding liability.&nbsp;In other words, the insurer waives its right to argue \u2018failure of notice\u2019 once it has denied coverage on other grounds.\u201d&nbsp;&nbsp;<em>Newman v. Scottsdale Ins. Co.<\/em>, 301 P.3d 348, 360 (Mont. 2013).&nbsp;<\/p>\n\n\n\n<p>Examples abound.&nbsp;<em>See Tri-State Ins. Co. v. Smith<\/em>, 449 S.W.2d 698, 700 (Ark. 1970) (\u201cIt is well settled that in an action on a liability insurance policy the insurer is precluded from defending its liability upon the ground of a violation by the insured of the policy provisions as to notice and forwarding of suit papers where the insurer has denied liability on some other ground.\u201d);&nbsp;<em>Shell Oil Co. v. Winterthur Swiss Ins. Co.<\/em>, 12 Cal. App. 4th 715, 763 (1993) (\u201cIf the insurer asserts that the underlying claim is not a covered occurrence or is excluded from basic coverage, then earlier notice would only result in earlier denial of coverage\u201d);&nbsp;<em>Strickler v. Huffine<\/em>, 618 A.2d 430, 435 (Pa. Super. Ct. 1992) (where an insurer\u2019s \u201cstrategy would have been to deny coverage and to refuse to participate in any defense\u201d regardless of when notice was given, the policyholder \u201csucceed[s] in demonstrating that [the insurer] suffered no prejudice attributable\u201d to late notice).<\/p>\n\n\n\n<p>This \u201cfutility doctrine\u201d is not limited to late notice issues. Consent-to-settle clauses can sometimes operate as a forfeiture of coverage if a policyholder settles an underlying claim without the express consent of its liability insurer.&nbsp;But many jurisdictions, including New York and Pennsylvania, will allow a policyholder to enter into a reasonable settlement without first obtaining the consent of its insurer so long as the insurer has already denied coverage.&nbsp;<em>See Isadore Rosen &amp; Sons, Inc. v. Sec. Mut. Ins. Co. of N.Y.<\/em>, 291 N.E.2d 380, 382 (N.Y. 1972) (\u201cThe New York rule is that where an insurer unjustifiably refuses to defend a suit, the insured may make a reasonable settlement or compromise of the injured party\u2019s claim, and is then entitled to reimbursement from the insurer, even though the policy purports to avoid liability for settlements made without the insurer\u2019s consent.\u201d) (quotation omitted);&nbsp;<em>Kolve v. Aegis Ins. Co.<\/em>, 537 A.2d 7, 8 (Pa. Super. Ct. 1988) (recognizing the \u201cwell-established rule\u201d that \u201ca contracting party by his conduct may render inoperative conditions of the contract on which he might otherwise insist,\u201d and holding \u201c[i]t would have obviously been an unavailing effort for the [insured] to have sought the [insurer\u2019s] consent for the settlement when he had already been advised by the [insurer] that it considered his policy coverage to be inapplicable\u201d).&nbsp;An insurer \u201calso releases its insured from the duty to cooperate by denying coverage or taking measures that render cooperation futile.\u201d&nbsp;<em>J.P. Morgan Securities Inc. v. Vigilant Insurance Co.<\/em>, 53 Misc. 3d 694, 702 (N.Y. Sup. 2016),&nbsp;<em>aff\u2019d<\/em>, 151 A.D.3d 632 (N.Y. App. Div. 2017).<\/p>\n\n\n\n<p><strong>Takeaways<\/strong><\/p>\n\n\n\n<p>Policy conditions are important and should not be ignored.&nbsp;Providing timely notice of a claim and cooperating with its insurer gives an insured the greatest opportunity to preserve its rights and benefits under the insurance policy. That said, there clearly are circumstances where compliance with conditions precedent to coverage would be futile, and in such cases, an insured may still be entitled to coverage.<\/p>\n\n\n\n<p>Should a dispute over coverage arise, policyholders should be weary of defenses predicated on a purported failure to comply with the notice condition, the duty to cooperate, or other conditions precedent to coverage.\u00a0There is no standard, one-size fits all approach to analyzing the validity of such defenses, and policyholders should consider involving coverage counsel as early as possible to assess the availability of such defenses. It may just be that strict enforcement of a condition precedent to coverage would be futile.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><strong>When one of your cases is in need of a construction expert, estimates, insurance appraisal or umpire services in defect or insurance disputes &#8211; please call Advise &amp; Consult, Inc. at 888.684.8305, or email <a href=\"mailto:experts@adviseandconsult.net\">experts@adviseandconsult.net<\/a>.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Max J. Louik and Alexa L. Austin | The Policyholder Perspective Conditions Precedent to Coverage Insurance policies typically are subject to certain conditions precedent to coverage.&nbsp;As the name suggests, conditions precedent to coverage are obligations placed on the insured that, in the normal case, must be complied with in order for coverage to attach.&nbsp; Take&hellip; <a class=\"more-link\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-conditions-to-coverage\/\">Continue reading <span class=\"screen-reader-text\">Conditions\u00a0to Coverage May Be More Conditional Than You Thought<\/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":[10791,30,9914],"tags":[9895,4739,23,9979],"class_list":["post-904047","post","type-post","status-publish","format-standard","hentry","category-commercial-general-liability-policy","category-general-liability-policy","category-insurance-coverage","tag-advise-consult","tag-commercial-general-liability-policy","tag-insurance-coverage","tag-occurrence-based-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>Conditions\u00a0to Coverage May Be More Conditional Than You Thought - Advise &amp; Consult, Inc.<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-conditions-to-coverage\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Conditions\u00a0to Coverage May Be More Conditional Than You Thought - Advise &amp; Consult, Inc.\" \/>\n<meta property=\"og:description\" content=\"Max J. Louik and Alexa L. Austin | The Policyholder Perspective Conditions Precedent to Coverage Insurance policies typically are subject to certain conditions precedent to coverage.&nbsp;As the name suggests, conditions precedent to coverage are obligations placed on the insured that, in the normal case, must be complied with in order for coverage to attach.&nbsp; Take&hellip; Continue reading Conditions\u00a0to Coverage May Be More Conditional Than You Thought\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-conditions-to-coverage\/\" \/>\n<meta property=\"og:site_name\" content=\"Advise &amp; Consult, Inc.\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Advise-Consult-Inc-126949043996790\/\" \/>\n<meta property=\"article:published_time\" content=\"2025-03-05T22:56:29+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-03-05T22:56:32+00:00\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@adviseconsult\" \/>\n<meta name=\"twitter:site\" content=\"@adviseconsult\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-conditions-to-coverage\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-conditions-to-coverage\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#\/schema\/person\/0a11abe008083d5fb19c2b0feefe7bd7\"},\"headline\":\"Conditions\u00a0to Coverage May Be More Conditional Than You Thought\",\"datePublished\":\"2025-03-05T22:56:29+00:00\",\"dateModified\":\"2025-03-05T22:56:32+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/insurance-coverage-conditions-to-coverage\/\"},\"wordCount\":977,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/www.myconstructionexpert.com\/blog\/#organization\"},\"keywords\":[\"Advise &amp; 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