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. www.InsuranceCommunityUniversity.com Insurance Litigation For Non-legal Insurance Professionals.

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Presentation on theme: ". www.InsuranceCommunityUniversity.com Insurance Litigation For Non-legal Insurance Professionals."— Presentation transcript:

1 . www.InsuranceCommunityUniversity.com Insurance Litigation For Non-legal Insurance Professionals

2 . www.InsuranceCommunityUniversity.com Your Instructors Today The Law Offices of 15250 Ventura Blvd., 9th Floor Sherman Oaks, CA 91403 (818) 205-9955 P (818) 205-9944 F rfreedman@tharpe-howell.comrfreedman@tharpe-howell.com www.Tharpe-Howell.comwww.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.

3 . www.InsuranceCommunityUniversity.com Panel Members Tim LakeInsurance Coverage Opinions, Litigation and Appeals Johnna HansenInsurance Coverage Litigation Trial Attorney Robert Freedman Commercial Transactions Litigation

4 . www.InsuranceCommunityUniversity.com Disclaimers  California Law  Information Purposes ONLY  Information does not constitute legal advise  Contact Attorney To Discuss Specific Matters

5 . www.InsuranceCommunityUniversity.com 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

6 . www.InsuranceCommunityUniversity.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

7 . www.InsuranceCommunityUniversity.com Topics To Be Discussed  Agents / Broker E&O  California Claims Handling Statutes  Risk Management Tips 7

8 . www.InsuranceCommunityUniversity.com 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

9 . www.InsuranceCommunityUniversity.com Active Areas Of Insurance Coverage Litigation  Breach Of Contract – Denial Of Coverage  Bad Faith – Extra Contractual Damages  Bad Faith – Refusal To Defend And Indemnify

10 . www.InsuranceCommunityUniversity.com Active Areas Of Insurance Coverage Litigation  Declaratory Relief  Contribution  Subrogation 10

11 . www.InsuranceCommunityUniversity.com Formal Insurance Coverage Letters  Tender 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

12 . www.InsuranceCommunityUniversity.com Formal Insurance Coverage Letters  Reservation 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

13 . www.InsuranceCommunityUniversity.com California Claims Handling Statutes California 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

14 . www.InsuranceCommunityUniversity.com California Claims Handling Statutes California 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

15 . www.InsuranceCommunityUniversity.com 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

16 . www.InsuranceCommunityUniversity.com 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

17 . www.InsuranceCommunityUniversity.com 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

18 . www.InsuranceCommunityUniversity.com 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

19 . www.InsuranceCommunityUniversity.com Bad Faith Extra Contractual Damages  Economic 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

20 . www.InsuranceCommunityUniversity.com 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

21 . www.InsuranceCommunityUniversity.com 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

22 . www.InsuranceCommunityUniversity.com 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

23 . www.InsuranceCommunityUniversity.com Risk Management  Maintain Records Of Correspondence  Document Requests For Coverage From Insureds  Disclose (In Writing) Coverage Limitations / Exclusions / SIR’s / Deductibles  Insured To Complete And Execute All Applications  Know Insured’s Business Models, Risks, And Entities

24 . www.InsuranceCommunityUniversity.com Risk Management  Confirm Coverages Obtained  Confirm Persons, Entities, & Properties Insured  Written Authorization / Endorsement From Insurers For AIE’s  Communicate Notice Of Claim To Proper Insurers  Request Status Of Claim From Insurer Every 30 Days 24

25 . www.InsuranceCommunityUniversity.com 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


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