Topic: Insurance

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Asbestos exclusion upheld in US

An exclusion for claims ‘arising out of asbestos’ was upheld by a US appeal court because it is unambiguous and therefore enforceable. The appeal court overturned a $36 million judgment against the insurer, which is only part of the policyholder’s liability for $120 million worth of asbestos-related claims. The court did not accept the argument that the … Continue reading

Claim rejected for misrepresentation (US)

A Pennsylvania court held that the insurer was not liable because of misrepresentation for a portion of a $227 million settlement by a building owner arising from a building collapse that took seven lives and injured 12 people. The event happened as a result of an uncontrolled collapse of a four-storey building which was being demolished … Continue reading

No cover for botched real estate deal (USA)

Where an insurance policy covered an estate agent for acts committed solely ‘in the performance of services as a real estate agent/broker of non-owned properties, for others for a fee’, the Utah Supreme Court denied coverage for an estate agent’s botched deal in which the agent persuaded a company to make an investment in a … Continue reading

Could v would (UK)

In a judgment in the lower court in a reinsurance non-disclosure case the judge referred to what ‘could’ have happened if certain loss statistics had been produced whereas the relevant test was what ‘would’ have happened in that situation. The appeal court held that people, including judges, do not always speak with precision in the … Continue reading

Digitizing the insurance value chain

If you are interested in using hi-tech to get your insurance or other financial services business to the front of the curve, you should read this. The Norton Rose Fulbright global team, in association with R3, has published a paper on applying blockchain and distributed ledger technology in the insurance sector. R3 is a leading … Continue reading

Laws amendment to accommodate demarcation regulations

The pending changes to the Medical Schemes Act and the Long-term and Short-term Insurance Acts to accommodate the demarcation regulations were made on 1 April 2017 including the new definition of ‘business of a medical scheme’. The definition of ‘business of a medical scheme’ in the Medical Schemes Act 1998 makes it clear that if you … Continue reading

Exclusion for medical services in a medical malpractice claim (US)

Over a 150 patients claimed damages against a hospital because of an outbreak of fungal meningitis and related infections which resulted from the patients receiving injections with contaminated substances. The court held that there was no claim under the insurer’s commercial package policy based on personal injury claims because the policies excluded bodily injury ‘due … Continue reading

Operation of retroactive date

Where an insurance policy had a retroactive date so that there was no indemnity for any claim ‘arising from or in any way involving any act, error or omission committed’ prior to 5 June 2009, the court held that the indemnity was due because there was no direct or indirect causal connection between the events preceding … Continue reading

What is a written demand for damages or relief?

A professional indemnity policy required the insured to give notice to the insurer of any ‘written demand for monetary damages or non-pecuniary relief’. A letter from solicitors reserving rights to pursue a claim and expressing the view that there was a strong claim against the insured was held not to be a written demand and … Continue reading

Failure of PI insured to report potential malpractice suit (US)

The question debated in a claim under a lawyers’ professional indemnity policy was whether the attorneys could have reasonably expected the underlying malpractice action and should have reported it to their insurers. The insurers argued that a claim should have been expected from an expressly unhappy client. The attorneys said the suit was not reasonably … Continue reading

Cover for collapsed crane excluded by a contractor’s equipment exclusion (US)

A New York Court of Appeals rejected a claim for collapse of a tower crane during Hurricane Sandy because the policy had an exclusion for ‘contracted tools, machinery, plant and equipment’. It rejected the insured’s submission that the crane was covered as a ‘temporary structure’. Readers will remember the traumatic images of the boom of … Continue reading

Will we get reciprocal reinsurance arrangements?

The FSB’s Reinsurance Regulatory Review Position Paper in September 2016 sketches a reinsurance regime by which foreign reinsurers wishing to reinsure South African risks will have to register as a licensed branch in South Africa unless the foreign reinsurer is regulated by a country with an equivalent regulatory framework according to the FSB. Presumably the … Continue reading

What is an enquiry for legal expenses in insurance (EU)

Mr Massar took out legal expenses insurance managed by insurers DAS. Under Netherlands employment law, his employer applied to the Employee Insurance Agency, a public independent body, to terminate his employment contract on the ground of redundancy. Mr Massar employed an external lawyer to assist him at this stage against unjustified dismissal. DAS said that seeking … Continue reading

Mudslide is not an explosion (US)

An insured unsuccessfully contended that the destruction of a building during a mudslide was an explosion under the policy terms. Torrential rain in Boulder, Colorado in September 2013 triggered a mudslide that cascaded down a hill and destroyed the property, leading to a loss of $1.3 million. The policy excluded losses due to water-based causes, including … Continue reading

Directors and officers policy does not cover executive-induced decline of company (US)

A California company specialising in plumbing fixtures unsuccessfully sought cover under a directors and officers policy for a claim brought by three former directors based on the decline of the business because of the chief executive’s erratic behaviour. The court held that the so-called ‘insured-v-insured’ exclusion unambiguously bars coverage for a claim such as that … Continue reading
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