Topic: Insurance

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Shop owners need to reasonably protect their patrons

The High Court in Gqeberha has confirmed that the shop owner has the legal duty to take the reasonable steps to prevent harm to its patrons and to take the reasonable steps to warn customers of potential dangers. Whilst shopping at the store of the defendant, the claimant, slipped and fell due to cake flour … Continue reading

Baby-sitting may be a “business” under an insurance policy exclusion and a word on ambiguity (US)

Baby-sitting may be a “business” under an insurance policy exclusion and a word on ambiguity (US) In a tragic incident, a baby-sitter who received $25 per day when she provided home daycare services, was caring for a deceased infant who died while in her care from bedding asphyxia.  It was held that the baby-sitter did … Continue reading

Insurable Interest (England)

Insurable Interest (England) In this High Court of Justice decision the insured claimed under a marine cargo open policy. The insured had purchased cargos of grain under various contracts and paid for those against presentation by the sellers of warehouse receipts issued by the warehouses. The warehouses were however acting fraudulently in issuing multiple warehouse receipts … Continue reading

Insurer’s refusal to pay excess body shop storage fees upheld (US)

Insurer’s refusal to pay excess body shop storage fees upheld (US) A Massachusetts Appeals Court refused to allow a class action against an insurer accused of deducting excess body shop storage fees for vehicles deemed total losses because the policy wording permitted the deduction.  Under the policy, the insurer agreed to pay for “reasonable expenses … Continue reading

Insurance, liquidation and business rescue

Insurance policies, particularly commercial policies providing business interruption, may contain provisions dealing with the consequences which flow for the parties, and the question of continuing cover and any indemnity, in the event of the liquidation of an insured. The relevant clauses are often outdated and should be reviewed having regard to the relevant provisions of … Continue reading

Warranty and Indemnity insurance

Insurers and intermediaries involved  in providing warranty and  indemnity insurance will be interested in this recent judgment dealing with contractual warranties and an indemnity of EBS International (Pty) Limited and  another v Shaun Edward Wright and which is relevant to any subrogated recovery. The seller had represented that its tax affairs were in order. Those … Continue reading

Fraudulent insurance claims

Recent media reports highlight the challenges faced by the insurance industry in dealing with fraudulent insurance claims. Reportedly South African life insurers detected 4287 fraudulent and dishonest claims worth R787.6 million for the 2021 year. This blog frequently reports on South African judgments, and those from around the world, dealing with rejection of fraudulent claims. … Continue reading

Declining to quote is not a refusal to insure

In this matter the question arose whether there had been a material non-disclosure of a refusal by an insurer to insure. The relevant insurer had declined to furnish a quotation. In proposing for the insurance, the insured had been asked four questions which the court categorised as referring to the insurance cover in existence at … Continue reading

Transfer of funeral insurance business

A court ordered a life company to transfer a portfolio of funeral business to the new life underwriter when the independent intermediary terminated its relationship with the company and  moved the business to another life insurer.  The court held that once the intermediary agreement between life insurer and intermediary was terminated, the parties were restored … Continue reading

Insurance and meaning of self-insured retention (US)

A self-insured retention is the amount of loss that a policyholder must pay out of pocket before coverage kicks in. In this judgment Colonial Pipeline Company v AIG Specialty Insurance Company, 1:19 –cv-762-MLB (US District Court Georgia, the policy included a US$10 million self-insured retention.  The insurer would “pay covered Loss, in excess of the … Continue reading

Pollution Exclusions and a Possible Claim (US)

In this judgment Colonial Pipeline Company v AIG Specialty Insurance Company, 1:19 –cv-762-MLB in the US District Court Georgia the insured had discovered a gasoline leak in its petroleum system which caused the insured substantial damages.  The insurer declined to indemnify the insured for those damages. One of the disputes was whether the policy covered a … Continue reading

Data hack leading to payment card replacements indemnified under general liability policy

The massive 2013 data hack affecting Target Corp with losses of $138 million in bank settlements by Target has led to a judgment against the insurer for the insured “loss of use of tangible property that is not physically injured”.  The policy required “property damage” caused by an “occurrence” which included an “accident”.  The court … Continue reading

Insuring cyber risks: remember its OT as well as IT

The buzz about the Internet of Things of a few years ago has died down but the cyber world and its things are becoming increasingly interconnected.  When considering insuring cyber risks, insurers must remember it is not only IT (Information Technology) but also OT (Operational Technology) that needs to be evaluated.  Hackers know better than … Continue reading

Insurance contamination exclusion upheld as unambiguous and properly located in policy

Faced with an unambiguous lead contamination exclusion, a damages claimant, alleging personal injury to a child from ingesting lead from the paint in a rented property, unsuccessfully contended that the exclusion was unenforceable because it was allegedly hidden 30 pages into the policy. According to the exclusion, the insurance did not apply to injury “arising … Continue reading

“Consequent upon” in policy wording connotes ‘but-for’ causation (US)

A Texas court, whose judgment was confirmed on appeal, found that an excluded loss “consequent upon” handing over gold coins to another against a fraudulent cheque invokes a more direct type of causation than “due to” or “arising out of”.  A loss sustained “consequent upon” an event connotes ‘but-for’ causation and the consequence must be … Continue reading

Review of a decision by the Life Insurance Ombudsman

In this recent judgment the insurer rejected the life policy claim of the executor of the deceased estate relying on an exclusion in the policy that liability would not arise where death resulted from a condition that pre-existed the existence of the policy if that death occurred before the expiration of twelve months from the date … Continue reading

Forfeiture clauses and claims tainted by fraud

This blog was co-authored by Anika de Kock, Associate and Lara Thom, Candidate Attorney. In the case of Discovery Insure Limited v Masindi, the court had to consider whether a claim “tainted with fraud” lodged by a policyholder had the effect of rendering the whole claim voidable, even the parts not tainted by fraud and … Continue reading