Tag archives: Insurance

A previous group insurance scheme became unlawful and the contracts unenforceable when Insurance Act 2017 commenced

In September 2023 the Supreme Court of Appeal held that, where 8 000 individual funeral policy members had formed part of a group scheme under the Long-term Insurance Act 1998 which was no longer a “group” scheme as defined in the Insurance Act 2017 from 01 July 2018, the insurance policies and the related intermediary … Continue reading

Policy interpretation: flood endorsement (Botswana)

This 2012 judgment in which Norton Rose Fulbright successfully acted for the insurer, is worth revisiting in the context of the unprecedented levels of flooding being experienced in South Africa (and around the world). The insured had been engaged by the Government of Botswana to construct a dam and was required to design and construct … Continue reading

Medmal claim unsuccessful for failure to notify request for medical records (US)

A Maryland US court declined a doctor’s request for an indemnity from his medical malpractice insurers because the insured doctor failed to report a request for medical records from the patient’s lawyer as required by the policy during the policy period. The attorney’s request for medical records was sent on 20 April 2021. The insurance policy … Continue reading

Subrogation – The circumstances and remedies for an insurer’s compromised rights

An indemnity policy constitutes a contractual agreement in terms of which the insurer indemnifies the insured in the event of a loss. The policy is neither intended to unjustifiably enrich nor undercompensate the insured. Its primary purpose is to restore the insured to their prior financial position subject to indemnity limits and avoid double indemnity. … Continue reading

Insurance claims rejection for failure of insured to submit to examination under oath (US)

A Massachusetts appeal court refused to uphold an insurer’s fire claim rejection that was based on an alleged failure of the insured to submit to a “reasonably required” examination under oath in the course of investigating the claim because, on the facts, the insured had not wilfully and without excuse refused to present its president … Continue reading

Arising from, in connection with, directly or indirectly, arising directly or indirectly from or in any way connected with: insurance (Aus)

This Australian judgment considered whether the insurer could correctly rely on a number of exclusions to a claim by its insured for cover under the liability section of the policy. The policy used two composite formulations to connote the requisite relationship between the liability and the exclusion. The first formulation excluded liability “arising from, or … Continue reading

Director must refund defence costs to D&O insurer despite alleged partial success (US)

A Delaware bankruptcy judge held that a D&O insurer can clawback more than $6 million in advancements of costs to the director’s criminal defence lawyers even if some charges against the director were dropped for practical reasons, not because of the director’s innocence. The case stems from the notorious conduct of the CEO of Insys Therapeutics … Continue reading

Insurance and aggregation clauses (UK)

There is a substantial body of English case law explaining the import of a contrast between different aggregation clauses. AXA Reinsurance (UK) PLC v Field (1996) 1 WLR 1026 at 1035 contrasted the words “arising from one originating cause” with the words “arising out of one event” used to define the unifying factor used in … Continue reading

Problems with ‘other insurance’ clauses

In a US decision as to which of two insurers was the primary insurer with a duty to defend the policyholder, the ‘other insurance’ clauses in each policy were different. The ‘other insurance’ provision in the Secura policy provide that “if other valid and collectable insurance is available to the insured for a loss” coverages … Continue reading

Covid-19 Insurance and Damage (UK)

In this judgment the insured restaurant argued that the requirement in the murder, suicide or disease extension that the interruption or interference with the insured business be caused by damage did not require physical damage. It was common cause that there had been no physical loss or damage to the insured premises or property used … Continue reading

A non-life insurer can insure its first-party risks

A March 2023 decision of the Financial Services Tribunal found that there is no implied prohibition in the Insurance Act on ‘traditional’ insurers (not cell) underwriting risks for both its own first party risks and third party risks. Abacus Insurance Limited (“Abacus”), a traditional insurer, holds a non-life insurance licence, permitting it to underwrite third … Continue reading

Insurance and meaning of “sudden, unintended and unexpected happening”

In this recent High Court judgment, the insurance policy under consideration contained a pollution exclusion with the proviso that the exclusion did not apply where the pollution was caused by a “sudden, unintended and unexpected happening” during the period of the insurance. It was common cause that the contamination of the third party’s land was … Continue reading