Tag archives: Insurance

Lloyd’s 2.0 Metallica 0.0 for Covid-19 concert cancellation claim

On 18 March 2024 the California appellate court dismissed an appeal by Frantic Inc, professionally known as heavy metal band Metallica, claiming losses under a Cancellation, Abandonment and Non-Appearance Insurance policy because it was subject to a Communicable Disease exclusion excluding “any loss directly or indirectly arising out of, contributed by, or resulting from any communicable … Continue reading

The proof is not in the pleadings – parties may not rely on an Anton Piller order to construct a cause of action

An Anton Piller order allows a prospective litigant to instruct the sheriff of the court to search a property and seize specific documentary evidence when a “real and well-founded apprehension” exists that such evidence will be hidden or destroyed before litigation begins. In arecent judgment (1760.pdf (saflii.org)), the High Court emphasized that, for an Anton … Continue reading

Medical expenses paid by medical aid are not deductible from damages

In this February 2024 judgment, the Pretoria High Court rejected the Road Accident Fund’s argument that it is not liable for medical scheme members’ past medical expenses paid by the injured person’s medical scheme following a motor vehicle accident. Section 19 of the Road Accident Fund Act, 1996 excludes the RAF’s liability in certain circumstances, … Continue reading

Principles of USA Insurance Law similar to South Africa

This US judgment’s summary of Michigan insurance law will be largely familiar to South African readers: “An insurance policy is much the same as any other contract. It is an agreement between the parties in which a court will determine what the agreement was and effectuate the intent of the parties. Accordingly, the court must … Continue reading

$3.7 million pool damage claim not insured because of business risk and professional liability exclusions (US case)

An insurance coverage dispute arose out of the construction of a “disappearing floor pool” at a residential home in Montana, US. The pool and spa included several water features such as an infinity edge, a basin to catch water overspilling the edge (a “vanishing edge basin”), a movable and disappearing pool and spa deck, a … Continue reading

The importance of listing the insured properties in a policy schedule (US case)

In 2021, a warehouse developed by a property developer and already occupied by the tenant collapsed during a tornado causing injuries and deaths. The developer sought an indemnity under its insurance policy covering bodily injury and property damage liability. The right to indemnity was declined by the court because the warehouse was neither explicitly nor … Continue reading

An “accident” includes successive events without interruption, under the Montreal Convention

In a claim for damages for personal injury arising from an event on the defendant airline, the Court of Justice for the European Union found that, for the purposes of Article 17 of the Montreal Convention, an accident can be an unforeseen, harmful, and involuntary series of intrinsically linked events taking place successively, without interruption, in … Continue reading

Dishonest Insurance Claim: Materiality

The insured instituted a claim against the respondent insurer for payment of the replacement value of his stolen motor vehicle. The claim was rejected by the insurer, who alleged that the insured had supplied it with dishonest information when making the claim. The insured alleged that he had given a lift to two women and … Continue reading

An insurer is not a CPA Supplier

Mokgoke v Momentum Insure Company Limited (NCT/279251/75(1)(b) – Rule 34) [2023] ZANCT 35 (20 September 2023) The applicant submitted a claim to his insurer, water leakage of his motor vehicle in June 2020. Two days later the insurer collected the vehicle and referred it to various service providers. The insurer informed the applicant that his … Continue reading

What is a ‘claim for damages’ under a claims-made insurance policy? (US)

Under a “claims-made” liability insurance policy, whether a communication to the insured constitutes a “claim” or a “claim for damages” determines whether the policy is applicable to the claim. The Delaware Supreme Court held that an unclear and amorphous letter from an attorney did not constitute a “claim for damages” required by the policy. A … Continue reading

Duties of Auditors and Compliance Officers are owed to Intermediary not Third Party Insurers

Hollard Insurance Company Ltd and Others v Insure Group Management Ltd (in liquidation) and Others (21/43014) [2023] ZAGPJHC 371 (25 April 2023) A number of insurers issued summons against an intermediary (the first defendant), its auditor (the second defendant) and its compliance officer (the third defendant) in relation to premiums collected by the intermediary and … Continue reading

An Acknowledgement of liability to third party interrupts prescription

The Free State High Court confirms in J.H.V v Centlec (SOC) Ltd and Others that an acknowledgement of liability by the debtor interrupts prescription, even if the acknowledgement is not made directly to the creditor. The applicant approached the High Court for a declaratory order that he was not indebted to Centlec SOC Ltd, the municipal electricity … Continue reading

How not to prosecute an insurance claim

This is a strange judgment from the Pretoria High Court.  The insured sought an order that the insurer pay the alleged value of his motor vehicle, after it had allegedly been written off in an accident. The court noted that the insurer had “repudiated his claim due to non-disclosure of material information at the inception … Continue reading

Insurance does not cover deliberate conduct (US)

The insured pharmaceutical company was sued for flooding the California pharmaceutical market with opioids, concealing the facts, disregarding its duties, and ignoring risks as a result of which people became addicted and even died as a result of opioid use. The insured sought an indemnity from the insurer’s which covered “bodily injury caused by an … Continue reading

Role of intention and punctuation when interpreting insurance guarantees

In January 2024 the High Court held that an insurer’s guarantee that ambiguously contained two incompatible  expiry dates, namely the date of issue of the final completion certificate under the construction contract and the date on which the contractor had to pay under the consequent final payment certificate, should be interpreted in a businesslike fashion … Continue reading

Troublesome vultures pecking a roof is an insurance-excluded “infestation” (US)

In January 2024 a US court found that the pecking damage to the roof of a Maryland shopping centre by turkey vultures was caused by an “infestation” excluded under the policy. The commercial property damage policy excluded cover for “nesting, infestation or discharge of waste by birds”. The court found that the vulture presence on … Continue reading

Sky UK Limited v Riverstone Management Agency Limited

Contractors All Risks Insurance:  Any One Event (UK) – Part 3 In this judgment, discussed previously [here and here] the final issue for determination was the question of application of the insured’s Retained Liability.  The relevant clause read: “The policy deductible was €10 000 each and every loss, but there was a deductible for claims … Continue reading

Subrogation of a claim by operation of law is not a void transfer of rights by a party (UK)

A sale contract for maritime surveillance aircraft delivered in Japan provided that the contract must “not be assigned or transferred in whole or in part by any party to any third party, for any reason whatsoever, without the prior written consent of the other party”. Such a transfer would be void. The buyer insured the … Continue reading
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