Under typical Commercial General Liability policies, which are triggered by an “occurrence” during the policy period, an insured can safely wait until being served with a complaint to notify the insurer about the litigation. But policies written on a “claims made” basis, such as many Errors and Omissions policies or Employment Practices Liability policies, raise the specter of forfeiting any coverage at all for not notifying the insurer of a “claim” long before the insured knew that it would have to lawyer up and defend against a lawsuit.

Scottsdale Indemnity Co. v. Convercent, Inc., a recent decision from the federal court in Colorado, demonstrates this risk and the hole that an insured can inadvertently dig for itself. Continue Reading Traps await the unwary in claims-made insurance policies

Yesterday, the Oregon Court of Appeals dealt a hefty blow to insurance companies seeking to exclude coverage for property damage to multi-family dwellings and for awards of attorney fees. In Hunters Ridge Condominium Ass’n v. Sherwood Crossing, LLC, the Oregon Court of Appeals held that an insurance company’s “Multi-Unit New Residential Construction” exclusion was unclear as to whether it excluded coverage for property damage to both residential-only and mixed-use condominiums. Given there were two plausible ways to read the exclusion, the Oregon Court of Appeals held the exclusion must be construed against the insurance company. Continue Reading Not so fast insurance company, that judgment against your insured may in fact be covered

Photo by JOH_4595 is licensed under CC BY 2.0.

In a recent case, Oregon Shakespeare Festival Ass’n v. Great American Ins. Co., the federal District Court for the District of Oregon adopted a liberal interpretation of “property damage.” The Oregon Shakespeare Festival Association (OSF) suffered a loss during its season: nearby wildfires caused smoke to infiltrate a partially outdoor theater where performances were being held, necessitating cancellations.

OSF’s insurance policy covered “direct physical loss or damage” to its property and the “actual loss of Business Income” caused by such loss or damage. To get coverage for the business losses it sustained by cancelling performances, OSF had to show that the smoke infiltration, the undisputed reason for the cancellations, was “direct physical loss or damage” to property. Continue Reading Oregon federal court endorses broad definition of “property damage”

Intention can be a tricky concept in many areas of the law, from criminal prosecutions to insurance-coverage cases, as illustrated in a recent California case, Hung Van Ong v. Fire Ins. Exchange (Apr. 3, 2015). The Ong court had to choose between two views of what “vandalism” means in an insurance policy — one from a “legal” point of view that would destroy coverage, and one from an “ordinary” point of view that would create it. Honoring the keystone principle in these kinds of cases that a tie in a close case goes to the insured, the coverage-friendly interpretation won the day. Continue Reading Interpreting “vandalism” shows how ambiguity works in insurance-coverage disputes

In Kaady v. Mid-Continent Casualty Co. (June 25, 2015), the Ninth Circuit recently spurned an insurer’s attempt to conflate two separate losses in an attempt to deny coverage on the grounds that the insured’s pre-policy knowledge of the first loss made the second one a “known loss” that fell outside of coverage. Continue Reading Ninth Circuit clarifies that one “known loss” doesn’t mean you know them all

Last week, the Sixth Circuit Court of Appeals affirmed a ruling denying insurance coverage to a homeowner for damages resulting from a fire when a medical-marijuana operation inside the home caught fire.  The case, Nationwide Mut. Fire Ins. Co. v. McDermott (Feb. 24, 2015), revolved around whether coverage for property damage under a homeowner’s policy was properly denied because of the owner’s failure to inform the insurer of her husband’s operation of a medical-marijuana grow and distribution facility inside her home.  The Court answered that question in the affirmative, finding that the policy required the homeowner “to notify [Nationwide] as soon as possible of any change which may affect the premium risk under th[e] policy,” including, but not limited to, “changes … in the occupancy or use of the residence premises.” (emphasis in the original).

According to the homeowner, the policy language was never intended to require her to inform her insurance company of every possible change in the use or occupancy of her home.  The insured argued that, under the insurer’s interpretation, homeowners would be required to notify the insurer anytime they invited guests over to stay at the home, or introduced a new house plant.  The Sixth Circuit didn’t buy this hypothetical: Continue Reading Up in Smoke: Insured Cannot Recover Damages Caused by Fire from Home Medical-Marijuana Operation

The Seventh Circuit just released an opinion in Strauss v. Chubb Indemnity Insurance on November 18, 2014, upholding coverage for insureds who discovered the presence of long-term water damage five years after their insurance policies had expired, and likely well after the statute of limitations passed for a construction-defect action. With this opinion, the Seventh Circuit joins with other jurisdictions that have determined there is coverage for long-term latent defects that go undiscovered for years. Continue Reading Past the Statute of Limitations for a Construction-Defect Case? Try Looking at Your First-Party Property Policy for Coverage.

The Oregon Court of Appeals yesterday issued an opinion confirming that Oregon law remains faithful to the bedrock principle in coverage disputes that ambiguities in a policy must be resolved in favor of the insured.

In Patton v. Mutual of Enumclaw Ins. Co. (Oct. 8, 2014), an insured seeking coverage under his homeowner’s policy found himself between a rock and hard place, at least under the insurer’s erroneous attempt to link two unconnected policy provisions to deny coverage. Lowell Patton’s house burned down on November 8, 2001 and he sought the full value to rebuild under the “replacement cost” coverage written by Enumclaw.

Continue Reading Oregon Court of Appeals Rejects Insurer’s Heads-I-Win, Tails-I-Win Policy Interpretation

The Ninth Circuit, applying Arizona law, recently held that an insurer may avoid the duty to defend innocent insureds based on somewhat unique terms in a liability policy. In IFC v. Roman Catholic Church, (9th. Cir July 30, 2014), the Court began with a simple question: “Does ‘any’ mean ‘any,’ or does ‘any’ mean ‘any one?’” Given this question, the answer appears to be easy, but this question may not have been the right one, at least according to a dissenting opinion. Continue Reading Ninth Circuit hands out tough decision for innocent insureds seeking a defense from the insurer