A liability policy typically requires the insured to cooperate with the insurer. Under the provision, the insured must, among other things, cooperate with the insurer in investigating or settling of the claim. Breach of the cooperation clause by the insured relieves the insurer of liability under the policy. But the insurer must show
June 2008
Liability Policy for Professional Services Does Not Cover Alleged Violations Under False Claims Act.
By Tred R. Eyerly on
Coverage for a suit involving false billing claims submitted in violation of the False Claims Act is generally not recognized under a liability policy. This was the result reached in a recent case decided by the Tenth Circuit. See Zurich Am. Ins. Co. v. O’Hara Regional Center for Rehabilitation, Nos. 06-1357 and…
Supreme Court Overturns Insurer’s Denial of Disability Benefits Based in Part on Conflict of Interest
By Tred R. Eyerly on
The United States Supreme Court decided an insurance-related case last week involving the insurer’s potential conflict of interest in its dual role in administering and paying benefits under an ERISA plan. Metropolitan Life Ins. Co. v. Glenn, No. 06-923 (U.S. Supreme Ct. June 19, 2008). MetLife was the administrator and insurer of…
When Does the Duty to Defend Start?
By Tred R. Eyerly on
The question "when does the duty to defend start?" arises quite frequently. Succinctly, it starts immediately upon the filing of a covered lawsuit and tender to the insurer. "The defense duty is a continuing one, arising on tender of defense and lasting until the underlying lawsuit is concluded, or until it has been shown that…
Hawaii Appellate Court Again Addresses Payment of No-fault Benefits
By Tred R. Eyerly on
In a prior post, we discussed two appeals by Dr. Emerson Jou to the Hawai`i Intermediate Court of Appeals regarding notice requirements for reimbursement from no-fault policies. In a recent, third case pursued by Dr. Jou, the ICA agreed notice of denial of benefits was required pursuant to Haw. Rev. Stat. 431:10C-304…
Endorsement Referencing Non-existent Standard is Not Enforceable
By Tred R. Eyerly on
The Ninth Circuit recently decided that the insurer’s reliance upon a non-existent policy limit referenced by an endorsement was not supportable. See Ferguson v. Coregis Ins. Co., No. 06-35867 (9th Cir. June 3, 2008).
The policy issued to Coeur d-Alene School District by Coregis referred in several places to the…
Hawaii Federal District Court Remands Based On Undecided Coverage Issue
By Tred R. Eyerly on
The Hawaii Federal District Court recently remanded a coverage case to allow the Hawaii state court to decide whether an exclusion in a professional liability policy was applicable. See Keown v. Tudor Ins. Co., 2008 U.S. Dis;t. LEXIS 42996 (D. Haw. May 30, 2008).
The insured was a realtor and…
Hawaii Federal District Court Finds No Duty to Defend or Indemnify Under Homeower’s Policy
By Tred R. Eyerly on
Perhaps the most surprising aspect of a recent decision by the Hawaii Federal District Court is that the insurer agreed to defend under a homeowner’s policy, albeit under a reservation of rights.
In Allstate Ins. Co. v. Sylvester, 2008 U.S. Dist. LEXIS 42386 (D. Haw. May 21, 2008), the insured…
Coverage Found for Insured Under Vendor’s Endorsement
By Tred R. Eyerly on
In Sturla, Inc. v. Fireman’s Fund Ins. Co., 67 Haw. 203, 684 P.2d 960 (1984), the Hawai`i Supreme Court determined that the distributor of allegedly defective carpet was an insured under a Vendor’s Endorsement, but found there was no coverage based on exclusions in the policy. The opposite result was reached in…