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Make Sure You Allege Mental Incomptency When Seeking a Defense in an Assault Case for There to Be a Defense Obligation

Recently, the Superior Court of Pennsylvania found that an insurer had properly denied a defense to its insured who had been sued for assault. See Kiely on Behalf of Feinstein v. Philadelphia Contributionship Ins. Co., 2019 PA Super 90 (Mar. 26, 2019). The facts before the court indicated that Christine Feinstein had hired Nydia Parkin as a domestic employee in her residence. Inexplicably, Feinstein physically attacked Parkin during her employment. Parkin sued for assault. Feinstein tendered the claim for a defense to her homeowner insurance company. The claim was denied on the ground that the assault was not an occurrence. In the ensuing coverage trial, Feinstein's attorney argued that Feinstein had suffered from a stroke and bipolar disorder and may even have had dementia at the time of the assault. The court nonsuited the case, finding that the attorney's testimony did not prove Feinstein's mental capacity was diminished to a point where she could not appreciate the nature of her conduct. The case was affirmed on appeal. The Superior Court held that Feinstein's reported mental incapacity, irrespective of whether it was real or imagined, was irrelevant because the underlying complaint did not mention mental incapacity. Instead, the complaint alleged that Feinstein had attacked Parkin, including choking and punching her, while uttering racial epithets, and that Parkin did not provoke the attack or fight back. Under those circumstances, the Superior Court found that Feinstein's mental health was not in question and that it was error for the trial court to even consider Feinstein's health in assessing the insurer's duty to defend.

Rhode Island Supreme Court Says That Insurance Companies Do Not Owe Third-party Claimants Any Duty To Attempt Settlement

In Summit Insurance Co. v. Stricklett, 199 A.3d 523 (R.I. 2019) the court found that the insurer did not owe a minor child pedestrian who was struck by the insured's vehicle or the child's parents any duty to attempt to settle the child's personal injury claim. The court resoundingly rejected the claimant's argument that the insurance company owed them a duty of good faith and fair dealing in settlement negotiations. In rejecting this assertion, the court discussed how the insurer's duty to settle arose from the contractual fiduciary duty that was owed between the insurer and its insured. In contrast, the relationship between the insurance company and a third party was adversarial, which did not give rise to a fiduciary obligation on the part of the insurance company to the claimant.

A Settlement Demand Is Required As A Prerequisite In A Liability Claim To The Insurer's Duty To Settle

The Georgia Supreme Court recently held in First Acceptance Ins. Co. of Georgia, Inc. v. Hughes, 826 S.E.2d 71 (Ga. 2019) that a liability insurance company's duty to settle arose when a valid settlement demand was presented by the injured party that fell within the insured's policy limits. Only under those circumstances did an insurer risk breaching that duty if it rejected a reasonable settlement demand. This case involved a multiple vehicle traffic accident which resulted in one fatality and the injury to five individuals. The insured's policy limits were $25,000 per person/$50,000 per accident and were insufficient to fully compensate all of the injured parties. Because of this, the insurance company sent the injured parties' attorneys a letter proposing a joint settlement conference/mediation to resolve all claims. The Georgia Supreme Court found that as a threshold matter the insurer's duty to settle arose only when the injured party presented a valid offer to settle within the insured's policy limits. As support for its conclusion that "sound" policy supported the making of a written settlement demand as a prerequisite to a liability insurer's duty to settle. The court noted that without an offer within the policy limits, the only evidence of an essential element of the insured's case - that the insurer could have settled the case within the policy limits - would be "after-the-fact testimony of the injured party that he would have settled within the policy limits. Such testimony was unreliable and often self-serving or the product of collusion between the insured and the injured party.

BAD FAITH

The First Circuit U.S. Court of Appeals recently upheld a district court's ruling that an insurance company's claim administrator's handling of a medical malpractice lawsuit was in conformity with Massachusetts statute regarding reasonable settlement.

MAKE SURE YOU'RE ACCURATE WHEN YOU EXPLAIN WHY THE POLICY WAS CANCELLED

The Colorado Court of Appeals in Brown v. American Standard Ins. Co. of Wisconsin, 436 P.3d 597 (Colo. App. 2019) recently found that the insurance company's reason for cancelling the policy must be accurate for the cancellation to be effective. The Colorado Court of Appeals, as a matter of first impression, held that when the insurance company provides the reason for its policy cancellation (in this case an automobile policy), the reason given by the insurer must be accurate. If the reason is not accurate, the notice of cancellation is ineffective. In doing so the court rejected the insurance company's argument that the cancellation was effective, irrespective of whether the reason was actually accurate in situations where the insured did not contest the cancellation until after the accident had occurred. However, the Colorado appellate courts had previously held that insureds who received defective notification of cancellation were permitted to sue their insurance company without having previously challenged the cancellation.

Untimely Ror Letter Leads To Estoppel

Recently the Kansas Supreme Court held that the insurance company's untimely reservation of rights letter estopped the insurer from denying coverage. In Becker v. The Bar Plan Mutual Insurance Co., 419 P.3d 212 (Kan. 2018), the trial court ruled that the insurance company that had issued the attorney's claim made professional liability policy had no duty to defend a claim made before the policy's inception, notwithstanding the insurance company's failure to reserve its rights to deny coverage in a timely manner. The trial court found that coverage could not be expanded by estoppel. However, the Kansas Supreme Court disagreed.

Timing Is Everything When It Comes To Malicious Prosecution Coverage

The Illinois Supreme Court in First Mercury Ins. Co. v. Ciolino, 107 N.E.3d 240, appeal denied, 108 N.E.3d 840 (Ill. 2018), considered when a malicious prosecution claim became an "offense" for purposes of insurance coverage and whether the claim fell within the subject policy. The Court found that when dealing with malicious prosecution claims, the date of occurrence for triggering coverage was the date that the prosecution commenced and not the date on which plaintiff was exonerated. The Court noted that the use of the term "offense" in the policy did not demonstrate the intent of the parties that coverage would only be triggered upon the fulfillment of all elements of the tort of malicious prosecution under Illinois law. The Court found that coverage was dependent upon whether the insured's offensive conduct was committed during the policy period, irrespective of whether there had been an accrual of the malicious prosecution tort.

Choose Your Own Poison

The Washington Court of Appeals recently adopted a choose your own poison approach to cases where an insurer exhausts its policy limits in settlement of one claim while other related claims remain unresolved. In Singh v. Zurich American Ins. Co., 428 P.3d 1237 (Wash. App. Div. I, 2018) the court found that an insurance company's fiduciary duty may preclude the insurer from exercising policy rights.

Illinois Court Treats SIR As A Primary Policy Requiring Exhaustion

In Lamorak Ins. Co. v. Kone, Inc., 2000 Ill. App. (1st) 163398 (Ill. App. May 15, 2018), the Illinois Appellate Court found that in policies containing self-insured retentions, that the SIR was to be treated as a primary policy that had to be exhausted before the insured could tap into the excess layer of coverage.

In For One, In For All Rule Does Not Apply To Title Insurers In Pennsylvania

Under the so-called "in for one, in for all" rule, if there is one covered claim on a multi-count complaint while other claims are not covered, the insurer is required to defend the entire action. Recently, the US Court of Appeals for the Third Circuit in Lupu v. Lone City, LLC, 903 F.3d 382 (3rd Cir. 2018) (interpreting Pennsylvania law) held that a title insurer was entitled to limit its duty to defend only to covered claims. The court found that title insurance policies differed from general liability policies because title insurance policies are limited to loss from defects that cloud or invalidate a title. Because title insurers cover past defects in title, title insurers were entitled to limit their risk by searching the public records before issuing a policy. This was different than general liability insurance which typically provided insurance against future events. Additionally, general liability insurance companies typically promise to defend "a suit" or "any suit" seeking damages for covered acts or omissions. In contrast, title insurers promise to defend only claims arising from defects in title.

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