Insurance Litigation For Non-legal Insurance Professionals

1. Insurance Litigation For Non-legal Insurance Professionals

2. Your Instructors TodayThe Law Offices of Johnna Hansen, Esq. Robert Freedman, Esq. Timothy Lake, Esq. Mr. Lake is a Firm Partner and Chair of its Insurance Coverage and Bad Faith Practice Group. Ms. Hansen is a Firm Partner and Trial Attorney who has handled over 100 bench and jury trials during her career. 15250 Ventura Blvd., 9th Floor Sherman Oaks, CA 91403(818) 205-9955 P (818) 205-9944 F rfreedman@tharpe-howell.comwww.Tharpe-Howell.com

3. Panel Members

4. Disclaimers • California Law • Information Purposes ONLY • Information does not constitute legal advise • Contact Attorney To Discuss Specific Matters

5. About Tharpe and Howell, LLC • 65 Attorney Civil Litigation Firm • Representing Insureds, Self -Insureds, and Insurers • California, Nevada, Arizona, Utah And Washington • Tharpe-Howell.Com

6. Topics To Be Discussed • Constitutes Majority Of Appellate Opinions • Insurance Coverage Opinions • Insured V. Insurer – Breach Of Contract / Bad Faith • Insurer V. Insurer – Indemnity And Contribution • Insurer V. Insured – Subrogation

7. Topics To Be Discussed • Agents / Broker E&O • California Claims Handling Statutes • Risk Management Tips

8. Goals of Webinar • Insight Into Active Areas Of Insurance Coverage Litigation • How And Why Cases Develop • Touch On Important Cases And Statutes • Tips For Risk Management

9. Active Areas Of Insurance Coverage Litigation • Breach Of Contract – Denial Of Coverage • Bad Faith – Extra Contractual Damages • Bad Faith – Refusal To Defend And Indemnify

10. Active Areas Of Insurance Coverage Litigation • Declaratory Relief • Contribution • Subrogation

11. Formal Insurance Coverage Letters • Tender Letters: Timely And Complete • Opinion Letters: Predict How Courts Will Interpet Coverage / Analysis Of Facts, Law And Policy Terms • Opinion Letters: Use With Advice Of Counsel – Defense For Bad Faith Claims

12. Formal Insurance Coverage Letters • Reservation Of Rights Letters: Preserves Insurer’s Rights To Deny Or Limit Coverage While Investigating / Defending Claims • Buss V. Superior Court – Allocation Between Covered And Uncovered Claims

13. California Claims Handling StatutesCalifornia Code of Regulations • Section 2695.5(e)(1):   • 15 days to acknowledge claim and specify information needed • Section 2695.5(b)(1): •  15 days to respond to communication from claimant • Section 2695.7(b): • Insurer required to accept/ deny claim within 40 days after receiving proof

14. California Claims Handling StatutesCalifornia Code of Regulations • Section 2695.7(c)(1): • If more time is required, insurer must provide written notice and specify additional information required, and reasons for inability to make a decision; written notice must be provided every thirty (30) days until a determination is made or notice of legal action.

15. Typical Reasons For Denial Of Coverage Insured Party / Insured Interest: • Bodily Injury, Property Damage, Advertising Injury Caused By “Occurrence” • Completed Operations Coverage • Failure To Satisfy Sir • Continuous Trigger: Montrose V. Admiral

16. Typical Reasons For Denial Of Coverage Professional Liability Policies: • Claims Made And Reported Policies • E&O Claims: “Claim” During The Policy Period Against An “Insured” For Wrongful Act” In Rendering “Professional Services”

17. Bad Faith-Refusal To Defend And Indemnify • Wrongful Denial Of Benefits Or Defense • Duty Of Good Faith And Fair Dealing  • First Party – Duty To Reasonably Investigate And Pay Benefits • CGL -   Duty To Investigate; Provide Defense Upon “Potential” For Coverage • CGL -   Duty To Pay Damages “Actually” Covered • CGL -   Duty To Achieve Reasonable Settlements Within Policy Limits

18. Bad Faith-Refusal To Defend And Indemnify • Tort Liability: Breach Of Duty Of Good Faith And Fair Dealing • No Bad Faith If There Is No Coverage Under The Policy • Damages:  Policy Benefits, Accrued Interest, Consequential Damages • Time Limitations: (Absent Policy Limitations): 4 Years Breach Of Contract & 2 Years - Covenant Of Good Faith And Fair Dealing

19. Bad Faith Extra Contractual Damages • Economic Losses • Emotional Distress • Attorneys’ fees Incurred To Enforce Payment Of Benefits Denied Or Delayed In Bad Faith Are Recoverable As Tort Damages: Brandt V. Superior Court • Punitive Damages

20. Equitable Subrogation • Insurer That Has Paid Loss “Steps Into The Shoes Of Its Insured” To Recover From Parties Legally Responsible  • Policy Provisions Or Assignment • Action In Name Of Insurer Or Insured • Same Defenses May Be Asserted • Anti-Subrogation – Can Not Sue Insured For Loss

21. Agent & Broker E&0 • Distinction Between Agent And Broker • Duty To Obtain Policy And Coverage Requested • Claims Handling Exposure • Extent Of Duty Based On Relationship And Expertise • Failure To Procure / Misrepresentations As To Coverage

22. Agent & Broker E&0 • Two (2) Year Statute Of Limitations  • Duty To Third Party Beneficiary ( Business To Business Markets, Inc. V. Zurich) • Trial Within A Trial • Damages: Insurance Benefits

23. Risk Management • Maintain Records Of Correspondence • Document Requests For Coverage From Insureds • Disclose (In Writing) Coverage Limitations / Exclusions / SIR’s / Deductibles • Insured To Complete And Execute All Applications • Know Insured’s Business Models, Risks, And Entities

24. Risk Management • Confirm Coverages Obtained • Confirm Persons, Entities, & Properties Insured • Written Authorization / Endorsement From Insurers For AIE’s • Communicate Notice Of Claim To Proper Insurers • Request Status Of Claim From Insurer Every 30 Days

25. In Conclusion • Provided A General Overview • Contact Us For More Information: • Offices in: California, Nevada, Arizona, Utah and Washington Visit us on the web! tharpe-howell.com