New York Appellate Division: Second Department Contradicts First Department, Denying Insurer's Recoupment of Defense Costs for Uncovered Claims
March 01, 2021 —
Jasjeet K. Sahani - Saxe Doernberger & Vita, P.C.New York law has historically allowed insurers to recoup defense costs paid on behalf of an insured if there is ultimately no coverage for the underlying action, provided that the insurer reserved its rights to seek reimbursement. On December 30, 2020, the New York Appellate Division, Second Department declined to follow this longstanding principle in American Western Home Insurance Co. v. Gjonaj Realty & Mgt. Co.,1 by holding that the insurer was not entitled to recoup defense costs, even where it was determined that the claim was not covered under the insurance policy.
In American W. Home Ins. Co., the insureds were named as defendants in an underlying personal injury action. More than four years after the accident, and a $900,000 default judgment against the insureds, they tendered the lawsuit to their commercial general liability insurer, American Western Home Insurance Company (“American”). American denied coverage based on untimely notice, but after the default judgment was subsequently vacated, it agreed to defend the underlying action subject to a reservation of rights. The reservation of rights specifically reserved American’s right to deny coverage if the vacatur of the default judgment against the insureds was reversed. Further, American reserved its right to recover the costs of defending the underlying litigation.
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Jasjeet K. Sahani, Saxe Doernberger & Vita, P.C.Mr. Sahani may be contacted at
JSahani@sdvlaw.com
Coverage Issues: When You Need Your Own Lawyer in a Construction Defect Suit
October 16, 2013 —
CDJ STAFFWhen an insurer hires an attorney on behalf of a client in a construction defect suit, that attorney is the client’s lawyer, but as Mike Curry writes on the website of Pendleton Wilson Hennessey & Crow, PC, a point may come when you need to hire your own additional attorney. Even though an insurance company client may refer to the lawyer as “the insurance carrier’s attorney,” Mr. Curry cites the words of the Colorado Bar Association’s ethics committee, “the insured is the client to whom the lawyer’s duty of loyalty is owed, regardless of any retention agreement the lawyer may have with the carrier.”
Mr. Curry then offers the example of what happens when the insurance company advises its client that it may not cover. “You presumably call your attorney and ask him to explain what’s going on, what the letter means, and what to do next.” All the attorney can say is “I cannot offer legal advice on coverage issues.”
This is the limitation of what Mr. Curry refers to as “the tripartite relationship.” The attorney has been retained for issues related to the construction defect dispute between the insured and the plaintiff. Not between the insurer and its insured. The attorney has, as he points out, a fiduciary obligation to the insurance company.
When coverage issues arise, “an independent attorney — one you hire — can help you with the coverage issues that your insurance-assigned attorney simply cannot address.” He further notes that “personal counsel owes no fiduciary obligation to the insurance company,” and can be “utilized to persuade the carrier to provide coverage or settle the case.”
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Trump Order Waives Project Environment Rules to Push COVID-19 Recovery
June 15, 2020 —
Debra K. Rubin, Mary B. Powers & Jim Parsons - Engineering News-RecordCiting the "national emergency" spurred by the COVID-19 pandemic's economic hit, President Donald Trump has signed an executive order that directs federal agencies to bypass environmental laws to expedite infrastructure projects, including those on federal lands, as a stimulus.
Reprinted courtesy of Engineering News-Record attorneys
Debra K. Rubin,
Mary B. Powers and
Jim Parsons
Ms. Rubin may be contacted at rubind@enr.com
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Construction Defects as Occurrences, Better Decided in Law than in Courts
December 09, 2011 —
CDJ STAFFConstruction defect claims are now occurrences for insurance purposes in four states, Arkansas, Colorado, Hawaii, and South Carolina, yet there are still frustrations for commercial general liability policyholders. Business Insurance describes court decisions on whether construction defect claims are covered as “incongruous,” and this drives up coverage and litigation costs. Construction firms often find they are defending themselves on two fronts, both the construction defect claim and also whether their insurance covers it.
Frank Armstrong, the Senior Vice President and National Director of Construction Claims for Willis North America says that the problem starts with the word “occurrence,” as various state courts have different interpretations of the word. “Certain pieces of it don’t fit well, at lest according to some courts in the country, with coverage for construction defect risks.”
Another insurance executive, Julian Ehlich, the Senior Vice President of Claims for Aon Risk Solutions’ construction services group notes that “jurisdictions differ, so policyholders don’t know what they’re going to get.”
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#10 CDJ Topic: Carithers v. Mid-Continent Casualty Company
December 30, 2015 —
Beverley BevenFlorez-CDJ STAFFCraig Martin of
Lamson Dugan and Murray, LLP on his
Construction Contractor Advisor blog used the Carithers case to demonstrate how “[w]hen you are involved in construction litigation, you have battles on several fronts, including those against subcontractors, owners, insurers and the court. Shoring up your defenses on each of these fronts is imperative, or you may lose the battle or, worse yet, the war.” Martin discusses the various “battle fronts” including the “Claim Against Contractor,” “Where Are You Litigating,” “Claim Against Insurance Company,” and “Damages.”
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In the article, “Duty to Defend Construction Defect Case Affirmed, Duty to Indemnify Reversed In Part,” attorney
Tred R. Eyerly also covered the Carithers case. Eyerly explained, “Determining whether there was coverage for the damages awarded required the court to decide which trigger applied. Examining the policy language, the court determined that property damage occurred when the damage happened, not when the damage was discovered or discoverable. Therefore, the district court did not err in applying the injury in fact trigger.”
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"Repair Work" Endorsements and Punch List Work
May 20, 2019 —
Jeremiah M. Welch - Saxe Doernberger & Vita, P.C.The recent white paper on
Repair Work Endorsements by
Jeremiah Welch, drew a storm of responses. Most were appreciative and included follow up questions, but there were those that lamented along the lines of: “How can that be? We’ve been doing it this way for years…”. For the skeptics, the best approach to test the premise of the paper (that most “repair work endorsements” are at best redundant with the PCO extension and at worst restrictive) is to try to formulate a scenario where coverage would be available under a “repair work endorsement” but not under a PCO extension.
Several folks asked about the impact of PCO extensions and repair work endorsements on “punch list” work. “Punch list” work presents a related but different problem. The first issue is understanding what is meant by the term “punch list”. You won’t find that term in an ISO CGL policy. You may find it defined in a construction contract and a Google search will yield several similar definitions. In general, our industry uses the term “punch list” to describe items identified toward the end of a project (often after the contractually defined point of “substantial completion”) which must be completed in order to fully comply with the contract requirements/scope. In short, “punch list” items are items necessary to complete the work.
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Jeremiah M. Welch, Saxe Doernberger & Vita, P.C.Mr. Welch may be contacted at
jmw@sdvlaw.com
Georgia Court of Appeals Upholds Denial of Coverage Because Insurance Broker Lacked Agency to Accept Premium Payment
December 07, 2020 —
Lawrence J. Bracken II, Michael S. Levine & Rachel E. Hudgins - Hunton Insurance Recovery BlogIn American Reliable Insurance Company v. Lancaster, the Georgia Court of Appeals reversed the denial of a property insurer’s summary judgment motion concerning the insurer’s denial of a fire loss claim. The basis of the denial was that the policyholders had failed to pay the policy premium. The policyholders, Charlie and Wanda Lancaster, claimed that they had paid their policy premiums for several years to their insurance agent, Macie Yawn. In October 2014, American Reliable mailed a renewal notice to the Lancasters notifying them that premium payments had to be made directly to the insurer. After it did not receive payment from the Lancasters, American Reliable sent them a cancellation notice in December 2014, again notifying them that payments be made directly to the insurer. The Lancasters denied having received either notice from American Reliable, but the record included a receipt for certificate of mailing.
After the Lancaster’s home burned down in 2015, American Reliable denied coverage on the grounds that the policy had been cancelled for nonpayment of premium. In the subsequent coverage action, the trial court denied American Reliable’s motion for summary judgment, ruling that a factual issue existed as to the actual and apparent agency of the insurance agent, Yawn. On appeal, the Court of Appeals found that the trial court erred in deciding that there was a factual issue concerning Yawn’s agency. Specifically, the Court of Appeals ruled that the record showed American Reliable had terminated Yawn’s agency to accept policy premiums, and that the Lancaster’s received notice of that termination in the renewal and cancellation notices. In addition to determining that Yawn was not an actual agent, the Court held that Yawn did not have apparent agency, because the notices sent to the Lancasters stated that the premium payment was to be paid to American Reliable, not to the agent.
Reprinted courtesy of
Lawrence J. Bracken II, Hunton Andrews Kurth,
Michael S. Levine, Hunton Andrews Kurth and
Rachel E. Hudgins, Hunton Andrews Kurth
Mr. Bracken may be contacted at lbracken@HuntonAK.com
Mr. Levine may be contacted at mlevine@HuntonAK.com
Ms. Hudgins may be contacted at rhudgins@HuntonAK.com
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COVID-19 Win for Policyholders! Court Approves "Direct Physical Loss" Argument
October 12, 2020 —
Gregory D. Podolak & Christine Baptiste-Perez - Saxe Doernberger & VitaLate last week, a Missouri federal district court provided a significant victory for insurance policyholders for COVID-19 losses. In Studio 417, Inc. v. The Cincinnati Insurance Company 6:20-cv-03127-SRB (W.D. MO, So. Div., Aug. 12, 2020), the Court was called upon to decide whether allegations involving the presence of COVID-19 in and around physical structures qualify as “direct physical loss or damage” to covered property. For those actively monitoring the COVID-19 insurance coverage litigation landscape, this has been a central question – and hotly contested debate – in virtually all first-party property and business interruption claims. Through a detailed and well-reasoned discussion, the Court answered the question with an emphatic “Yes.”
The Plaintiffs – a proposed class of hair salons and restaurants - purchased “all-risk” property insurance policies (the “Policies”) from Cincinnati. The Policies provide that Cincinnati would pay for “direct ‘loss’ unless the ‘loss’ is excluded or limited.” They also defined a “Covered Cause of Loss” as “accidental [direct] physical loss or accidental [direct] physical damage.” The Policies did not contain a virus exclusion. Anecdotally, Cincinnati has been vocal about the general lack of virus exclusions on its standard forms, having recently publicized that the company considers such exclusions “unnecessary” because, in its view, “a virus does not produce direct physical damage or loss to property.” From Cincinnati’s perspective, the insuring agreement is not triggered by these events, so there’s no need to analyze exclusions. Cincinnati relied heavily on that analysis in this case.
Reprinted courtesy of
Gregory D. Podolak, Saxe Doernberger & Vita, P.C. and
Christine Baptiste-Perez, Saxe Doernberger & Vita, P.C.
Mr. Podolak may be contacted at gdp@sdvlaw.com
Ms. Baptiste-Perez may be contacted at cbp@sdvlaw.com
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