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Claims Made Liability InsuranceOccurrence vs. Claims Made PoliciesClaims-made policy forms prevail among insurers underwriting Professional, Directors and Officers, Employment Practices and Pollution liability insurance. For certain industries (i.e. pharmaceuticals) claims-made forms are widely used to write Products liability. Occurrence policies cover claims from “occurrences” during the policy period, regardless of when the claim first becomes known or is reported to the carrier. While claims filed years after an occurrence may be covered, policyholders and insurers are left with uncertainty as to adequate liability limits and/or proper loss reserves. Typical claims-made policies cover only those “claims made” and reported to the carrier during the policy period (or during an extended reporting period). Liability insurance written on an occurrence policy form and later renewed as a claims-made policy presents potentially serious gaps in coverage. Claim disputes between insureds and carriers arise from a number of sources, including Coverage Triggers, Retroactive Dates, and Tail Coverage. Coverage TriggersClaims-made liability insurance is designed to cover “wrongful acts” (actual or alleged) stemming from an error, omission or negligence of the named insured. The definition of “wrongful act” varies by type of professional liability policy purchased. For example, one common definition of “wrongful act” in Employment Practices Liability policies includes “sexual harassment, discrimination or wrongful termination.” Conversely, the definition of “wrongful act” in a D&O policy can be “any actual or alleged breach of duty, misstatements or misleading statements committed by the insured.” The definition of “Wrongful Act” is critical in serving as the “claim trigger” under a given claims-made policy. Retroactive DateCoverage for (unknown) acts which occurred during a “prior” policy period ("prior acts coverage") begins on the “retro date” and continues to the current policy period. “Prior acts coverage" is usually available only if the expiring coverage was also a claims-made policy. “Full prior acts coverage” responds to claims from acts occurring at any time prior to the current policy period. Tail CoverageWhile the policy’s “retro date” establishes the earliest date of coverage, the "extended reporting period" determines the final date of coverage (typically 30-60 days after policy expiration). "Tail coverage" is provides coverage for exposure to unknown liability claims when the insured person (or entity) retires, is acquired, ceases operations or decides not to renew insurance. We welcome a call to discuss your specific case issues: 817.980.4897. Claims Made Expert Witness CasesCases are listed only after we are disclosed as an Insurance Expert to opposing counsel.Claims-Made policy forms are used to write virtually all Insurance Agent Errors and Omissions policies. Click here to view a list of our Insurance Agent Errors and Omissions Cases. The following Cases involved Claims-Made policies other than Insurance Agent Errors and Omissions October 2009 – Retained by counsel for physician seeking claim payment under his Professional Liability policy. Case required expertise in Claims Made medical malpractice Professional Liability Insurance, Workers Compensation and Insurance Bad Faith. Lowe vs. TMLT, Cause No. 348-223452-07; 348th Judicial District Court of Tarrant County, Texas. Attorney Bill Kirkman - Bourland & Kirkman, LLP (817) 336-2800. May 2009 – Retained as a Professional Liability Expert to analyze issues of Insurance Bad Faith and Claims Made policies for Real Estate Brokers & Agents professional liability. Haynes v. Griffin, et al Cause No. 08-13312-G, 134th State District Court of Dallas County, TX. Plaintiff counsel Nathan Ziegler, (806) 765-8801. May 2007 - Retained as plaintiff counsel's Insurance expert to provide analysis and opinions regarding Agent Errors & Omissions and Insurance Bad Faith. Case issues involved placement of Claims Made Medical Malpractice insurance and Agent Standard of Care to advise when advising clients of Professional Liability market conditions. during insurance placement. Attorney Michael Hance, Franklin & Hance, PSC (502) 637-6000. Leslie Hill, M.D. v. SCW Agency, et al. Case No. 04-CI-07409 in Jefferson Circuit Court, Division 10, Commonwealth of Kentucky. February 2006 - Retained by defense counsel for insurance carrier. Case involved Agent Errors & Omissions as to timely reporting claims for General Liability Insurance and Professional Liability Insurance where both policies were issued by the same carrier. Attorney Carol Keough - Coats Rose Yale Ryman Lee (713) 653-7372; REO vs. Zurich American Insurance Co., RN Jones Agency, Inc. & Sidney Brown Cause No. C-1739-01-CA (Severed cause). August 2004 - Case involved General Liability and Professional Liability coverage issues relative to compliance with insurance requirements in a software contract. Defense Attorney Dan Bates - Decker, Jones, McMackin, McClane, Hall & Bates, P.C., Fort Worth, TX, (817) 336-2400. Bell Helicopter v. Global Technical Services, Inc., Cause # 17-215027-05, 17th District Court, Tarrant County, Texas. Burl Daniel, CPCU, CIC, CRM | 817.980.4897 | burl@burldaniel.com |
