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Insurance Litigation Professional Liability Insurance Policy Exclusions

Wiley Rein LLP

Contractual Liability Exclusion Bars Coverage Where Lawsuit Against Insured Arises Out of a Contractual Obligation

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The Appellate Court of Maryland, applying Maryland law, has held that an insurer had no duty to defend or indemnify an insured under a professional liability policy containing a contractual liability exclusion for a lawsuit...more

Wiley Rein LLP

No Coverage for Malpractice Suit Where Insured Misrepresented Prior Knowledge of Potential Claim

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A Connecticut state court has held that an insurer owes no coverage to an insured law firm that misrepresented its prior knowledge of a potential malpractice claim to be filed by a former client. Evans & Lewis, LLC v. Nat’l...more

Wiley Rein LLP

Prior Knowledge Provision Precludes Coverage for Known Sexual Assault Under Either an Objective or Subjective Standard

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The Superior Court of New Jersey, Appellate Division, applying New Jersey law, has held that a professional liability policy afforded no coverage for a lawsuit alleging sexual misconduct because the insured had knowledge of...more

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Business Enterprise Exclusion Bars Coverage for Claim Arising out of Conduct Related to Joint Venture

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The United States District Court for the Middle District of Florida, applying Florida law, has held that a Business Enterprise exclusion in a professional liability policy barred coverage for claims brought against a law firm...more

Rivkin Radler LLP

Insurance Update - April 2024

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Dominance was the theme of this year’s NCAA basketball tournament, with the UConn men’s team winning back-to-back championships and the South Carolina women’s team reclaiming the title with a perfect record. But let’s not...more

Wiley Rein LLP

Wrongful Business Practices and Wrongful Death Lawsuits Against Nursing Facility Alleging Understaffing Held Not Related Claims

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The United States District Court for the Central District of California, applying California law, has held that wrongful business practices and wrongful death lawsuits against a nursing facility both alleging understaffing by...more

Wiley Rein LLP

No Coverage for Claims arising from Billing Practices under Professional Liability Policy

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The United States District Court for the Middle District of Florida, applying Florida law, has held that a law firm was not entitled to coverage under a professional liability policy for claims involving its allegedly...more

Rivkin Radler LLP

Insurance Update - February 23, 2024

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In this month’s insurance update, we address: •Whether opioid suits allege an occurrence - •Whether the recurring presence of wild turkeys is “infestation” - •Whether improper copying of an industry publication was in...more

Wiley Rein LLP

Wage and Hour Violation Exclusion Applies to Allegations of Untimely Payments in Connection with Scheme to Underpay Employees

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A Pennsylvania federal court, applying Pennsylvania law, held that a policy’s Wage and Hour Violation exclusion applied to the entirety of underlying class actions that alleged the insured employer schemed to underpay its...more

Wiley Rein LLP

Lawsuit not a “Related Claim” to Earlier Demand Letter, but Policy Rescinded Based on Material Misrepresentations in Application

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The United States District Court for the Middle District of Florida has held that an insurer was entitled to rescind a professional liability insurance company where the insured architecture firm made multiple material...more

Wiley Rein LLP

Based on Defamation Allegations, Insurer Must Defend Property Management Company against Lawsuit for Unlawful Security Deposit and...

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The United States District Court for the Southern District of California, applying California law, held that a professional liability insurer had a duty to defend a property management company against a class action lawsuit...more

Robinson+Cole Data Privacy + Security Insider

Insurer Denies Coverage Under Professional Liability Policy for Lawyer’s Email Compromise

Insurance coverage for cyberattacks can be tricky for anyone to navigate, including lawyers. To illustrate this point, a case in New Jersey caught my eye that I thought would be an interesting read for our followers who are...more

Rivkin Radler LLP

Insurance Update - June 2023

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Courts took up some interesting insurance questions this past month. Here’s some we address in our June Insurance Update. When a government sponsored cyberattack infects computers worldwide, does the war exclusion apply? ...more

Wiley Rein LLP

Coverage Barred by Related Claim Made Prior to Policy Period and Prior Knowledge Exclusion

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Applying New York law, the United States District Court for the Southern District of New York has held that no coverage exists under a professional liability policy because the lawsuit for which the insured sought coverage...more

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Sexual Misconduct Sublimit Applies to Negligence Claims Against Employer Where Claims Would Not Exist “But For” Employee’s Sexual...

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The Eastern District of Pennsylvania, applying Pennsylvania law, has held that a healthcare professional liability policy’s sexual abuse/misconduct sublimit applied to claims of negligent hiring and supervision against the...more

Wiley Rein LLP

New York Statutory Remedy Limited to a Single Policy Period

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In a win for Wiley’s client, the New York Supreme Court Appellate Division affirmed a trial court’s determination that New York Insurance Law Section 3426’s prohibition on coverage reductions in renewal policies where notice...more

Wiley Rein LLP

Professional Services Exclusions Bar Coverage for a Pharmacy Technician’s Mistake in Dispensing Medication

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The Western District of North Carolina has held that the professional services exclusions of two different policies issued to a staffing agency negated any duty to defend a lawsuit alleging a pharmacy technician improperly...more

Wiley Rein LLP

Prior Knowledge Exclusion Bars Coverage for Entire Lawsuit Alleging Multiple Instances of Wrongdoing

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The United States District Court for the District of Vermont has held that there is no coverage under a CGL and professional liability policy for all claims in an underlying suit brought against an insured residential care...more

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Prior Knowledge Provisions Barred Coverage for Malpractice Claim Based on Pre-Policy Sanctions and Default Judgment

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The Montana Supreme Court has held that there was no coverage under a lawyers professional liability policy for a client’s malpractice claim because the lawyer knew of and failed to disclose, prior to the insured law firm’s...more

Carlton Fields

Ninth Circuit Applies Willful Violation of Law Exclusion in Professional Liability Policy To Preclude Coverage for Wrongful Death...

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In National Fire & Marine Insurance Company v. Hampton, No. 19-17235 (9th Cir. Oct. 21, 2020), the Ninth Circuit held that a doctor’s guilty plea to the unlawful distribution of a controlled substance barred insurance...more

Wiley Rein LLP

Doctor’s Guilty Plea Establishes Basis for “Willful Violation” Exclusion from Coverage in Wrongful Death Case

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Applying Nevada law, the Ninth Circuit has held that a professional liability insurer did not have a duty to defend or indemnify a doctor for a wrongful death action because the doctor’s guilty plea triggered an exclusion for...more

Wiley Rein LLP

No Coverage for TPA in Claim Arising from Extracontractual Exposure to Insurer

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A federal district court has ruled that a third-party administrator’s professional liability policy does not afford coverage for a claim against the TPA arising from an excess judgment against the TPA’s...more

Wiley Rein LLP

Prior Knowledge Exclusions Apply Where Insured Received Three Letters from Potential Claimants and Issued Two Litigation Holds...

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In a case in which Wiley represented the insurer, the United States District Court for the Eastern District of Virginia, applying New York law, has held that three prior knowledge exclusions barred coverage under an...more

Wiley Rein LLP

Insurer Waived Right to Assert Policy Exclusion First Raised in Answer to Declaratory Judgment Complaint

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The U.S. District Court for the Southern District of New York, applying New York law, has concluded that an insurer waived the right to assert a policy exclusion as a coverage defense in a declaratory judgment action after...more

Carlton Fields

Years of Embezzlement Precluded From Coverage Under E&O Policy’s Commingling Exclusion

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A federal district court in North Dakota recently granted an insurer’s motion to dismiss in Campbell Property Management LLC v. Lloyd’s Syndicate 3624, finding that both prongs of a “commingling exclusion” to coverage...more

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