Double-check existing policies for whistleblower coverage

Whistleblower lawsuits under the False Claims Act, also known as qui tam actions, have become more common in recent years. This is particularly so in heavily regulated industries and those in which the government routinely pays or reimburses costs, such as health care, pharmaceuticals, finance, construction and defense. Companies defending themselves against government investigations and FCA actions often have the insurance coverage they need — but frequently overlook it.

Our group recently authored an article in Business Insurance discussing insurance coverage for FCA investigations and actions. As discussed at greater length in the article, businesses facing whistleblower suits and government investigations often have coverage in standard policy types, including employment practices liability (EPL), errors and omissions (E&O), directors and officers (D&O), and commercial general liability (CGL) policies. For instance, EPL policies, which cover losses from claims stemming from wrongful employment practices, may respond to FCA claims because FCA suits frequently include a claim of retaliation by the whistleblowing employee. Where employment-related claims are also at issue and intertwined or interrelated with the FCA claims, courts have ruled that EPL insurers have a duty to defend the entire action. Continue Reading

Insurance Coverage for Statutory Damages Under Professional Liability Policies

Increasingly, companies are being named as defendants in putative class actions, like those brought under the Fair Credit Reporting Act and Telephone Consumer Protection Act, involving violations of statutes that contain provisions mandating certain damages or ranges of damages. One question raised is whether “statutory damages” are uncovered “fines” or “penalties,” or whether they are covered losses. Continue Reading

2016 Insurance and Risk Management Checklist

As we start a new year, there is no time like the present to evaluate your company’s insurance and risk management program and plan for the year. What should you consider as you move into 2016? Take a look at our checklist of questions you should consider now to evaluate your risk management program this year.

365 Days Later: Lessons Learned from the Pennsylvania Supreme Court

One year ago today, the Pennsylvania Supreme Court issued the first two of four important insurance-coverage law opinions that it would hand down in 2014 and 2015. Those four decisions – which address a number of topics including insurer bad faith, trigger of coverage, policy exclusions, and settlements and reservations of rights – significantly impacted the legal landscape in the commonwealth.

While much has already been written about the specific holding in each of those cases, policyholders can still learn more from each of the decisions. Now – 365 days later – is a good time to reflect on those lessons:

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Stadium Owners Watching Closely To See if Insurer Fumbles Reggie Bush Claim

San Francisco 49ers running back Reggie Bush reportedly intends to sue the city of St. Louis after slipping on a concrete surface behind the St. Louis Rams’ bench during a recent game, injuring his knee and ending his season. If a lawsuit is brought, St. Louis (which owns the Rams’ stadium where the injury occurred) likely will look to its liability insurer to pay for its defense and for any damages awarded to Bush at trial. While the insurer may dispute St. Louis’s claim, the city has a strong argument for coverage, and stadium owners across the world—who have a duty of care to the hundreds of multi-millionaire professional athletes who compete on their fields and pitches—will be watching closely to see if the insurance company fumbles the claim. Continue Reading

Eastern District of New York ultimately arrives at right outcome when interpreting “Employer’s Liability” exclusion in CGL policy

In Hastings Development, LLC v. Evanston Insurance Company, No. 14-cv-6203 (ADS)(AKT) (Oct. 30, 2015), the U.S. District Court for the Eastern District of New York correctly determined that an “Employer’s Liability” exclusion in a commercial general liability (“CGL”) policy only applied and precluded coverage when an insured is sued by its own employee(s) and not by an employee(s) of a co-insured. Believing that the exclusion was ambiguous, and based on “the lack of any probative extrinsic evidence” concerning the parties’ intent, the district court applied “the rule of contra preferentem” and found it “appropriate to adopt the Plaintiff’s interpretation of the exclusion because the Plaintiff is the insured and its interpretation of the exclusion is the narrower interpretation.” Continue Reading

PA Policyholders May Find Road Blocks In Obtaining Coverage For Misappropriation of Advertising Ideas under CGL Policies

Last week, the United States Court of Appeals for the Third Circuit issued a ruling that may make it more difficult for Pennsylvania policyholders to obtain coverage for the misappropriation of advertising ideas under standard commercial general liability policies. In The Hanover Insurance Company v. Urban Outfitters, Inc., No. 14-3705 (Oct. 23, 2015), the Third Circuit adopted a standard for the “prior publication” exclusion – an exclusion that precludes coverage for misappropriation of material that was first published before the insurance policy incepted – that may prove difficult to overcome.

In a recent client alert, members of Reed Smith’s Insurance Recovery Group discuss the Third Circuit ruling, and its potential impact on Pennsylvania insureds.

Beware of Good Intentions: Insurer Cannot Escape Duty to Defend by Interpleading Policy Limits That Were Not Subject to Competing Claims

On October 6, 2015, the United States District Court, Northern District of California held that an insurer breached its duty to defend by interpleading remaining policy limits and ceasing its defense of its insured.  Doublevision Entertainment, LLC v. Navigators Specialty Insurance Company, N.D. Cal., No. C 14-02848 WHA. Despite language in the policy stating that the insurer was not obligated to defend after it had deposited remaining policy limits with a court, the district court held that Navigators could not simply interplead the funds and abandon its insured “at the moment of her greatest peril.”

Navigators issued an errors and omissions policy to Commercial Escrow Services (“CES”) and its principal, Antoinette Hardstone. Beginning in 2010, CES and Hardstone were sued by a number of customers alleging improper escrow handling. After CES and Hardstone tendered to Navigators, Navigators assumed the defense of the claims.  While the claims were pending, the California Department of Corporations conducted an investigation into CES and determined that it had a shortage of $195,750. The Department of Corporations appointed a receiver, who had authority to collect any insurance proceeds needed to cover the shortage.

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Third Circuit Holds That Terms of Insurance Policy Renewal ‘Must be the Same or Nearly the Same as the Initial Contract’

Recently, resolving an insurance-coverage dispute, the U.S. Court of Appeals for the Third Circuit held that “for a contract to be considered a renewal, it must contain the same, or nearly the same, terms as the original contract.”  The court’s precedential ruling in Indian Harbor Insurance Co. v. F&M Equipment, Ltd., No.14-1897 (Oct.15, 2015), which is likely to have effects outside of the insurance-coverage context as well, means at the very least that when an insurance company promises to offer its insured a “renewal,” it cannot simply offer a subsequent insurance policy with new terms, even if the insurer provides the policyholder notice of the changes.

In a recent client alert, members of Reed Smith’s Insurance Recovery Group discuss the Third Circuit ruling and its implications for policyholders and insurers both.

Will it Cost More To Protect Your Company and Board from Cyber Attacks?

Businesses may find it more challenging to purchase or renew cyber liability insurance coverage, according to recent articles by Advisen¹, Reuters, and follow-up communications with Robert Parisi, managing director and National Cyber Risk Product Leader at Marsh. Brokers are warning that policyholders should expect sharp increases in premiums and deductibles, coupled with declining limits. Although cyber insurance coverage has been around for a number of years, about “75% of commercial entities still don’t buy the coverage,” according to Parisi. Marsh expects the cyber insurance market to continue growing faster than any other line of commercial insurance. Despite the overall growth, “some carriers have retreated from certain sectors” in the cyber insurance marketplace because the risks and costs associated with cyber attacks continue to be unpredictable for businesses and insurers alike. In part because of recent high-profile attacks, some cyber liability insurance carriers are less willing to take on certain risks, particularly in large health care and retail, or are simply charging as much as triple the premiums for renewals of coverage. Parisi noted that before issuing a policy, carriers may subject a policyholder to more intrusive underwriting – “asking a lot of questions” about the nature of a policyholder’s cyber defenses. Carriers may also in some cases require policyholders to undergo costly improvements, such as requiring retailers to invest in sophisticated encryption technology to protect payments from hackers. As the cyber insurance market continues to mature and evolve, policyholders should be aware and seek assistance when negotiating new or renewal cyber coverage to ensure they obtain the most comprehensive coverage available to fit their needs.

 

  1. Chad Hemenway, Hardening Market, Shifting Players Make Building A Cyber Insurance Tower Challenging, Advisen News (Oct. 12, 2015), available with subscription at www.advisenltd.com.
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