Insured vs Insured Exclusion Precludes Coverage

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In many insurance policies, particularly directors and officers liability policies, coverage is precluded if one insured brings a claim against another insured. But what happens if one of the named plaintiffs is not an insured party? A recent Sixth Circuit Court of Appeals case addresses this issue.

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When Claims-Made Primary and Occurrence Excess Policies Clash

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Decades ago, professional liability policies, like most liability policies, were written on an occurrence basis. If a claim was incurred during the insurance policy period, the policy would respond to the claim regardless of when the claim was made against the defendant and noticed to the insurance company. As we know from environmental and asbestos claims, that can take decades.

Then along came claims-made polices. Under a typical claims-made policy, if a claim is made against the defendant and reported to the insurance company during the policy period, that insurance policy will respond to the claim regardless of when the occurrence took place (as long as the claim occurred after the policy’s retroactive date). If the claim was made after the policy period and , that policy would

In New York, legislative and regulatory efforts to keep medical professionals practicing in New York led to a quirky medical malpractice insurance system where most primary medical malpractice policies were claims-made policies, but New York medical professionals were provided with excess policies written on an occurrence basis.

This leads to a recent case that explored the issues that arise when occurrence-based excess policies sit on top of claims-made primary policies.

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A New Argument in a Case Is Not a “Claim” for Insurance Purposes

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Claims-made insurance policies, especially in professional liability and financial lines, have been around for decades. Most policyholders and insurers understand the purpose of a claims-made policy compared to an occurrence-based policy. Yet every so often a case comes along that raises a new wrinkle about claims-made coverage. In a recent case before the Seventh Circuit Court of Appeals the court had to determine whether a new argument made in an ongoing lawsuit was an independent “claim” for purposes of a claims-made professional liability policy.

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