Reed Smith Insurance Recovery Group’s Post

In the recent case of Furtado v Lloyd’s Underwriters, the Ontario Court of Appeal examined whether an insured could secure coverage for two separate claims under their company’s directors and officers’ policy. This ruling emphasizes the key differences between occurrence-based and claims-made and reported policies. It also underscores the importance for insureds to carefully review their policies’ reporting requirements and to promptly inform their insurer of any claims or relevant situations. Check out the article co-authored by my Toronto colleagues Belinda Bain and Luke Sabourin, for a deeper look into the case and its implications: https://bit.ly/3X34mtW #gwlgTO #insurancelaw #insurancepolicy #insurancecoverage

Facts are that the Investigator's report was that the loss was only waste cotton in small quantity. The Surveyor’s final report says that no remains of cotton yarn was found but loss was of old cotton.  Exact loss could not be ascertained, in the absence of any purchase bills, stock, manufacturing, and its process flow records and transportation details. As per both reports, the cotton yarn was stored in a wound manner, it could not have been completely damaged within a few hours. It was concluded that the loss was not covered under any of the specific perils. On this basis, the claim was repudiated. The State Commission, however, rejected the Surveyor’s report for the reasons mentioned in para 13 of NCDRC judgment. It held the report as perverse merely on the ground that available audited stock statement was not considered. It was likely that the records were burnt in the fire is an assumption that has not been pleaded by the complainant. NCDRC in that context held that although the Surveyor’s report is not the final word, it cannot be departed unless it is found to be perverse and arbitrary. For a Surveyor’s report to be declared unacceptable, it is essential that it should be shown to be perverse and arbitrary.

Facts are that the Investigator's report was that the loss was only waste cotton in small quantity. The Surveyor’s final report says that no remains of cotton yarn was found but loss was of old cotton.  Exact loss could not be ascertained, in the absence of any purchase bills, stock, manufacturing, and its process flow records and transportation details. As per both reports, the cotton yarn was stored in a wound manner, it could not have been completely damaged within a few hours. It was concluded that the loss was not covered under any of the specific perils. On this basis, the claim was repudiated. The State Commission, however, rejected the Surveyor’s report for the reasons mentioned in para 13 of NCDRC judgment. It held the report as perverse merely on the ground that available audited stock statement was not considered. It was likely that the records were burnt in the fire is an assumption that has not been pleaded by the complainant. NCDRC in that context held that although the Surveyor’s report is not the final word, it cannot be departed unless it is found to be perverse and arbitrary. For a Surveyor’s report to be declared unacceptable, it is essential that it should be shown to be perverse and arbitrary.

The Court of Appeal handed down judgment this morning in Various Eateries v Allianz - see my summary below. Another milestone reached in the ongoing story of Covid-19 business interruption insurance litigation. It is interesting to note the "material distinction" that the CoA found between composite insurance policies and those that were not composite. Butcher J made a similar comment at first instance in Stonegate. Cockerill J found a material distinction in Corbin & King such that separate limits of indemnity were available to each insured entity. Will be interesting to see what Jacobs J makes of that same issue in his pending judgment following the Liberty Mutual test cases last year, and of course furlough, which was not live in Various Eateries. #insurance #businessinterruption #policyholders #hospitality

Unnecessary and unreasonable delays on claims matters may very well result in a damages claim and further costs ... a reality that ought to be front of mind for those managing the claims work queue:   ''Where there are undue delays, an insured may bring an application to force their insurer to decide within a certain number of days. If its delay has led to financial losses, the insured may be able to claim for special damages, i.e., consequential loss, depending on the policy terms.   If a matter concerning an undue delay is heard in court, the insured may ask for punitive costs in their court papers."   #insuranceclaims #claimsmanagement #claimshandling #lifeinsurance #insuranceindustry #reinsurance

Mike Stockalper recently authored the Law360 Expert Analysis article titled, “Insured Takeaways From 10th Circ. Interrelated Claims Ruling.” This article discusses the ramifications of American Southwest Mortgage Corp. v. Continental Casualty Co. case, where the Tenth Circuit applied a broad interpretation of Oklahoma law on “interrelated acts”, creating a concerning precedent for policyholders seeking to maximize coverage under a professional liability policy with per claim limits. Mike discusses the implications to companies with a similar exposure seeking to maximize per claim limits and options for those companies to explore. The full article can be found at this link here. #SDVLaw #Law360 #ExpertAnalysis #TenthCircuit #Law #Coverage #ClaimLimits #Insurance #Policyholders

The cost of property and casualty #insurance is rising significantly faster than broader consumer price #inflation. Premiums on home insurance policies have risen at double the pace of annualized income growth since the early 2000s. Emerging trends could continue to exacerbate this imbalance. Theft, natural disasters, and litigation are all on the rise and piling pressure on insurers, forcing them to raise premiums. That is in addition to broader inflation increasing the cost of labor and materials associated with repairs and construction. Despite the increase in payouts to address claims, insurer shares have been on the rise lately, outperforming other portions of the financial sector in 2024.

Failure to disclose risks can, at worst, lead to insurance being cancelled after the fact and an uninsured strata scheme. However, in such circumstances, it falls to the insurer to establish its written underwriting guidelines, which would have led to insurance being declined. More commonly strata schemes will be faced with: 1. Increased premiums (sometimes significant, and in multiples of normal terms), 2. Increased deductibles or excesses for certain types of claims or claims that generally leave strata schemes with more of an insured loss component. And/or, 3. Exclusions for certain types of claims or losses (e.g. exclusions for consequential damage caused by cladding or notified defects Read The Latest Chambers Russell Lawyers Feature Blogs For More Now: https://lnkd.in/gwN4AT8y

FACTS about Public Adjusters you may not know. 1) They represent the policyholder throughout the claim process. 2) No settlement. No fee. 3) Licensed and bonded. 4) Understands policy provisions and can contend them against the insurance company. 5) Provides peace of mind to contractors as well as policyholders. You wouldn't go to court without a lawyer, would you? Don't have a claim without a PA. #insuranceclaim #largeloss #commercialproperty #multifamily #residential #firedamage #haildamage #WindDamage #WaterDamageRestoration #publicadjuster License # 2986206