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Insurance Coverage Litigation
Second Edition
By Eugene Anderson, Esq., Jordan S. Stanzler, and Lorelie
S. Masters, Esq.
TABLE OF CONTENTS
Preface xxxv
Acknowledgements xxxix
CHAPTER 1 AN INTRODUCTION TO STANDARD-FORM GENERAL LIABILITY INSURANCE 1-1
§1.01
Introduction 1-3
§1.02 Standardization 1-7
[A] Revising
and "Saleability" 1-16
[B] Effects
of Standardization 1-18
§1.03 The Drafting Process: Improvements and Clarifications 1-20
§1.04 Origins of "Comprehensive" Coverage 1-22
[A] Benefits
and Selling Points of Comprehensive Coverage 1-25
[B] Drafters
of the Standard-Form Policy 1-30
§1.05 Insurance Coverage for Gradual Injury 1-31
§1.06 Insurance Coverage Under Multiple Insurance Policies 1-34
§1.07 Broad Insurance Coverage for Bodily Injury 1-35
§1.08 Broad Insurance Coverage for Loss of Use 1-36
§1.09 The Sudden-and-Accidental Pollution Exclusion 1-37
§1.10 Insurance Coverage for Business Torts 1-38
§1.11 Post-1985 Comprehensive General Liability Insurance Policies
1-39
§1.12 Anatomy of an Insurance Policy 1-42
[A] The Declarations
1-42
[B] Who Is
an Insured 1-43
[1] Additional Insureds 1-45
[2] Exclusions 1-48
[3] Anti-Indemnity Statutes 1-49
[4] Causation and Negligence 1-49
[5] The "Other Insurance" Problem 1-50
[6] Certificates of Insurance 1-51
[7] Coverage for Additional Insureds 1-51
[8] Coverage Under Additional Insured Endorsements 1-52
[9] Extent of Additional Insured's Coverage 1-57
[10] Effect of "Other Insurance" Clauses 1-57
[C] The Limits
of Insurance 1-59
[D] The Coverages
1-61
[E] Exclusions
1-63
[F] Definitions
1-64
[G] Conditions
1-65
§1.13 Self-Insurance 1-65
[A] Captives
1-67
CHAPTER 2 RULES OF INSURANCE POLICY INTERPRETATION
2-1
§ 2.01 Introduction: Insurance Policies as Contracts of Adhesion
and Modern
Contract
Theory 2-3
[A] The Textual
Approach 2-7
[B] Modern
Contract Theory 2-9
§2.02 The Purpose of Insurance 2-21
§2.03 Plain and Ordinary Meaning 2-24
§2.04 Ambiguity Construed Against the Drafter 2-28
§2.05 The Reasonable Expectations Doctrine 2-36
[A] Varied
Applications 2-44
§2.06 Use of Evidence Outside the Insurance Policy to Interpret the
Meaning
of an Insurance
Policy Term . 2-49
§2.07 Evidence of Trade Usage, Course of Dealing, and Course of Performance
2-57
[A] Trade
Usage 2-57
[B] Course
of Dealing and Course of Performance 2-59
§2.08 Varieties of Evidence 2-60
[A] Regulatory
History 2-67
[B] Advertising
and Promotional Materials: Elements of the "Contract" 2-68
[C] Inconsistent
Positions 2-70
[Dl Other
Documentary Evidence 2-70
[El Expert
Testimony 2-73
§2.09 Arguments for Relaxing the Contra Proferentem Doctrine 2-76
[A] Rules
for Interpreting Insurance Policy Terms Drafted by the
Policyholder
2-77
[B] The "Sophisticated
Policyholder" Defense 2-78
CHAPTER 3 INSURANCE COMPANY'S DUTY TO DEFEND AND PAY DEFENSE
COSTS AND DUTY TO SETTLE 3-1
§3.0l Introduction 3-3
[A] The Duty
to Defend and the Duty to Pay Defense Costs 3-4
[B] Contents
of This Chapter 3-7
§3.02 The Potential-for-Coverage Standard 3-9
[A] Groundless,
False, or Fraudulent Claims 3-15
[B] Multiple
Claims, Some Covered, Others Not 3-18
[C] Environmental
Cases 3-25
[D] Pre-Tender
Defense Costs 3-30
§3.03 Use of Extrinsic Facts to Determine an Insurance Company's
Duty to
Defend 3-34
§3.04 Insurance Company's Duty to Investigate 3-40
§3.05 Resolution of Doubts Regarding the Insurance Company's Duty
to Defend 3-45
§3.06 Disclaimers of Liability and Reservations of Rights 3-51
[A] Reservation
of Rights 3-53
[B] Disclaimers
of Liability 3-56
[1]
Effect of Failure to Assert Defenses with Specificity in
Disclaimer 3-57
[2]
Timeliness of Disclaimer 3-60
[3]
Liability for Costs of Settlement or Judgment 3-65
[4]
Estoppel or Waiver When Insurance Company First Accepts,
But Later Attempts to Disclaim, Coverage 3-68
§3.07 Right to Independent Counsel 3-69
§3.08 Effect of Insurance Company's Erroneous Refusal to Defend 3-76
[A] Recoverable
Damages 3-78
[B] Loss
of Rights Under the Insurance Policy 3-82
§3.09 Duty to Defend upon Exhaustion of Indemnity Limits 3-89
[A] The Unlimited
Duty to Defend: Defense Clauses 3-89
[B] Decisions
Construing Pre-1966 Form Language 3-90
[C] Decisions
Construing 1966 Form Language 3-92
[1] Showing of Prejudice Required 3-95
[2] Cases Finding a Failure to Cooperate 3-98
[3] Waiver of Right to Rely on Defenses if Coverage Denied 3-99
§3.10 Effect of Coverage Defenses on the Insurance Company's Duty
to Defend 3-101
[A] Allegations
of Fraud in the Procurement - 3-104
[B] Other
Coverage Defenses 3-107
§3.11 Direct-Action Statutes 3-110
[A] Louisiana
3-111
[B] Wisconsin
3-113
[C] Puerto
Rico 3-113
[D] Guam
3-115
[E] Use of
Direct-Action Statutes Against Reinsurers 3-116
§3.12 Allocation of Defense Costs 3-117
[A] Case
Law Refusing to Prorate Defense Costs to the Policyholder 3-118
[B] Case
Law Apportioning Defense Costs to the Policyholder 3-123
[C] Apportionment
of Defense Costs Among Insurance Companies 3-126
§3.13 Insurance Company's Duty to Settle 3-130
[A] Basis
of Duty in the Implied Covenant of Good Faith and Fair
Dealing
3-131
[B] Settlement
of a Claim by the Insurance Company Without the
Policyholder's
Consent 3-134
[1] Prejudice Requirement 3-136
[C] Policyholder
Need Not Prove Its Own Liability - 3-144
[1] Claims in Mass Tort Cases 3-148
[2] Public Policy 3-150
Exhibit 3-1 A Policyholder's Checklist: Responding to Reservation of Rights
3-151
CHAPTER 4 TRIGGER OF COVERAGE 4-1
§4.01 Background
[A] Introduction:
The General Rule and Coverage Under Multiple
Policy
Periods 4-5
[1] Policy Language 4-6
[2] Repeated and Progressive Injury Cases 4-9
[B] Drafting
History: Coverage Under Multiple Policies; Rejection of
Alternative
Trigger Theories 4-15
[1] The 1966 CGL Program: Clarification of Coverage for
Gradual Injury 4-16
[2] Why the "Occurrence" Definition? 4-20
[3] Coverage Under Multiple Insurance Policies/ Manifestation
and Other Trigger Theories Rejected 4-22
[4] The Toxic Tort Crisis (l970s-1980s): Manifestation Again
Rejected 4-28
[5] Proposed Solution to the Multiple Policy Issue: The Claims-
Made Policy 4-31
§4.02 Continuous Trigger 4-33
[A] Continuous
Trigger of Coverage 4-33
[1] Po1icyholders' Expectations 4-35
[2] Courts' Concerns About Administrative Convenience 4-37
[B] Application
of Continuous Trigger 4-39
[1] Trigger for Liability for Implantation of Silicone Gel Breast
Implants 4-41
[2] Application of the Continuous Trigger in Construction Defect
Cases 4-43
[3] Other Characterizations of the Trigger 4-46
[4] Insurance Industry Arguments for a Continuous Trigger 4-48
[5] Choice-of-Law Issues 4-50
[6] Conclusion 4-50
[C] Application
of Continuous Trigger in Environmental Insurance
Coverage
Cases 4-51
§4.03 Exposure Trigger 4-57
[A] Exposure
Trigger 4-57
[B] Application
of Exposure Trigger 4-58
[C] Exposure
Trigger in Environmental Insurance Coverage Cases 4-60
§4.04 Injury-in-Fact Trigger 4-61
[A] Injury-in-Fact
Trigger 4-61
[B] Application
of Injury-in-Fact Trigger 4-66
[C] Injury-in-Fact
in Environmental Insurance Coverage Cases 4-74
[D] Proof
of Injury-in-Fact 4-77
§4.05 Manifestation Trigger 4-84
[A] Manifestation
Trigger 4-84
[B] Application
of Manifestation Trigger 4-87
[1] Date of Diagnosability 4-87
[2] Assumption of Administrative Convenience - 4-87
[3] Application in Particular Contexts 4-89
[4] Claims-Made Effect 4-95
[5] Analogy to the "Known Loss" Theory 4-96
[6] Conclusion 4-96
[C] Manifestation
Trigger in Environmental Insurance Coverage Cases 4-96
§4.06 Triggers of Coverage Under Other Circumstances 4-99
[A] Triggers
of Coverage Applied in Other Fact Situations 4-99
[1] Installation of a Defective Product 4-100
[2] Installation of Asbestos 4-104
[3] Negligent Installation
[4] "Cause" Trigger
[B] Trigger
of Coverage for a Policyholder's Liability for Loss of Use 4-111
[1] 1966 Form 4-111
[2] 1973 Form 4-112
[3] 1986 Form 4-115
§4.07 Allocation 4-116
[A] Allocation:
The Scope of Each Insurance Company's Duty to
Indemnify
4-119
[1] Applicable Policy Language
[2] Insurance Industry's Contemporaneous Understanding of the
Policy Language 4-122
[3] Majority Rule: Joint and Several Liability 4-126
[4] "Other Insurance" Clause Does Not Change the Result 4-139
[5] Minority Rule of Allocation: Proration 4-143
[a] Pro Rata
Decisions 4-144
[b] Pro Rata
Schemes 4-148
[c] Complications
Raised by Proration 4-153
§4.08 "Anti-Stacking" Arguments and "Deemer Clauses"
4-156
[A] "Anti-Stacking"
4-159
[B] So-Called
"Deemer Clauses" 4-160
§4.09 Survey of Law 4-163
[A] Survey
of Law on Trigger of Coverage 4-163
[B] Survey
of Law on Allocation 4-188
CHAPTER 5 NOTICE OF A CLAIM OR ACTION 5-1
§5.01 Introduction 5-3
§5.02 Jurisdictions Following Modern Rule 5-6
[A] Basis
for the Modern Rule: Recognition of Insurance Policies as
Contracts
of Adhesion 5-8
[1] Reasonable Expectations 5-11
[2] Forfeiture Interpretation 5-11
[3] Public Policy Considerations 5-12
[4] Excess Insurance 5-14
[B] Purpose
of Notice Provisions 5-14
[C] Two-Step
Test 5-16
[1] Did the Delay Constitute a Breach 5-19
[2] What Constitutes Prejudice? 5-20
§5.03 Jurisdictions Following Old Rule 5-25
[A] Is Timely
Notice a "Condition Precedent"? 5-26
[B] Reasonableness
of Policyholder's Notice 5-28
§5.04 State-by-State Survey of the Notice Issue 5-32
§5.05 The Duty to Cooperate 5-51
§5.06 Difference in the Standard for Notice Under Excess Insurance
Policies 5-56
[A] Reasonableness
Standard Under the Notice Provisions in Excess
Insurance
Policies 5-57
[1] Notice-Prejudice Rule and Prejudice-Presumption Rule 5-63
[2] Per Se Notice Rule 5-66
[B] Notice
Law in New York 5-70
[1] Timeliness of Notice as Question of Fact 5-72
[2] New York's Modern Rule for Insurance Companies 5-75
[C] Insurance
Industry Custom and Practice Recognizing That Notice to
Umbrella
and Excess Insurance Companies Is Different 5-77
[D] Waiver
of a Notice Defense by Excess Insurance Companies 5-83
§5.07 "Loss Payable" Clauses 5-89
Exhibit 5-1 A Policyholder's Checklist: Responding to Reservation of Rights
and Nonwaiver Agreements 5-95
CHAPTER 6 CHOICE OF LAW 6-1
>§ 6.01 Introduction 6-3
§6.02 Threshold Issues for Choice of Law 6-5
[A] Choice-of-Law
Analysis Usually Is Considered Necessary Only as
to
Issues Upon Which Actual Conflicts Exist 6-5
[B] Addressing
Choice of Law on an Issue-by-Issue Basis Rather Than
on
a "Global" Basis 6-12
[1] Issue-by-Issue Basis 6-12
[2] Global Choice of Law 6-17
§6.03 Choice-of-Law Provisions 6-19
[A] Ambiguity
Created by Lack of a Choice-of-Law Clause in Most
General
Liability Insurance Policies 6-19
[B] "Service
of Suit" Clause as a Choice-of-Law Provision 6-25
[1] Use of London Insurance Companies' Contemporary
Drafting History of the Service of Suit
Clause 6-28
[2] Rules of Contract and Insurance Policy Construction on the
Service of Suit Clause 6-34
§6.04 Approaches to Choice of Law 6-37
[A] Lex
Loci Contractus 6-37
[B] Restatement
(Second) of Conflict of Laws 6-47
[1] Evaluation of Contacts Under Restatement Second
Section 188 6-47
[2] Place of Contracting 6-48
[3] Place of Negotiation of the Contract 6-49
[4] Place of Performance 6-50
[5] Location of the Subject Matter of the Contract 6-51
[6] Domicil, Residence, Nationality, Place of Incorporation,
and Place of Business of the Parties 6-53
[7] Evaluation of Conflicts Principles Under Section 6 of
Restatement (Second) 6-54
[8] Needs of the Interstate and International System 6-55
[9] Relevant Policies of the Forum 6-56
[10] Relevant Policies of Other Interested States and the
Relative Interests of Those
States in the Determination of
the Particular Issue 6-57
[11] Protection of Justified Expectations 6-60
[C] Other
Approaches Similar to That of Restatement (Second) 6-64
[1] Government Interest Analysis 6-64
[2] Choice-Influencing Considerations Analysis 6-66
[D] Site-Based
Choice of Law in Environmental Coverage Actions 6-66
[1] Section 193 of the Restatement (Second) 6-66
[2] The Interest of the State of the Site 6-69
§6.05 Miscellaneous Issues Affecting Choice of Law 6-80
[A] Provisions
of Some Case Management Orders Setting Separate
Discovery
and Briefing Phases for Choice of Law 6-80
[1] Why Courts May Enter CMOs 6-80
[2] CMO Provisions Relating to Choice of Law 6-81
[3] Cases Rejecting Phasing of Choice of Law 6-84
[B] Change
of a Policyholder's Principal Place of Business in the
Middle
of the Period of Insurance Coverage 6-86
CHAPTER 7 INSURANCE COVERAGE FOR NEGLIGENT AND INTENTIONAL
INJURY 7-1
§7.01 Introduction . 7-3
§7.02 Burden of Proving That the Policyholder Expected or Intended
the Injury 7-6
§7.03 Standards 7-7
§7.04 Historical Evidence That the Insurance Industry Intended That
a
Subjective
Standard Apply 7-9
[A] History
of Exclusion (a) 7-10
[B] Rejection
of Foreseeability Standard 7-12
[C] Required
Proof of Intent to Cause Injury by High- Level Management 7-15
§7.05 Decisions Applying Subjective Standard 7-16
§7.06 Courts That Have Followed So-Called Objective Standards 7-19
§7.07 Separate Standard for "Expected" 7-21
§7.08 Decisions Regarding Intentional Acts 7-23
[A] Negligent
or Reckless Conduct 7-25
[B] Morally
Culpable Conduct and Public Policy 7-27
§7.09 Standard on Expected/Intended Issue in Environmental Insurance
Coverage
Cases 7-32
§7.10 Standard in Products Liability Cases 7-39
§7.11 Cases in Which the Policyholder Is Held Liable for the Actions
of
Third Parties
7-43
CHAPTER 8 INSURANCE COVERAGE FOR PUNITIVE DAMAGES ASSESSED
AGAINST A POLICYHOLDER 8-1
§ 8.01 Introduction 8-3
§8.02 Overview of the Issue of the Insurability of Punitive Damages
8-6
§8.03 Choice-of-Law Considerations 8-7
§8.04 Insurance Policy Construction Test 8-11
§8.05 Public Policy Relating to Insurance Coverage for Punitive Damages
8-16
[A] Availability
of Insurance Coverage for Punitive Damages as a
Matter
of Public Policy 8-17
[1] Reasonable Expectation of Coverage 8-17
[2] Intentional Torts 8-19
[B] Insurance
Company Arguments That Coverage of Punitive
Damages
Violates Public Policy 8-20
[1] The McNulty Rule 8-20
[2] Vicariously Assessed Punitive Damages 8-21
§8.06 Jurisdictional Survey 8-24
CHAPTER 9 THE NUMBER OF OCCURRENCES IN CASES INVOLVING CONTINUOUS OR
REPEATED BODILY INJURY OR PROPERTY DAMAGE 9-1
§ 9.01 Introduction 9-3
§9.02 Policy Language and Drafting History 9-6
[A] Insurance
Industry Intent 9-9
[B] Deductibles
Issue 9-12
§9.03 "Cause" Test 9-12
[A] Court
Decisions Finding One Occurrence 9-13
[1] Discrimination Claims 9-18
[2] Child Molestation Cases 9-20
[3] Fraudulent Acts 9-21
[4] Products Liability Cases 9-22
[5] Criticism of the Cause Test 9-27
[B] Court
Decisions Finding Multiple Occurrences 9-27
§9.04 Number-of-Occurrences Test Focusing on the Liability-Triggering
Event 9-32
[A] Application
of the Liability-Triggering Event Test 9-32
[B] Case
Law Using Similar Reasoning 9-36
§9.05 "Unfortunate Events" Test Applied by Some New York
Courts 9-36
§9.06 English Rule: Accident or Occurrence May Be Viewed from the
Perspective
of the Victim 9-39
§9.07 Number of Occurrences in First-Party Insurance Cases 9-42
§9.08 Number of Deductibles 9-43
CHAPTER 10 COVERAGE FOR THE COSTS OF LOSS MITIGATION
10-1
§ 10.01 Introduction 10-3
§10.02 Insurance Industry Documents Discussing Insurance Coverage
for
Costs Paid
by a Policyholder to Mitigate Damages 10-5
§10.03 Case Law Addressing Coverage for Loss Mitigation Costs Spent
to
Reduce the
Amount of Damages 10-9
[A] Globe:
Bases for Coverage of Loss Mitigation Costs 10-9
[B] The Hauenstein
Doctrine 10-11
[C] Equity
and Policy Interpretation 10-13
[D] Rejection
of Equitable Considerations 10-15
[E] Distinctions
between "Prophylactic" Measures and Mitigation Costs 10-19
§10.04 Case Law Addressing Coverage Costs to Replace Defective Products
or Work 10-22
[A] Asbestos-Related
Property Damage 10-23
[B] Refusal
of Coverage 10-27
§10.05 Case Law Addressing Loss Mitigation Costs in the Environmental
Context 10-29
[A] Response
Costs versus "Prophylactic" Costs 10-30
[B] New Jersey
Law on Coverage for Cleanup of Groundwater 10-35
[1] New Jersey Case Law 10-36
[2] Trend in the New Jersey Courts - 10-41
[C] Refusal
of Coverage 10-41
§10.06 Case Law Addressing the Policyholder's Reasonable Expectation
of
Coverage
for Loss Mitigation Costs 10-42
§10.07 "Mitigation Clauses" in General Liability Insurance
Policies 10-44
[A] Scope
of Mitigation Clause 10~44
[B] Absence
of Mitigation Clause - 10-46
[C] Insurance
Industry Drafting History of the "Mitigation Clause" 10-47
§10-08 Concluding Remarks 10-50
CHAPTER 11 BAD FAITH REGARDING CONDUCT OF INSURANCE
COMPANIES 11-1
§11.01 Introduction 11-5
§11.02 Insurance Companies' Duty of Good Faith and Fair Dealing 11-8
§11.03 Breach-of-Contract Actions for Insurance Company Bad Faith
11-9
§11.04 Tort Cause of Action for Bad Faith for Third-Party Insurance
Claims 11-12
§11.05 Special Nature of Insurance Contracts - 11-16
§11.06 Insurance Companies' Fiduciary Duties to Policyholders 11-26
§11.07 Tort Cause of Action for Bad Faith for First-Party Insurance
Claims 11-34
[A] Public
Policy Considerations in Favor of the Bad-Faith Tort 11-35
[B] Unequal
Bargaining Power in Favor of the Insurance Company 11-36
[C] The Minority
Rule: Refusal to Recognize Tort in First-Party Context 11-44
§11.08 Standards for Proving Bad Faith in a First-Party Action 11-45
[A] "Negligence"
Standard 11-46
[B] Hybrid
Standard 11-46
[C] "Evil
Mind" Standard 11-48
§11.09 Whether a Finding of Coverage Under the Insurance Policy Is
Necessary 11-50
§11.10 Specific Types of Insurance Company "Bad Faith"
11-53
[A] Failure
to Settle 11-53
[B] Failure
to Investigate 11-57
[C] Other
Examples of Bad-Faith Conduct by Insurance Companies 11-61
[1] The Law of Contract 11-65
[2] The Duty of Good Faith and Fair Dealing 11-67
[3] The Reasonable Expectations Doctrine 11-68
[4] Fraudulent Misrepresentation 11-70
§11.11 Insurance Company's Continuing Duty of Good Faith During Litigation
11-70
§11.12 Duty of Good Faith and Fair Dealing of a Primary Insurance
Company
to Excess
and Umbrella Insurance Companies 11-76
§11.13 Damages Available for Bad Faith 11-80
[A] Extra-Contractual
Damages 11-80
[B] Recoverability
of Attorneys' Fees in Insurance Coverage Cases
Generally
11-81
[C] Recoverability
of In-House Legal Costs 11-84
[D] Pittsburgh
Plate Glass and Its Progeny 11-86
[E] Pitfalls
to Policyholders' Recovery 11-88
[F] Continental
Casualty Co. v. Cole 11-90
[G] Punitive
Damages 11-91
[1] Public Policy Issues 11-92
[2] Evil Intent 11-94
[3] Reasonableness of Failure to Pay 11-95
[4] Other Standards 11-95
[5] Failure to Investigate 11-97
[6] Failure to Settle 11-97
[H] Recovery
of Consequential Damages 11-98
[1] Standards for Recovery of Consequential Damages from
Insurance Companies 11-99
[2] Death-of-a-Company Damages 11-107
§11.14 Types of Discovery Available in Bad-Faith Actions 11-108
[A] Work-Product
Doctrine 11-108
[B] Attorney-Client
Privilege 11-111
§11.15 Statutory Bases for insurance Company Liability for Bad Faith
11-112
[A] Unfair
Claims Practices Acts 11-113
[1] Private Right of Action 11-115
[2] General Business Practice Requirement 11-116
[3] Remedies 1-118
[4] Potential Preemption of Common-Law Cause of Action 11-118
[5] Violation of Statute as Evidence of Bad Faith if Pleaded
Through Another Statute 11-119
[B] State
Consumer Protection Statutes 11-120
[1] Private Right of Action Under State Consumer Protection
Laws 11-121
[a] No Cause
of Action for Business Consumers 11-122
[b] Cause
of Action Available to Business Consumers 11-122
[2] Deceptive and Unfair Acts or Practices 11-125
[3] Statutes of Limitations 11-127
CHAPTER 12 ESTOPPEL AND ALTERNATIVE CAUSES OF ACTION
12-1
§12.01 Introduction 12-3
§12.02 Estoppel and Related Theories 12-3
[A] Judicial
Estoppel 12-5
[1] Preservation of Judicial Integrity 12-6
[2] Application of Doctrine 12-8
[3] Broad View of Doctrine: "Success" of Prior Statement Not
Required 12-11
[4] Narrower View of Doctrine: Prior Statement Must Have
Been "Successful" 12-13
[5] Interpretation of "Success" 12-14
[6] Public Policy Arguments in Favor of the Broader View 12-15
[B] Equitable
Estoppel 12-17
[1] Reasonable Expectations 12-18
[2] Promissory Estoppel 12-25
[C] Regulatory
Estoppel 12-26
[1] Morton and Related Cases 12-26
[2] Roots of Regulatory Estoppel Doctrine in Patent Cases 12-31
[D] Quasi-Estoppel
12-32
[1] Elements of the Doctrine 12-32
[2] Application of Doctrine 12-34
[E] Mend-the-Hold
Doctrine 12-35
[1] Procedural or Substantive Rule 12-38
[2] Comparison to Judicial Estoppel 12-39
[F] Inconsistent
Positions as Admissions Against Interest - 12-39
§12.03 Alternative Causes of Action 12-40
[A] Breach-of-Implied
Warranty Theories 12-43
[1] C&J Fertilizer 12-44
[2] Other Case Law 12-46
[3] Congressional View 12-47
[4] Insurance Industry Representations 12-48
[5] Expectation of Coverage 12-49
[6] UCC Applicability 12-50
[B] Conspiracy
to Conceal Facts 12-51
[C] Other
Attempts 12-53
CHAPTER 13 ISSUES ARISING UNDER UMBRELLA AND EXCESS
INSURANCE POLICIES 13-1
§13.01 Introduction 13-5
§13.02 Structure of a Multilayer Insurance Program: Characteristics
of
Primary,
Umbrella, and Excess Insurance 13-5
§13.03 Primary Insurance Underlying Excess Layers 13-7
§13.04 Distinctions Between Umbrella and Excess Insurance 13-10
[A] Umbrella
Insurance Coverage 13-11
[1] Ultimate Net Loss 13-12
[2] Limits of Liability 13-16
[3] Other Features 13-17
[B] Excess
Insurance Coverage 13-18
§13.05 Need to Examine Insurance Policy to Determine Whether It Is
an
Umbrella
or an Excess Policy 13-20
§13.06 Development of Umbrella and Excess Insurance 13-21
§13.07 Characteristics of Umbrella and Excess Insurance Policy Forms:
Follow-Form
and Stand-Alone Insurance Policies 13-25
[A] Use of
Standard-Form Language in Umbrella and Excess Insurance
Policy
Forms 13-25
[B] Follow-Form
Provisions in Excess Insurance Policies 13-29
[1] Clear Identification of Underlying Policy 13-31
[2] Amendment or Deletion of Terms 13-34
[C] Stand-Alone
Excess Insurance Policy Forms 13-38
§13.08 Exhaustion of Underlying Layers and Attachment Point of Umbrella
and Excess
Insurance Policies 13-39
[A] Aggregate
Limits 13-40
[1] Ambiguous Provisions 13-40
[2] Exceptions in Follow-Form Provisions 13-44
[B] Issues
of Potential Dispute Under Excess Insurance Policies
Regarding
Exhaustion of Underlying Coverage 13-45
§13.09 Payment of Defense Costs by Umbrella and Excess Insurance
Companies
13-49
[C] Coverage
for Defense Costs Under Umbrella and Excess Insurance
Policy
Forms 13-50
[1] Limitation of Defense Obligations to Be Explicit 13-51
[2] Defense Costs Within or in Addition to Limits of Liability . . 13-53
[3] "Assume Charge" Clause 13-54
[4] "Consent" Provision 13-59
[5] Follow-Form Provision .. 13-61
[B] Assigning
Defense Obligations to Primary and Excess Insurance
Companies
13-61
[1] When Duty to Pay Defense Costs Attaches 13-64
[2] Equitable Allocation of Defense Costs 13-69
[3] Resolving the issues 13-72
§13.10 Standard for Notice Under Umbrella and Excess Insurance Policy
13-72
§13.11 Excess Insurance Company's Right to Sue for Failure to Settle
an Action 13-73
[A] Equitable
Subrogation 13-74
[B] Triangular
Reciprocity . 13-76
§13.12 Duties of an Excess Insurance Company When an Underlying Insurance
Company Becom
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