Litigating Insurance Coverage Claims:
From Start to Finish
• INSURANCE COVERAGE CONTRACT
LANGUAGE 101
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Common Terms, Coverage Limits and Exclusions
Insurer's Duty to Defend
Insurer's Duty to Indemnify
Triggers of Coverage
Insured's Rights and Protections
Litigating Insurance Coverage Claims:
From Start to Finish
INSURANCE COVERAGE
CONTRACT LANGUAGE 101
Common Terms, Coverage Limits
and Exclusions
• First Party v. Third Party
Insurance Claims
• Occurrence and Claims
Made Policies
• The Rules of Construction
• Exclusions
Litigating Insurance Coverage Claims:
From Start to Finish
INSURANCE COVERAGE
CONTRACT LANGUAGE 101
Insurer's Duty to Indemnify
Triggers of Coverage
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An Occurrence: ‘an accident,
including continuous or repeated
exposure to substantially the
same general harmful
conditions’
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Notice to Insurer/Demands
Litigating Insurance Coverage Claims:
From Start to Finish
INSURANCE COVERAGE
CONTRACT LANGUAGE 101
Insurers Duty to Defend
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Four Corners Rule
Notice vs. Fact Pleading
Extrinsic Evidence
In For a Penny…
Potential Conflicts
Litigating Insurance Coverage Claims:
From Start to Finish
INSURANCE COVERAGE
CONTRACT LANGUAGE 101
Insured's Rights and Protections
• “Bad Faith” Claims
• Section 155: Vexatious and
Unreasonable Delay
• The So-Called “Duty to
Settle”
Litigating Insurance Coverage Claims:
From Start to Finish
CASE EVALUATION AND
PRE-LITIGATION STEPS
▫ Case Intake and Informal Investigation Tactics
▫ Finding Sources and Limits of Coverage
▫ Negotiating the Claim With the
Claimant/Insurance Company
▫ Tendering a Claim for Defense
▫ Insurance Company Claim Investigation
▫ Denial of Coverage and its Potential
Consequences for Both Sides
▫ Insurance Coverage Case Law Update
Litigating Insurance Coverage Claims:
From Start to Finish
CASE EVALUATION AND
PRE-LITIGATION STEPS
• Case Intake and Informal
Investigation Tactics
• Finding Sources and Limits of
Coverage
• Insurance Company Claim
Investigation
• Tendering a Claim for Defense;
“Pleading Into Coverage”
Litigating Insurance Coverage Claims:
From Start to Finish
CASE EVALUATION AND
PRE-LITIGATION STEPS
Negotiating the Claim With the
Claimant/Insurance Company
How much am
I bid for this
$20 bill?
Litigating Insurance Coverage Claims:
From Start to Finish
CASE EVALUATION AND
PRE-LITIGATION STEPS
Denial of Coverage and its Potential
Consequences for Both Sides
“An insurer has three options if it wishes
to dispute coverage: (1) it may seek a
declaratory judgment as to non-coverage,
(2) it may provide coverage under a
reservation of rights, or (3) it may deny
coverage.”
Litigating Insurance Coverage Claims:
From Start to Finish
CASE EVALUATION AND
PRE-LITIGATION STEPS
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Insurance Coverage Case Law Update
Caterpillar, Inc. v. Century Indem. Co., 2011 WL 488935 (3rd Dist. 2011)
American Service Ins. Co. v. United Auto. Ins. Co., 2011 WL 1501566 (1st Dist. 2011)
West American Ins. Co. v. Yorkville Nat., 238 Ill.2d 177, 939 N.E.2d 288 (2010)
Piser v. State Farm Mut. Auto. Ins., 405 Ill.App.3d 341, 938 N.E.2d 640 (1st Dist. 2010)
Santa's Best Craft, L.L.C. v. Zurich American Ins., 941 N.E.2d 291 (1st Dist. 2010)
American Family Mut. Ins. Co. v. Guzik, 406 Ill.App.3d 245, 941 N.E.2d 936 (3rd Dist. 2010)
Pekin Ins. Co. v. Wilson, 237 Ill.2d 446, 930 N.E.2d 1011 (2010)
Continental Cas. Co. v. Donald T. Bertucci, Ltd., 399 Ill.App.3d 775, 926 N.E.2d 833 (1st Dist. 2010)
Rein v. State Farm Mut. Auto. Ins. Co., 2011 WL 855652 (1st Dist. 2011)
Lorenzo v. Capitol Indem., 401 Ill.App.3d 616, 928 N.E.2d 1274 (1st Dist. 2010)
Founders Ins. Co. v. Munoz, 237 Ill.2d 424, 930 N.E.2d 999 (2010)