Chapter 1 INTRODUCTION TO INSURANCE
I. OVERVIEW
II. UNDERSTANDING RISK MANAGEMENT
III. UNDERSTANDING BASIC INSURANCE CONCEPTS.
IV. CONSIDERING THE VARIOUS PRIMARY LINES OF INSURANCE.
V. CONSIDERING REINSURANCE
VI. CONSIDERING THE INSURANCE INDUSTRY AND ITS REGULATION
Chapter 2 INSURANCE AGENT AND BROKER LIABILITY
I. OVERVIEW
II. DETERMINING INTERMEDIARIES DUTIES.
III. GENERAL CONSIDERATIONS CONCERNING INTERMEDIARIES LIABILITY TO INSUREDS
IV. INTERMEDIARIES LIABILITY TO INSUREDS FOR SPECIFIC ACTS
V. THE LIABILITY OF INTERMEDIARIES TO INSURERS OR OTHER INTERMEDIARIES
VI. INDEMNITY OF INSURERS BY INTERMEDIARIES
VII. EXPERT TESTIMONY IN INSURANCE AGENT AND BROKER CASES
Chapter 3 READING INSURANCE POLICIES
I. OVERVIEW
II. CONSIDERING INSURANCE ARCHITECTURE
III. CONSTRUING COVERAGE
IV. CONSIDERING THE GRANT OF INSURANCE COVERAGE
V. CONSIDERING EXCLUSIONS IN THE INSURANCE POLICY
VI. CONSIDERING CONDITIONS IN THE INSURANCE POLICY
VII. CONSIDERING ENDORSEMENTS IN THE INSURANCE POLICY
Chapter 4 ANALYZING INSURANCE PRODUCTS
I. OVERVIEW
II. POLICY CONSTRUCTION PERSPECTIVES: SHIFTING BURDENS OF
PROOF AND PERSUASION
III. ANALYZING CHOICE OF LAW ISSUES
IV. ANALYZING INSURANCE POLICY PROVISIONS
Chapter 5 APPLYING DOCTRINES TO OVERRIDE POLICY
INTERPRETATION PRINCIPLES
I. OVERVIEW
II. APPLYING PERTINENT PUBLIC POLICIES
III. APPLYING PERTINENT EQUITABLE PRINCIPLES
Chapter 6 UNDERSTANDING BAD FAITH
I. OVERVIEW
II. CONSIDERING BASIC TENETS OF BAD FAITH
III. WHAT IS BAD FAITH?
IV. CONSIDERING EXAMPLES OF BAD FAITH
V. CONSIDERING THE ROLE OF EXPERTS IN BAD FAITH CASES
VI. CONSIDERING THE DEFENSES TO BAD FAITH ALLEGATIONS
VII. CONSIDERING INSURERS AGENTS AND ATTORNEYS ACTIONS IN THE CONTEXT OF BAD FAITH ALLEGATIONS
VIII. WHO MAY BRING BAD FAITH CLAIMS?
IX. CONSIDERING DAMAGES RECOVERABLE IN BAD FAITH CASES
X. CONSIDERING REVERSE BAD FAITH
Chapter 7 RESEARCHING INSURANCE COVERAGE
I. OVERVIEW
II. UNIQUE CONTRACT WITH MULTI-PARTY CHARACTERISTICS
III. FRAMING THE QUESTION
IV. MARSHALLING FACTS
V. SOURCES OF POLICY LANGUAGE
VI. SEARCHING FOR AUTHORITIES AND PERSUASIVE ANALYSIS
VII. ORGANIZING AUTHORITY LOCATED BY SEARCH INTO DECISION, ARGUMENT OR ADVICE.
VIII. CONFRONTING CONTRARY CASES
Chapter 8 ASSESSING INSURANCE COVERAGE
I. OVERVIEW
II. STEP ONE: INVESTIGATE THE CLAIMS FOR WHICH COVERAGE IS
SOUGHT
III. STEP TWO: CONSIDER CLIENTS OBJECTIVES
IV. STEP THREE: QUANTIFY VALUE OF CLAIMS
V. STEP FOUR: EVALUATE LIKELY RECOVERY
Chapter 9 DETERMINING THE DUTIES OF THE INSURED
I. OVERVIEW
II. SOURCES OF INSUREDS DUTIES
III. SATISFYING DUTY TO NOTIFY INSURER OF LOSSES, OCCURRENCES AND CLAIMS
IV. SATISFYING SUIT LIMITATION CLAUSES IN FIRST-PARTY POLICIES
V. SATISFYING INSUREDS DUTY TO COOPERATE
VI. COMPLY WITH CONSENT-TO-INCUR-DEFENSE COSTS AND CONSENT TO SETTLE CLAUSES
VII. COMPLYING WITH DUTY TO PRESERVE PROPERTY
VIII. COMPLYING WITH DUTY TO PRESERVE EVIDENCE.
IX. COMPLYING WITH DUTY TO PRESERVE INSURERS SUBROGATION RIGHTS
X. CONSEQUENCES OF FAILURE TO PAY PREMIUM
XI. FORMS
Chapter 10 TENDERING THE CLAIM
I. OVERVIEW
II. UNDERSTANDING TENDER
III. TENDERING LIABILITY CLAIMSWHEN, HOW, AND TO WHOM
IV. CONSIDERING CONSEQUENCES OF FAILURE TO TENDER
V. CONSIDERING TARGETED TENDER
VI. RE-TENDERING CLAIM OR SUIT AFTER INSURER HAS DENIED COVERAGE
VII. FORMS
Chapter 11 DETERMINING THE INSURERS RESPONSE
I. OVERVIEW
II. Insurers Obligations in Responding to Claim
III. INSURERS OPTIONS IN RESPONDING TO CLAIM
Chapter 12 ADJUSTING THE FIRST-PARTY PROPERTY INSURANCE
CLAIM
I. OVERVIEW
II. CONSIDERING ROLE OF CLAIMS ADJUSTER
III. ROLE OF PUBLIC ADJUSTER
IV. INTERPRETING THE POLICY
V. ADJUSTERS INVESTIGATION
VI. CLAIM DOCUMENTATION
VII. EXAMINATION UNDER OATH (EUO)
VIII. ALTERNATIVE DISPUTE RESOLUTION OPTIONS DURING ADJUSTMENT PROCESS
X. CONSEQUENCES OF ACCEPTING PAYMENT
XI. FAIR CLAIMS SETTLEMENT PRACTICES REGULATIONS
XII. ROLE OF RIGHT TO SUBROGATION AND SALVAGE OF DAMAGED PROPERTY
XIII. FORMS
Chapter 13 ADJUSTING THE THIRD-PARTY LIABILITY INSURANCE
CLAIM
I. OVERVIEW
II. UNDERSTANDING THE DUTIES OF THE THIRD-PARTY CLAIMS
ADJUSTER
III. UNDERSTANDING THE THIRD-PARTY CLAIMS ADJUSTERS
INVESTIGATION
IV. CONSIDERING THE ADJUSTERS DUTY TO KEEP THE INSURED AND
CLAIMANT INFORMED AS TO THE HANDLING OF THE CLAIM
V. CONSIDERING THE ADJUSTERS ADVANCE PAYMENTS TO THE
CLAIMANT AND SETTLEMENT WITH THE CLAIMANT
VI. CLAIM DOCUMENTATION
VII. CONSIDERING THE ROLE OF A CLAIMANTS LAWYER
VIII. CONSIDERING ALTERNATIVE DISPUTE RESOLUTION (ADR) OPTIONS DURING THE ADJUSTMENT PROCESS
IX. CONSIDERING THE PAYMENT OF CLAIMS PROCESS
XI. FORMS
Chapter 14 INITIATING INSURANCE COVERAGE LITIGATION
I. OVERVIEW
II. EVALUATING THE PROPOSED COVERAGE ACTION: PARTIES, FORUM, TIMING AND OTHER STRATEGIC CONSIDERATIONS
III. EVALUATING ADR AS A STRATEGY
Chapter 15 DRAFTING THE COMPLAINT
I. OVERVIEW
II. PRELIMINARY ISSUES
III. STRATEGIC CONSIDERATIONS IN DRAFTING
IV. POTENTIAL CAUSES OF ACTION AND REMEDIES
V. FORMS
Chapter 16 MANAGING THE RELATIONSHIP BETWEEN THE
COVERAGE CASE AND UNDERLYING LITIGATION
I. OVERVIEW
II. ASCERTAINING POSSIBLE CONFLICTS BETWEEN AN INSURANCE COVERAGE CASE AND UNDERLYING LITIGATION
III. OPTIONS FOR MANAGING AND RESOLVING THE CONFLICTS THAT MAY ARISE
IV. FORMS
CHAPTER 17 DRAFTING THE ANSWER AND AFFIRMATIVE
DEFENSES
I. OVERVIEW
II. INITIAL CONSIDERATIONS TO DRAFTING AND FILING ANSWER
III. REMOVAL OF LAWSUIT
V. ANSWERING THE ALLEGATIONS OF THE COMPLAINT
VI. ASSERTING AFFIRMATIVE DEFENSES IN AN ANSWER
VIII. ADDING NEW PARTIES
IX. FORMS
Chapter 18 DETERMINING WHETHER TO FILE PRE-DISCOVERY
MOTIONS
I. OVERVIEW
II. PRE-DISCOVERY MOTIONS COMMONLY FILED IN INSURANCE COVERAGE CASES
III. FORMS
Chapter 19 APPLYING ATTORNEY-CLIENT AND WORK PRODUCT
PRIVILEGES
I. OVERVIEW
II. UNDERSTANDING ATTORNEY-CLIENT AND WORK PRODUCT
PRIVILEGES IN INSURANCE CONTEXT
III. CONSIDERING HOW VARIATIONS IN INSURER-INSURED RELATIONSHIP AFFECT ATTORNEY CLIENT AND WORK PRODUCT PRIVILEGES
IV. CONSIDERING ATTORNEY-CLIENT AND WORK PRODUCT
PRIVILEGES REGARDING INSURER CLAIMS FILES
V. EVALUATING ATTORNEY-CLIENT AND WORK PRODUCT PRIVILEGES IN TRADITIONAL COVERAGE LITIGATION
VI. EVALUATING STRATEGIC CONSIDERATIONS
VII. ANALYZING ATTORNEY-CLIENT AND WORK PRODUCT PRIVILEGES
IN BAD FAITH LITIGATION
VIII. ANALYZING WAIVER OF ATTORNEY-CLIENT PRIVILEGE
IX. ANALYZING WAIVER OF WORK PRODUCT PRIVILEGE
X. ANALYZING PRIVILEGES IN INSURER-REINSURER CONTEXT
Chapter 20 CONDUCTING DISCOVERY
I. OVERVIEW
II. CREATING THE DISCOVERY PLAN
III. CONDUCTING DISCOVERY
IV. FORMS
Chapter 21 EXPERT WITNESS DISCOVERY
I. OVERVIEW
II. DETERMINING WHETHER EXPERT EVIDENCE IS ADMISSIBLE IN INSURANCE CASES
III. CONSIDERATIONS BEFORE HIRING AN EXPERT
IV. PREPARING AND RESPONDING TO WRITTEN DISCOVERY
PERTAINING TO EXPERTS
V. TAKING AND DEFENDING THE DEPOSITIONS OF EXPERTS
VI. SUPPLEMENTING YOUR EXPERT DISCLOSURES
VII. RECOGNIZING PRIVILEGE AND WORK PRODUCT ISSUES
VIII. FORMS
Chapter 22 DETERMINING WHETHER TO FILE MOTIONS FOR
SUMMARY JUDGMENT AND SUMMARY ADJUDICATION
I. OVERVIEW: SUMMARY JUDGMENT AND COVERAGE LITIGATION
II. SUMMARY JUDGMENT STANDARD
III. ANALYZING FACTS AND LAW: ARE YOU READY TO FILE MOTION
FOR SUMMARY JUDGMENT?
IV. STRUCTURING YOUR CASE TO WIN MOTION FOR SUMMARY
JUDGMENT
V. DEFEATING MOTION FOR SUMMARY JUDGMENT ON FACTS
VI. WRITING MOTION FOR SUMMARY JUDGMENT
VII. ORAL ARGUMENT
VIII. FORMS
Chapter 23 SETTLING INSURANCE COVERAGE DISPUTES
I. OVERVIEW
II. VALUING THE COVERAGE CLAIM FOR PURPOSES OF SETTLEMENT
III. STRUCTURING THE SETTLEMENT OFFER
IV. NEGOTIATING THE SETTLEMENT
V. DOCUMENTING THE SETTLEMENT
VI. ADDRESSING SUBROGATION RIGHTS AND CLAIMS
VII. UNDERSTANDING THE EFFECT OF SETTLEMENT ON NON-SETTLING
PARTIES
VIII. FORMS
Chapter 24 CONSIDERATIONS INVOLVED IN SETTLEMENT OF
THE UNDERLYING CASE
I. OVERVIEW
II. CONSIDERING INSURER AND INSUREDS RIGHTS WITH RESPECT TO
SETTLEMENT UNDER TYPICAL DUTY TO DEFEND PROVISIONS
III. CONSIDERING THE INSUREDS OBLIGATION TO COOPERATE WITH
INSURERS IN SETTLEMENT OF UNDERLYING CLAIMS
IV. CONSIDERING INSURER CONSENT TO SETTLEMENT POLICY
PROVISIONS
V. CONSIDERING ISSUES ARISING WHEN THE UNDERLYING LITIGATION
IS SETTLED WHILE A COVERAGE DISPUTE IS PENDING
VI. CONSIDERING THE IMPACT OF SETTLEMENT ON ISSUES RELATED
TO THE INSURANCE COVERAGE DISPUTE
Chapter 25 CONSIDERING ALTERNATIVE DISPUTE RESOLUTION
I. OVERVIEW
II. UNDERSTANDING MEDIATION
III. UNDERSTANDING ARBITRATION
IV. FORMS
Chapter 26 STRATEGIES FOR TRIAL
I. OVERVIEW
III. READYING THE COVERAGE CASE FOR TRIAL
IV. JURY SELECTION
V. OPENING STATEMENT
VI. THE INSUREDS CASE
VII. THE INSURANCE COMPANYS CASE
VIII. CLOSING ARGUMENT
Chapter 27 DECIDING WHETHER TO APPEAL
I. OVERVIEW
II. CONSIDERING BASIS FOR APPELLATE JURISDICTION
III. EVALUATING WHETHER TO APPEAL AND DETERMINING WHAT
ISSUES MAY BE APPEALED
IV. EVALUATING SPECIAL CONSIDERATIONS IN INSURANCE COVERAGE
APPEALS
Chapter 28 INSURANCE GUARANTY FUND PRINCIPLES
I. OVERVIEW
II. UNDERSTANDING STATE GUARANTY FUNDS
IV. UNDERSTANDING THE TYPES OF INSURANCE THAT PROPERTY/CASUALTY GUARANTY FUNDS COVER
V. DETERMINING COVERED CLAIMS
VI. UNDERSTANDING GUARANTY FUNDS IMMUNITY FROM OTHER
LIABILITIES
VII. FILING, ESTABLISHMENT, AND DETERMINATION OF CLAIMS
VIII. ASCERTAINING THE RELATIONSHIP BETWEEN GUARANTY FUNDS
AND RECEIVERS
IX. LITIGATING A CLAIM
X. CONSIDERING LARGE DEDUCTIBLE ISSUES
XI. UNDERSTANDING WORKERS COMPENSATION GUARANTY FUNDS
XII. UNDERSTANDING PROCEDURAL ISSUES
Chapter 29 SPOTTING ISSUES IN PARTICULAR PRACTICE AREAS
I. OVERVIEW
II. GENERAL DESCRIPTION OF ISSUE SPOTTING
III. UNDERSTANDING AND ORGANIZING THE FACTS
IV. UNDERSTANDING AND ORGANIZING INSURANCE POLICY
PROVISIONS
V. UNDERSTANDING AND ORGANIZING THE LAW
VI. IDENTIFYING POTENTIALLY HELPFUL INSURANCE IN THE VARIOUS
PRACTICE AREAS.
Chapter 30 UNDERSTANDING LIABILITY INSURANCE
I. OVERVIEW
II. TYPES OF LIABILITY COVERAGE
III. THE INSURING AGREEMENT
IV. INSURER DUTIES
V. MAJOR EXCLUSIONS
VI. MAJOR CONDITIONS
VII. ALLOCATION
VIII. POLICY LIMITS
IX. EXCESS AND UMBRELLA INSURANCE COVERAGE
X. CLAIMS-MADE POLICIES
XI. LOST POLICIES
XII. INSURANCE LITIGATION
XIII. TORT AND EXTRA-CONTRACTUAL LIABILITY
XIV. INSUREDS IN BANKRUPTCY
Chapter 31 UNDERSTANDING COMMERCIAL PROPERTY
INSURANCE
I. OVERVIEW
II. UNDERSTANDING BASIC PROPERTY INSURANCE POLICY
III. UNDERSTANDING LOSS ADJUSTMENT AND SETTLEMENTS
Chapter 32 UNDERSTANDING AUTOMOBILE INSURANCE
I. OVERVIEW
II. UNDERSTANDING TYPES OF COVERAGE AND ENDORSEMENTS
III. IDENTIFYING SOURCES OF COVERAGE
IV. PROVIDING NOTICE AND PROOF OF CLAIM
V. UNDERSTANDING DISCLAIMERS OF COVERAGE AND DENIALS OF
BENEFITS
VI. CONSIDER AVAILABLE BENEFITS.
VII. RESOLUTION OF DISPUTES AND OPTIONAL/MANDATORY
ARBITRATION
Chapter 33 UNDERSTANDING HOMEOWNERS INSURANCE
I. OVERVIEW
II. UNDERSTANDING FUNDAMENTAL PRINCIPLES OF HOMEOWNERS
INSURANCE
III. UNDERSTANDING PROPERTY COVERAGE IN HOMEOWNERS
POLICIES
IV. UNDERSTANDING LIABILITY COVERAGE IN HOMEOWNERS
POLICIES
V. UNDERSTANDING HOMEOWNERS INSURANCE CLAIMS
VI. UNDERSTANDING LIMITATIONS ON RECOVERY UNDER
HOMEOWNERS POLICIES
VII. UNDERSTANDING CANCELLATION OF HOMEOWNERS POLICIES
Chapter 34 UNDERSTANDING LIFE INSURANCE
I. OVERVIEW
II. UNDERSTANDING THE LIFE INSURANCE INDUSTRY
III. UNDERSTANDING STATUTORY SCHEMES RELEVANT TO LIFE
INSURANCE
IV. UNDERSTANDING LIFE INSURANCE PRODUCTS
V. UNDERSTANDING GENERAL PRINCIPLES OF LIFE INSURANCE
VI. PROVISIONS OF THE LIFE INSURANCE POLICYTERMS AND
ANALYSIS
VII. DETERMINING WHEN INTERPLEADER IS APPROPRIATE
VIII. UNDERSTANDING BENEFICIARY ISSUES
IX. CONSIDER UNIQUE LIABILITY ARISING OUT OF LIFE INSURANCE
Chapter 35 UNDERSTANDING DISABILITY INSURANCE
I. OVERVIEW
II. ERISA VERSUS NON-ERISA DISABILITY COVERAGE
III. DISABILITY INSURANCE
Chapter 36 UNDERSTANDING TITLE INSURANCE
I. OVERVIEW
II. APPRECIATING UNIQUE TITLE INSURANCE CONCEPTS
III. UNDERSTANDING COVERED RISKS
IV. UNDERSTANDINGS RISKS NOT COVERED BY MEANS OF EXCLUSION
OR EXCEPTION
V. UNDERSTANDING CONDITIONS AND STIPULATIONS
VI. EVALUATING AND USING TITLE INSURANCE PRODUCTS
VII. ASCERTAINING EXISTENCE OF NONPOLICY INSURER LIABILITY
VIII. FORMS
Chapter 37 UNDERSTANDING DIRECTORS AND OFFICERS
LIABILITY INSURANCE
I. OVERVIEW
II. APPRECIATING CONCEPTS UNIQUE TO DIRECTORS AND OFFICERS
LIABILITY INSURANCE
III. UNDERSTANDING COVERED RISKS
IV. UNDERSTANDING OPERATIVE PROVISIONS
V. Understanding Exclusions Under D&O Policies
VI. Understanding the Defense Obligation Under the D&O Policy
VII. UNDERSTANDING COMMON CONDITIONS IN D&O POLICIES AND
OTHER SIGNIFICANT PROVISIONS
VIII. UNDERSTANDING THE IMPACT OF THE INSUREDS
REPRESENTATIONS IN THE APPLICATION
Chapter 38 UNDERSTANDING ERRORS AND OMISSIONS
INSURANCE
I. OVERVIEW
II. UNDERSTANDING THE NATURE OF E&O INSURANCE
III. APPLYING FOR E&O INSURANCE
IV. WHO IS AN INSURED?
V. CONSIDER KEY POLICY CONTENTS
VI. CONSIDER EXCLUSIONS
VII. CONSIDER CLAIMS-MADE ISSUES UNDER PROFESSIONAL LIABILITY
POLICIES
VIII. CONSIDER THE RIGHTS AND DUTIES OF THE INSURED
IX. CONSIDER THE RIGHTS AND DUTIES OF THE INSURER
X. INSURING SPECIFIC PROFESSIONS
Chapter 39 UNDERSTANDING MULTIPLE INSURER SITUATIONS
I. OVERVIEW
II. RECOGNIZING WHEN MULTIPLE POLICIES APPLY TO ONE LOSS.
III. UNDERSTANDING PURPOSE AND FUNCTION OF OTHER
INSURANCE CLAUSES
IV. UNDERSTANDING HOW COURTS ALLOCATE LIABILITY AMONG
CONSECUTIVE INSURERS
V. UNDERSTANDING KEY CONCERNS WHEN NEGOTIATING AND
LITIGATING CLAIMS INVOLVING OTHER INSURERS (I.E., MULTICARRIER
CLAIM)
Chapter 40 UNDERSTANDING REINSURANCE
I. OVERVIEW
II. APPRECIATING PURPOSE OF REINSURANCE
III. CONSIDERING REINSURANCE REGULATION
IV. CONSIDERING INSURERS OBLIGATIONS TO REINSURERS IN CASE
OF CLAIM.
V. CONSIDERING REINSURERS OBLIGATIONS
VI. CONSIDERING DUTY OF UTMOST GOOD FAITH OR UBERRIMAE
FIDEI
VII. CONSIDERING FOLLOW THE FORTUNES/FOLLOW THE
SETTLEMENTS
VIII. CONSIDERING BROKERED MARKET
IX. CONSIDERING REINSURANCE ARBITRATION
X. FORMS