Remember the insurer is avoiding paying a claim it would otherwise have to pay based on its exercise of a notice condition in the policy; although occurrence based policies have similar notice requirements courts require the insurer to prove prejudice. the claims made carrier contends it should not have to prove prejudice (harm) from the late notice attempting to distinguish itself from an occurrence based policy; the court agrees without evidence of the underwriting realities by simply accepting the carrier’s argument the claims made carrier is prejudice as a matter of law based on erroneous assumptions about underwriting realities for claims made policies.
If a little old insuerd like me has to follow the late claims reporting language in my policies, then the big old insurer, who is also an insured should have to do the same, no?
Really! That is inexcusable for them not to know the rules given their profession. The right hand was not talking to the left. That is BIG bad faith award. I wouldn’t want to be that adjuster, but I wouldn’t mind being the insured cashing in.
big difference between an occurrence policy and a claims made, and that is what courts consistently recognize in these rulings. The requirement to report timely in a Claims Made policy is in the Insuring Agreement, not in a policy General Condition. So, to say its a claim that would be covered but for the late notice is not correct. To be covered, the claim must come within the Insuring Agreement, and a late reported claim does not meet the requirements of the Insuring Agreement.
Remember the insurer is avoiding paying a claim it would otherwise have to pay based on its exercise of a notice condition in the policy; although occurrence based policies have similar notice requirements courts require the insurer to prove prejudice. the claims made carrier contends it should not have to prove prejudice (harm) from the late notice attempting to distinguish itself from an occurrence based policy; the court agrees without evidence of the underwriting realities by simply accepting the carrier’s argument the claims made carrier is prejudice as a matter of law based on erroneous assumptions about underwriting realities for claims made policies.
If a little old insuerd like me has to follow the late claims reporting language in my policies, then the big old insurer, who is also an insured should have to do the same, no?
I want to know more about the 37 Mil bad faith claim. How did that happen?
Really! That is inexcusable for them not to know the rules given their profession. The right hand was not talking to the left. That is BIG bad faith award. I wouldn’t want to be that adjuster, but I wouldn’t mind being the insured cashing in.
LOL at … ACE Insurance whatevers …
Guess they weren’t too ACE now were they.
Steve
Insurance Marketing
http://www.4morereferrals.com
big difference between an occurrence policy and a claims made, and that is what courts consistently recognize in these rulings. The requirement to report timely in a Claims Made policy is in the Insuring Agreement, not in a policy General Condition. So, to say its a claim that would be covered but for the late notice is not correct. To be covered, the claim must come within the Insuring Agreement, and a late reported claim does not meet the requirements of the Insuring Agreement.
I wonder how many claims ACE denied because of late notice? Ummm! I see coverage!