Page printed from:
https://www.lawjournalnewsletters.com/2004/03/01/we-didnt-really-mean-intentional-structural-ambiguity-created-by-personal-injury-coverage
We Didn't Really Mean 'Intentional': Structural Ambiguity Created by 'Personal Injury' Coverage
The purpose of insurance is to insure. In attempting to see that this purpose is achieved, courts have developed the following rules of construction that are beyond dispute. First, grants of coverage are broadly construed. <i>See, e.g., Federal Home Loan Mtg. Corp. v. Scottsdale Ins. Co.</i>, 316 F.3d 431, 444 (3d Cir. 2003); <i>Community Found. for Jewish Educ. v. Federal Ins. Co.</i>, 16 Fed. Appx. 462, 465 (7th Cir. 2001); <i>Blum v. Allstate Ins. Co.</i>, No. 4:03CV401 CDP, 2003 WL 23009136, at *2 (E.D. Mo. Dec. 15, 2003). Second, exclusions to coverage are strictly construed. <i>See, e.g., Auto-Owners Ins. Co. v. Churchman</i>, 489 N.W.2d 431 (Mich. 1992); <i>Napoli, Kaiser & Bern, LLP v. Westport Ins. Co.</i>, No. 02 Civ. 7931 (JGK), 2003 WL 22952171, at *7 (S.D.N.Y. Dec. 15, 2003); <i>Dursham v. Nationwide Ins. Co.</i>, 92 F. Supp.2d 353 (D. Vt. 2000). Third, if there is any doubt as to whether coverage exists, such doubts should be resolved in favor of the existence of coverage. <i>See, e.g., American Bumper & Mfg. Co. v. Hartford Fire Ins. Co.</i>, 550 N.W.2d 475, 481 (Mich. 1996); <i>Hecla Mining Co. v. New Hampshire Ins. Co.</i>, 811 P.2d 1083, 1090 (Colo. 1991). All of these doctrines, while generally recognized, result in endless disputes between the insurance purchasers (policyholders) and insurance sellers (insurance companies) on a daily basis when the specific facts of a claim develop. But one recurring scenario is not addressed by these broad maxims of insurance law: What should a court do with the insurance contract that is, by its very nature, internally structured so that there is an inherent conflict that renders a determination of available coverage ambiguous before a claim is even presented?
By John N. Ellison, Robert E. Frankel and Kevin B. Dreher
March 01, 2004
The purpose of insurance is to insure. In attempting to see that this purpose is achieved, courts have developed the following rules of construction that are beyond dispute. First, grants
Read These Next
The parameters set forth in the DOJ's memorandum have implications not only for the government's evaluation of compliance programs in the context of criminal charging decisions, but also for how defense counsel structure their conference-room advocacy seeking declinations or lesser sanctions in both criminal and civil investigations.
The DOJ's Criminal Division issued three declinations since the issuance of the revised CEP a year ago. Review of these cases gives insight into DOJ's implementation of the new policy in practice.
This article discusses the practical and policy reasons for the use of DPAs and NPAs in white-collar criminal investigations, and considers the NDAA's new reporting provision and its relationship with other efforts to enhance transparency in DOJ decision-making.
There is no efficient market for the sale of bankruptcy assets. Inefficient markets yield a transactional drag, potentially dampening the ability of debtors and trustees to maximize value for creditors. This article identifies ways in which investors may more easily discover bankruptcy asset sales.
The Second Circuit affirmed the lower courts' judgment that a "transfer made … in connection with a securities contract … by a qualifying financial institution" was entitled "to the protection of ... §546 (e)'s safe harbor ...."