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Documentation Requirements: No Right for Excess Carriers to Second-Guess Primary Carriers' Settlement Payments

By Michael T. Sharkey
September 01, 2005

Since 2001, numerous insurance companies have sought to impose on asbestos liability claims so-called “Documentation Requirements” (“DRs”), seeking to limit coverage provided by its policies to those claims that meet certain criteria. Those insurance companies assert that the DRs are necessary to counter the growing number of unsubstantiated asbestos-related bodily injury claims brought against policyholders. Generally, the DRs require a policyholder to provide medical documentation and data to show each asbestos injury for each claimant, as well as provide product identification and exposure history. See Scott Moser, Mealey's Seminar, 16 Mealey's Litig. Rep. 12 (Dec. 11, 2001) (an attorney for Equitas speaking about the documentation requirements). The policyholders, on the other hand, see the DRs as unreasonable conditions to coverage that are not found anywhere in the policy language. They argue that in many cases it may be reasonable for them or for their primary carriers to settle or to have settled claims for which there is not yet fully developed information, to avoid, inter alia, increased defense costs and the possibility of a much higher judgment if the information developed is unfavorable.

Application of the DRs to claims that fall within the layer of the insurance company that is putting them forth is questionable, particularly where the insurance company is denying coverage on other grounds. Numerous courts have held that a policyholder in such a situation who settles in the face of a reasonable anticipation that the underlying claimant may be successful is not required to prove the underlying liability case against itself in order to receive coverage. See e.g., Uniroyal, Inc. v. Home Ins. Co., 707 F. Supp. 1368, 1378-79 (E.D.N.Y. 1988); U.S. Gypsum Co. v. Admiral Ins. Co., 643 N.E.2d 1226, 1244 (Ill. App. 1995); Luria Bros. v. Alliance Assurance Co., 780 F.2d 1082, 1091 (2d Cir. 1986).

An even less justified effort by excess insurance companies, however, is the subject of this article: the claim of certain excess carriers that they can deny coverage by asserting improper exhaustion of underlying coverage if the primary carrier settled claims without meeting the excess carriers' DRs. In some cases, such arguments have been advanced even when the settlements took place years before the insurance companies put forth the DRs. The imposition of DRs in that circumstance would require a policyholder to obtain claim files and underlying defense records for thousands or tens of thousands of claims, many of which may be decades old. After requiring the massive production and analysis of these records, the excess carrier then may determine that the primary carrier “improperly” paid a claim some 30 years ago without the foresight to obtain or retain claim data to satisfy DRs that did not yet exist. And based on its own conclusion, the excess insurance company would not participate in defense or indemnity because it believed its policy layer had not yet been reached.

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