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The Hazards of an Untimely Disclaimer of Coverage: Application of the Estoppel Doctrine to Bar Reliance upon Coverage Defenses

By Catherine E. Hamilton
October 06, 2005

Liability insurance policies typically require the insured to notify the insurance company “as soon as practicable” or “as soon as possible” of a suit or a potentially covered claim. Compliance with these “notice conditions” is often held to be a condition precedent to coverage under the policy, such that if the insured unreasonably delays notifying its carrier of a suit or claim, the insurer may be relieved of its duties under the policy. The purpose of these provisions is to protect the insurer by giving it adequate time to investigate the claim, control the litigation, posture the case for settlement, set reserves, and prevent fraud. Sybron Transition Corp. v. Sec. Ins. Co. of Hartford, 107 F.3d 1250, 1257 (7th Cir. 1997). But there is a cautionary note for insurers because the duty to provide prompt notice is not limited to the insured. Under limited circumstances, an insurer may be estopped from relying upon a coverage defense, such as late notice or an applicable exclusion from coverage, if it unreasonably delays denying coverage under the policy because, just like the insurer, the insured can potentially suffer prejudice from untimely communications. Incorporated Village of Pleasantville v. Calvert Ins. Co., 612 N.Y.S.2d 441 (N.Y. App. Div. 1994); Central Mut. Ins. Co. v. Kammerling, 571 N.E.2d 806 (Ill. App. Ct. 1991). This article discusses the elements of estoppel barring coverage defenses, application of the defense in special circumstances involving settlement of the underlying claim, and what an insurer should do if it is uncertain as to whether coverage actually exists under the policy.

Estoppel Cannot Create Coverage

An insured's assertion of estoppel against the insurer is subject to two impor- tant limitations.

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