Decisions
COVERAGE
Kampf v. Franklin Life (1960) | When the policy terms are clear, the function of the court is to enforce its provisions and not make it better for either party.
Burd v. Sussex Mutual (1970) | The duty to defend applies to only those injuries that would be covered if the claim was valid.
Rova Farms v. Investors Insurance Co. (1974) | Where an insurer reserves full control of the claims settlement process, the insurer has the duty to exercise good faith in settling claims.
Mt Hope Inn v. Travelers (1978) | When multiple alternative causes of action are stated, the duty to defend continues until every covered claim is eliminated.
DiOrio v. NJ Manufacturers (1979) | When the meaning of a phrase is ambiguous, the ambiguity is resolved in favor of the insured in line with the insured’s objectively reasonable expectations.
Ward v. Merrimack Mutual (1980) | In order to establish bad faith in a first party claim, the insured must establish an insurer’s “reckless indifference to facts or to other proofs submitted by the insured.”
Patterson Tallow v. Royal Globe (1981) | The coverage trigger in malicious prosecution and wrongful arrest claim is the date charges were filed against the claimant.
Zuckerman v. National Union (1985) | The fundamental principle of insurance law is to fulfil the reasonable expectations of the parties. The insurer is not required to show prejudice when denying a claim based on late notice against a claims made policy even though it must show prejudice in an occurrence policy.
Sparks v. St. Paul (1985) Because insurance polices are policies of adhesion, the courts must assume a particularly vigilant role in insuring conformity to public policy and the principles of fairness. Under exceptional circumstances, an insured may be entitled to “reasonable expectations” even if this differs from the unambiguous wording in the policy.
Werner Industries v. First State (1988) | If an insured’s reasonable expectations contravene the plain meaning of a policy, the plain meaning can be overcome only if the policy is inconsistent with public expectations and commercially accepted standards.
Longobardi v. Chubb (1990) | Generally a policy should be interpreted according to its plain and ordinary meaning.
Voorhees v. Preferred Mutual (1992) | When claim that emotional distress resulted in physical ramifications, it is covered under the bodily injury section of a liability policy. The accidental nature of an occurrence is determined by analyzing whether the alleged wrongdoer intended or expected to cause an injury. If not then the resulting injury is accidental even if the act that caused the injury was intentional.
State v. Signo Trading (1992) | The courts should resort to the doctrine of reasonable expectations only when the phrasing of the policy is so confusing that the average policyholder cannot make out the boundaries of coverage. Public policy considerations alone are not sufficient to permit a finding of coverage in an insurance contract when the plain language cannot be fairly read to otherwise provide coverage.
SL Industries v. American Motorists (1992) | An insurer has no duty to reimburse an insured for defense costs incurred before the insured reports the claim.
Nunn v. Franklin Mutual (1994) | The absolute pollution exclusion is enforceable in a commercial policy because commercial policyholders are more able to understand policy language.
Zacarias v. All State (2001) | A legislative mandate is required for the courts to expand coverage using a public policy rational.
Edwards v. Prudential Property/Casualty (2003) | Insurers have no duty to educate or counsel policyholders about the conditions of their policies.
Benjamin Moore v. Aetna (2004) | In a long-tail environmental exposure case, an insured must satisfy the full deductible for each triggered policy before it is entitled to indemnity from the insurer.
American Wrecking v. Burlington Insurance Co. (2008) | The doctrine of the reasonable expectations of an insured for coverage only applies in commercial insurance where there is ambiguity in the policy language.
Ferentz v. Frederick (2019) | Coverage was voided by the deliberate action of the insured to undermine its own defense so that the plaintive would win.