Policyholder Pulse
Contra proferentem is a foundational legal principle with particular importance in insurance law. It mandates that any ambiguities in an insurance policy are construed against the insurer and in favor of the insured. The doctrine recognizes that insurance policies generally are contracts of adhesion, in which the insurer wields the “power of the pen,” and the insured is invited to accept the terms of the pre-written agreement with little to no alteration. Contra proferentem mitigates the inherent inequality of an arrangement where insurers generally have sole drafting authority and insureds, often with limited bargaining power, must accept the insurers’ terms as written. By resolving ambiguities in those terms against the insurer, courts are able to counterbalance some of this inequity and find coverage for policyholders.
When a company receives a claim or lawsuit, it is critical to provide timely notice to its insurers. But when the claim is first made, sufficient facts may not yet be known to indicate which policy will respond. Many policies also contain language that purports to shift coverage to earlier insurance policies for claims that “relate back” to earlier events. As a best practice, policyholders and their brokers often provide notice of a claim under all policies that might cover a loss, to ensure that coverage is not defeated by failure to meet any obligation to give notice. This method of first providing notice for claims to multiple insurers, and then working with insurers to determine the correct policy to respond, is a well-established practice for managing insurance claims. Once the proper policy to respond to the claim is established, exclusions in the other policies kick in to avoid double coverage.
When you’re buying a new car, you rely on a good salesperson to impress you with all of its features and gadgets. But when it’s time for maintenance, or when something goes wrong, you don’t go back to that salesperson to look at the problem. You find a trustworthy mechanic. At insurance renewal time, it may seem like you’re just buying a new set of policies, and that your broker is the only person you need to find out what’s available on the market. But policy renewal is also part of scheduled maintenance for your company’s risk management program. A policyholder-side insurance coverage attorney is the mechanic that can help you make sure it runs right.
That was the message a federal magistrate judge in the Eastern District of New York delivered when she ruled that Certain Underwriters at Lloyd’s had waived attorney-client privilege by communicating with their counsel through a London broker.