The need to distribute the risk of economic loss that would accompany any number of potential misfortunes prompts most individuals and businesses to include insurance as a major element of their economic planning.
This far-reaching nature of the industry, along with the complex nature of the insurance contract itself, results in strong public interest which manifests itself both in extensive regulation of the industry and in the willingness of courts to invalidate certain provisions of a contract designed by an insurer to limit its risk.
In addition, the desire of the courts to protect the interest of the individual insured in any dispute between insurer and insured provides the underlying rationale for the courts to display considerable imagination in identifying ambiguities in the policy language, to interpret such ambiguities in favor of the insured, and even occasionally to ignore the contract entirely and resolve the issue in favor of the reasonable expectations of the insured.
These fundamental principles provide a characteristic flavor to insurance law that might be somewhat surprising to the attorney accustomed to conventional contract analysis. Whether your practice specializes in insurance law or you encounter the insurance problem only infrequently, National Legal Research Group can provide the assistance necessary to chart your client's course properly.
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Insurance law is so vast that only a representative sampling of problems and issues encountered can be given here. Typical problems involve:
Agents and brokers
Assignment and transfer of policy and policy loans
Bad faith and its accompanying potential for large punitive damage verdicts
Beneficiaries and rights to proceeds
Compromise, accord, and release
Appraisal and arbitration
Notice and proof of loss
Applications, binders, and riders
Insurable interest
Insurer's duties of coverage, defense, and settlement
Modification, reformation, rescission, and cancellation of contract
Premiums and assessments
Renewal and reinstatement of policy
Representations, warranties, and conditions
Settlements and releases
Subrogation, contribution, and apportionment
Waiver, estoppel, and incontestability
AUTOMOBILE INSURANCE: GENERAL LIABILITY
Determination of whether claims by persons other than the injured party are covered, such as claims by the injured person’s spouse or parents for loss of consortium or claims by the injured child's parents for mental distress
"Stacking" questions, where more than one vehicle may be covered, in one policy or in several policies
Enforceability and effect of "other insurance" clauses; who are additional insureds for purposes of coverage under the omnibus clause
Validity of the total driver exclusion endorsement
Whether an assault committed by the insured is an accident for coverage purposes
What constitutes "use" of an automobile?
Is the seller of an automobile still the owner where title has not been transferred?
What vehicles can qualify as substitute vehicles?
What are the insurer's duties regarding distribution of inadequate insurance proceeds among multiple claimants?
AUTOMOBILES: NO-FAULT INSURANCE
Validity and enforceability of the arbitration clause
Relatives and the residency requirement
Drivers, passengers, and pedestrians as insured; motorcycles, trucks, and other vehicles as uninsured highway vehicles
Coverage for hit-and-run accidents
Underinsured motorist coverage enforceability and effect of "other insurance" clauses
"Stacking" issues
The insurer's subrogation rights in actions against the uninsured motorist
The effect of settling with the uninsured motorist without the insurance company's consent
BANKER'S BLANKET BOND
What constitutes "dishonest or fraudulent" acts?
Necessity of proof that each separate transaction is fraudulent, as opposed to proof of a general course of fraudulent conduct
Does "loss" include funds misappropriated to pay delinquent interest?
Does a policy deductible amount apply to the total loss or separately to each occurrence?
Is prejudgment interest covered?
Are check-kiting schemes covered?
HEALTH INSURANCE LAWS AND ACCIDENT INSURANCE LAWS
Whether an injury is the direct and independent result of bodily injury caused by accident in light of the existence of a prior similar injury
Was insured "riding in an automobile" when he was found dead in his car inside his home's garage?
What acts are included as incidental or related to the insured's occupation?
Extent of the exclusion for loss resulting directly or indirectly from a preexisting illness or disease
Offsets for workers' compensation benefits paid
When are home nursing care services "reasonably necessary"?
FIRE INSURANCE LAWS
Problems associated with loss payee and mortgagee clauses
Fraud, false swearing, and misstatements in proof of loss
Damages issues
Problems arising from the possibility of arson
Whether losses caused by overheating, smoke, or soot are covered
Exceptions to coverage, such as storage, electrical current, explosion, and theft
PUBLIC LIABILITY INSURANC LAWS
Did an injury occur during the policy period where the insured incurred long-term exposure to ambient or ingested substances?
Is oral notice to the insurer of a claim against the insured sufficient to satisfy the notice requirement?
Does a claim for economic loss resulting from a statutory violation constitute an "occurrence"?
Under what circumstances is coverage properly denied on the ground that the insured's actions were intentional?
Insurability of punitive damages assessed against the insured
What activities fall within the "business pursuits" exclusion?
LIFE INSURANCE LAWS
Effects of property settlement agreements and divorce decrees on beneficiary provisions
Change-of-beneficiary problems
Problems created by and associated with suicide by the insured
Effect of concealment and misrepresentations in the application
Premiums and assessment problems
Proof-of-death and cause-of-death issues
Testimonials
"Suzanne is very easy to work with and engages quickly to the subject matter and issue at hand. This is the second project I have worked with her on and would certainly look forward to working with her in the future."
—Robert K. Finnell, Rome, GA
"As usual, Alfred Shackelford did a superb job. Your firm is apparently ready 24/7 to turn out legal brief writing and research. I couldn't ask for a better partner."
—Arthur Ballen, Cherry Hill, NJ
"Brad did a super job. He really analyzed the situation well. His writing and analysis were fabulous. Thanks for the prompt service."
—William Greenberg, Canton, MA
MEET A FEW OF OUR TOP Insurance LAW research ATTORNEYS
B.A., University of Virginia, 1980. J.D., University of Detroit School of Law, 1983. Member, Michigan, New York, and Virginia Bars. Prior to joining our firm, Suzanne served as a Law Clerk to The Honorable Stewart A. Newblatt, United States District Court for the Eastern District of Michigan, from 1983 to 1985.
B.A., University of Virginia, 1994. J.D., University of Florida Law School, 1998. Member, Maryland & D.C. Bars. Admitted, Fourth Circuit Court of Appeals. Prior to joining NLRG, Alistair clerked for a Maryland circuit court judge & worked in the litigation department of a Washington, D.C.-based firm.
B.A., with Distinction, University of Virginia, 1978. J.D., University of Virginia Law School, 1983. Member, Virginia Bar. Fred was an Associate at Williams Mullen in Richmond Virginia, and Tremblay & Smith, LLP, in Charlottesville, Virginia (where he focused on personal injury law), prior to joining our firm in 1987
B.A., College of William and Mary, 1983. J.D., Marshall Wythe School of Law, College of William and Mary, 1986. Member, Virginia, U.S. Fourth Circuit & Eleventh Circuit Courts of Appeals Bars. Jeremy joined NLRG in 1986 and is the editor of our Products Liability Update. Areas of expertise include Administrative Law, Evidence, Personal Injury, Immigration, Civil Procedure, & Products Liability/Consumer Protection
B.A., Denison University, 1982. M.B.A., University of Pittsburgh, 1984. J.D., University of Pittsburgh, 1986. Member, Florida Bar. Former Vice President and Trust Officer with the Wealth Management and Retirement Brokerage Services of Wachovia Bank. Brad managed a book of personal trust, guardianship, and fiduciary investment accounts.
