California Insurance Law

  • ID: 4196549
  • Book
  • Region: United States
  • 340 Pages
  • ALM Media, LLC
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California insurance coverage issues that can arise in connection with the most commonly-issued insurance contracts. The handbook is organized by types of property and casualty insurance policies, encompassing both personal and commercial lines. Includes typical provisions, issues raised by those provisions, treatment of those provisions by California courts. The handbook is geared towards attorneys who represent policy holders or insurers, Insurance claims personnel, and other attorneys whose work may be affected by insurance coverage issues.      

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Chapter 1

Introduction to Insurance Policies
1-1       TYPES OF POLICIES
1-1:1    Personal Lines Versus Commercial Lines Policies
1-1:2    Property Versus Liability Policies
1-1:3    Occurrence Versus Claims-Made Policies
1-1:4    Primary Versus Excess Versus Umbrella Policies
1-2       DIFFERENT TYPES OF PROPERTY POLICIES
1-2:1    All Risk Versus Specified Peril Policies
1-2:2    Automobile
1-2:3    Homeowners
1-2:4    Commercial Property
1-2:5    Builder’s Risk
1-3       DIFFERENT TYPES OF LIABILITY POLICIES
1-3:1    Automobile
1-3:2    Homeowners
1-3:3    Personal Lines Umbrella
1-3:4    Commercial General Liability
1-3:5    Errors and Omissions
1-3:6    Directors and Officers Liability
1-3:7    Employment Practices Liability
1-3:8    Commercial Lines Excess/Umbrella
1-4       THE CONCEPT OF FORTUITY IN INSURANCE POLICIES
1-5       STANDARDIZED FORMS
 
Chapter 2
Interpretation of Insurance Policies
2-1       CONTRACT INTERPRETATION GENERALLY
2-2       CONTRACT INTERPRETATION AS TO INSURANCE POLICIES
2-3       HOW TO READ A POLICY
            2-3:1    Policy Declarations Pages
            2-3:2    The Insuring Agreement
            2-3:3    Limitations
            2-3:4    Exclusions
            2-3:5    Give Backs
            2-3:6    Conditions
2-4       EFFECT OF ENDORSEMENTS
2-5       BURDENS OF PROOF
            2-5:1    Insured Must Prove Loss Falls Within Insuring Agreement
            2-5:2    Insurer Must Prove Exclusion or Limitation Removes Coverage
            2-5:3    Insured Must Prove Loss Falls Within Exception to Exclusion
            2-5:4    Burden of Proof Regarding Failure to Perform Conditions Precedent
 
Chapter 3
Commercial Property Coverage
3-1       PURPOSE OF PROPERTY COVERAGE
3-2       VALUED POLICIES
            3-2:1    Requirements
            3-2:2    Agreed Value Policies Are Disfavored
3-3       KEY PROVISIONS IN PROPERTY DECLARATIONS PAGES
3-4       THE PROPERTY INSURING AGREEMENT
            3-4:1    Covered Property
            3-4:2    Covered Cause of Loss—Specified or Named Peril
3-4:3    Covered Cause of Loss—All Risks
            3-4:4    The Concept of Fortuity in a Property Policy
            3-4:5    Indemnification Under a Property Policy

            3-4:6    Direct Physical Loss
                        3-4:6.1 What Constitutes a Direct Physical Loss
            3-4:6.2 What Is Not a Direct Physical Loss
                        3-4:7    Property Not Covered
3-5       DOES THE LOSS FALL WITHIN THE POLICY PERIOD
            3-5:1    Discrete Loss
            3-5:2    Continuous and Progressive Loss
            3-5:3    Manifestation Rule
            3-5:4    Delayed Discovery Rule
3-6       LIMITATIONS ON COVERAGE
            3-6:1    Property that Is Missing, Where Only Evidence of Loss Is Inventory Shortage
            3-6:5    Damage to the Interior of Any Building Caused by or Resulting from Rain, Snow, Sleet, Ice, Sand or Dust
3-7       ADDITIONAL COVERAGES
            3-7:1    Collapse
3-7:2    Water Damage, Other Liquids, Powder or Molten Material Damage
            3-7:3    Business Income
                        3-7:3.1             Definition of Business Income
                        3-7:3.2             Requirement That Operations Be Suspended
                        3-7:3.3             Suspension Caused By Covered Cause of Loss
                        3-7:3.4             Period of Restoration
                        3-7:3.5 Extended Business Income
            3-7:4    Extra Expense
            3-7:5    Civil Authority
            3-7:6    Forgery or Alteration
            3-7:7    Increased Cost of Construction
3-8       COVERAGE EXTENSIONS
            3-8:1    Newly Acquired or Constructed Property
            3-8:2    Personal Effects (and Property of Others)
             3-8:3   Valuable Papers and Records
3-9       EXCLUSIONS
            3-9:1    Application of Exclusions
                        3-9:1.1 Loss Resulting from Single Cause or Peril
                        3-9:1.2 Efficient Proximate Cause Doctrine
            3-9:2    Property Policy Exclusions
                        3-9:2.1 Section B.1 Exclusions
                                    3-9:2.1a           Ordinance or Law
                                    3-9:2.1b          Earth Movement
                                    3-9:2.1c           Governmental Action
                                    3-9:2.1d          War and Military Action
                                    3-9:2.1e           Water
                                                3-9:2.1e(1)      Flood, Surface Water
                                                3-9:2.1e(2)      Water Backing Up from Sewer or Drain
                        3-9:2.2 Section B.2 Exclusions
                                    3-9:2.2a           Dishonesty
                                    3-9:2.2b          False Pretense
                                    3-9:2.2c           Collapse
                                    3-9:2.2d          Pollution
                                    3-9:2.2e           Neglect
                                    3-9:2.2f           Other Types of Losses
                                                3-8:2.2f(1)       Wear and Tear

                                                3-9:2.2f(2)       Rust, Corrosion, Fungus, Decay, Deterioration, Hidden or Latent Defect or Quality in Property that Causes It to Destroy Itself
                                                3-9:2-2f(3)      Settling, Cracking, Shrinking or Expansion
                                                3-9:2-2f(4)      Nesting or Infestations
                                    3-9:2.2g           Repeated Seepage or Leakage of Water
                        3-9:2.3 Section B.3 Exclusions
                                    3-9:2.3a           Weather Conditions
                                    3-9:2.3b          Acts or Decisions
                                    3-9:2.3c           Negligent Work
            3-9:2.4 Ensuing Loss Provisions
3-10     LIMITS OF INSURANCE
3-11     DEDUCTIBLES
3-12     PROPERTY LOSS CONDITIONS
            3-12:1  Appraisal
            3-12:2  Duties in the Event of Loss or Damage
            3-12:2.1           Notice of Loss
            3-12:2.2           Protection of Property from Further Loss
            3-12:2.3           Production of Books, Records or Other Evidence Supporting the Loss
                        3-12:2.4           Proof of Loss
                        3-12:2.5           Examination Under Oath
            3-12:3              Legal Action Against Us
            3-12:4  Loss Payment
            3-12:5  Vacancy
            3-12:6  Co-Insurance
3-13     PROPERTY--GENERAL CONDITIONS
            3-13:1  Mortgageholders
            3-13:2  Policy Period/Coverage Territory
            3-13:3  Concealment or Fraud
3:14     OPTIONAL COVERAGES
            3-14:1  Employment Dishonesty
            3-14:2 Inflation Guard
            3-14:3 Replacement Cost
3-15     PROPERTY DEFINITIONS

 
Chapter 4
Commercial General Liability Policies
4-1       PURPOSE OF LIABILITY COVERAGE
4-2       DUTY TO DEFEND VERSUS DUTY TO INDEMNIFY
            4-2:1    How to Determine Duty to Defend
            4-2:1.1 An Insured’s Right to Independent Counsel
            4-2:2    How to Determine Duty to Indemnify
4-3       HOW TO READ A LIABILITY POLICY
4-4       KEY PROVISIONS IN LIABILITY DECLARATIONS PAGES
4-5       THE LIABILITY INSURING AGREEMENT
                        4-5:1    Types of Liability Insuring Agreements
                                    4-5:1.1 Coverage A
                                    4-5:1.2 Coverage B
                                    4-5:1.3 Combination (Business Liability Insuring Agreement)
                        4-5:2    Who Is an Insured
                                    4-5:2.1 Named Insured
                                    4-5:2.2 Effect of Joint Venture Exclusion
                                    4-5:2.3 Additional Insureds
                                                4-5:2.3a           Omnibus Provisions
                                                4-5:2.3b          Additional Insured Endorsements
                        4-5:3    Damages
                                    4-5:3.1 What Constitutes Damages
                                    4-5:3.2 What Does Not Constitute Damages
                                    4-5:3.3 Prohibition on Indemnification of Punitive Damages
                        4-5:4    Bodily Injury and Property Damage Coverage
                                    4-5:4.1 Bodily Injury
                                                4-5:4.1a           What Constitutes “Bodily Injury”
                                                4-5:4.1b          What Does Not Constitute “Bodily Injury”
                                    4-5:4.2 Property Damage
                                                4-5:4.2a           Tangible Property Requirement
4-5:4.2b          What Constitutes “Property Damage”
                                                4-5:4.2c           What Does Not Constitute “Property Damage”
                                    4-5:4.3 Occurrence
                                                4-5:4.3a           Accident Requirement
                                                4-5:4.3b          What Does Not Constitute an Occurrence
                                    4-5:4.4 Trigger of Coverage
                        4-5:5    Personal and Advertising Injury Coverage
                                    4-5:5.1 What Is Personal and Advertising Injury
                                    4-5:5.2 Offense Based
                                                4-5:5.2a           False Arrest, Detention or Imprisonment
                                                4-5:5.2b          Malicious Prosecution
4-5:5.2c           Wrongful Eviction, Entry, or Invasion of the Right of Private Occupancy
                                                4-5:5.2d          Defamation or Disparagement
                                                4-5:5.2e           Violation of Right of Privacy
                                                4-5:5.2f           Use of Another’s Advertising Idea
4-5:5.2g           Infringement of Copyright, Trade Dress or Slogan
                        4-5:6    Suit
                                    4-5:6.1 What Constitutes a Suit
                                                4-5:6.1a           Where Term Is Undefined
                                                4-5:6.1b          Where Term Is Defined
                                    4-5:6.2 What Does Not Constitute a Suit
            4-6       MEDICAL EXPENSES PROVISION
4-7       SUPPLEMENTARY PAYMENTS PROVISION
4-6:1    What Is Covered
                        4-6:2    When Is the Provision Inapplicable
            4-8       EXCLUSIONS AND LIMITATIONS
                        4-8:1    Application of Exclusions
                                    4-8:1.1 Concurrent Cause Analysis
                        4-8:2    Standard Liability Policy Exclusions and Limitations
4-8:2.1 Expected or Intended Acts
                                                4-8:2.1a           Insurance Code Section 533
                                    4-8:2.2 Contractual Liability
                                    4-8:2.3 Workers’ Compensation and Similar Laws
                                    4-8:2.4 Employer’s Liability
                                    4-8:2.5 Pollution
                                                4-8:2.5a           Absolute Pollution Exclusion
                                                4-8:2.5b          Sudden and Accidental
                                    4-8:2.6 Aircraft, Auto, Watercraft
                                    4-8:2.7 Damage to Property
                                    4-8:2.8 Damage to “Your Product” and “Your Work”
                                    4-8:2.10           Damage to Impaired Property
                                    4-8:2.11           Sistership Exclusion
                                    4-8:2.12           Classification Limitations
                                    4-8:2.13           Personal and Advertising Injury Exclusions
                                                4-8:2.13a         Exclusions Based on Insured’s Knowledge
                                                4-8:2.13b        Prior Publication Exclusion
                                                4-8:2.13c         Breach of Contract Exclusion
                                                4-8:2.13d        Failure of Goods, Products, Services to Conform
                                                4-8:2.13e         Infringement Exclusion
                                                4-8:2.13f         Employment-Related Practices
                                    4-8:2.14           Medical Expenses Exclusions
            4-9       LIMITS OF LIABILITY
            4-10     POLICY CONDITIONS
                        4-10:1  Bankruptcy
                        4-10:2  Duties in the Event of Occurrence, Offense, Claim or Suit
4-10:2.1           Ramifications of Insured’s Breach
                        4-10:3  Suit Limitation Clause
                        4-10:4  Other Insurance Clause
                                    4-10:4a            Escape Clauses Disfavored
4-10:5  Concealment/Fraud
4-10:6  Separation of Insureds Clause
                        4-10:7  Transfer of Rights of Recovery Against Others
            4-11     OTHER ENDORSEMENTS TO LIABILITY POLICIES        
                        4-12:1  Professional Services Exclusion
                        4-12:2  Insured vs. Insured Exclusion
            4-12:3  Residential Construction Exclusion
            4-12:4  Special Conditions Endorsement
 
Chapter 5
Commercial Automobile Policies
            5-1       PURPOSE OF COMMERCIAL AUTOMOBILE POLICY
            5-2       TYPES OF COVERAGE INCLUDED
                        5-2:1    Liability Coverage (Third Party)
                        5-2:2    Physical Damage Coverage (First Party)
                        5-2:3    Medical Payments Coverage
                        5-2:4    Uninsured Motorist Coverage
            5-3       COVERED AUTOS
                        5-3:1    Description of Covered Auto Designation Symbols
                        5-3:2    Owned Autos Acquired After Inception of Policy
                        5-3:3    Trailers, Mobile Equipment, and Temporary Substitute Autos
            5-4       LIABILITY COVERAGE
                        5-4:1    Insuring Agreement
                                    5-4:1.1 Who Is an Insured
                                                5-4:1.1a           Named Insured
                                                5-4:1.1b          Permissive Users
                                                5-4:1.1c           Anyone Liable for the Conduct of an Insured
                                    5-4:1.2 Bodily Injury and Property Damage
                                    5-4:1.3 Covered Pollution Cost or Expense
                                    5-4:1.4 Accident Requirement
                                    5-4:1.5 Resulting from Ownership, Maintenance or Use of a Covered Auto
                        5-4:2    Coverage Extensions
                                    5-4:2.1 Supplementary Payments
                                    5-4:2.2 Out of State Coverage Extensions
                        5-4:3    Typical Liability Exclusions
                                    5-4:3.1 Expected or Intended Injury Exclusion
                                    5-4:3.2 Contractual Liability Exclusion
                                    5-4:3.3 Workers’ Compensation Exclusion
                                    5-4:3.4 Employer’s Liability Exclusion
                                    5-4:3.5 Bodily Injury to a Fellow Employee Exclusion 
                                    5-4:3.6 Care, Custody or Control Exclusion 
                                    5-4:3.7 Handling of Property Exclusion
                                    5-4:3.8 Movement of Property by Mechanical Device Exclusion
                                    5-4:3.9 Completed Operations Exclusion 
                                    5-4:3.10           Pollution Exclusion 
                                    5-4:3.11           War Exclusion
                                    5-4:3.12           Racing Exclusion
                        5-4:4    Limit of Insurance
                                    5-4:4.1  One Accident
                                    5-4:4.2   Other Coverages
            5-5       PHYSICAL DAMAGE COVERAGE
                        5-5:1    Insuring Agreement
                                    5-5:1.1 Loss to Covered Auto
                                                5-5:1.1a           Comprehensive Coverage 
                                                5-5:1.1b          Specified Causes of Loss Coverage 
                                                5-5:1.1c           Collision Coverage 
                        5-5:2    Typical Exclusions
                                    5-5:2.1 Nuclear Hazard Exclusion 
                                    5-5:2.2 War or Military Action Exclusion
                                    5-5:2.3 Racing Exclusion 
                                    5-5:2.4 Wear and Tear Exclusion 
                                    5-5:2.5 Exclusion for Loss to Specified Devices and Equipment 
                        5-5:3    Limit of Insurance
                        5-5:4    Deductible
            5-6       MEDICAL PAYMENTS COVERAGE
                        5-6:1    Purpose of Coverage
                        5-6:2    Insuring Agreement
                                    5-6:2.1 Payment for Reasonable Expenses for Necessary Medical and Funeral Services to or for an Insured
                                    5-6:2.2 Who Is an Insured 
                        5-6:3    Typical Exclusions
                                    5-6:3.1 Vehicle Used as Premises
                                    5-6:3.2 Non-Covered Autos Owned by Named Insured 
                                    5-6:3.3 Non-Covered Autos Owned by Family Member
                                    5-6:3.4 Injury to Employee 
                                    5-6:3.5 Auto Business Other Than Named Insured’s Business
                                    5-6:3.6 War
                                    5-6:3.7 Use Without Reasonable Belief of Entitlement to Do So
                                    5-6:3.8 Racing 
                        5-6:4    Limits of Insurance
            5-7       UNINSURED MOTORISTS COVERAGE
                        5-7:1    Purpose of Coverage
                        5-7:2    Insuring Agreement 
                                    5-7:2.1 Uninsured Motor Vehicle Requirement
                                                5-7:2.1a           Includes Underinsured Motor Vehicle
                                                5-7:2.1b          Physical Contact Requirement for Hit and Run
                                                5-7:2.1c           What Does Not Constitute an Uninsured Motor Vehicle 
                                    5-7:2.2   Who Is an Insured
                        5-7:3    Typical Exclusions
                                    5-7:3.1 Punitive Damages
                                    5-7:3.2 Settlement Without Insurer’s Consent       
                                    5-7:3.3 Workers’ Compensation or Similar Law
                                    5-7:3.4 Non-Covered Autos 
                                    5-7:3.5 Non-Covered Leased Autos
                                    5-7:3.6 Use Without Reasonable Belief of Entitlement to Do So
                                    5-7:3.7 Public or Livery Conveyance
                        5-7:4    Limit of Insurance 
                                    5-7:4.1 Reduction for Accidents Involving Underinsured Vehicle
                                    5-7:4.2 Prohibition on Duplicate Payments 
                        5-7:5    Other Insurance 
                        5-7:6    Arbitration 
                                    5-7:6.1 Insurance Code Section 11580.2 
            5-8       LOSS CONDITIONS
                        5-8:1    Appraisal for Physical Damage Loss 
                        5-8:2    Insured’s Duties in the Event of an Accident, Claim, Suit or Loss
                        5-8:3    Suit Limitation Provision
                        5-8:4    Loss Payment Provisions
                        5-8:5    Transfer of Rights of Recovery 
            5-9       GENERAL CONDITIONS
                        5-9:1    Bankruptcy
                        5-9:2    Concealment, Misrepresentation and Fraud
                        5-9:3    Other Insurance Provisions
                        5-9:4    Policy Period and Coverage Territory 
                        5-9:5    Two or More Coverage Forms or Policies Issued by Insurer

Chapter 6
Personal Automobile Policies
            6-1       PURPOSE OF PERSONAL AUTO POLICY
            6-2       TYPES OF COVERAGE INCLUDED
                        6-2:1    Liability Coverage (Third Party)
                                    6-2:1.1 Purpose of Coverage
                                    6-2:1.2 Insuring Agreement
                                    6-2:1.3 Key Terms Defined
                                                6-2:1.3a           Insured
                                                6-2:1.3b          Bodily Injury  
                                                6-2:1.3c           Property Damage
                                                6-2:1.3d          Your Covered Auto 
                                                6-2:1.3e           Newly Acquired Auto
                                    6-2:1.4 Supplementary Payments
                                    6-2:1.5 Exclusions/Limitations
                                                6-2:1.5a           An Individual Who Intentionally Causes the “Bodily Injury” or “Property Damage”
                                                6-2:1.5b          “Property Damage” to Property Owned or Being Transported by That Insured
                                                6-2:1.5c           “Property Damage” to Property Rented to, Used by or in the Case of That Insured
                                                6-2:1.5d          “Bodily Injury” to an Employee of That Insured During the Course of Employment 
                                                6-2:1.5e           Public Livery or Conveyance
                                                6-2:1.5f           While Employed or Otherwise Engaged in the Business of Selling, Repairing, Servicing, Storing or Parking Vehicles 
                                                6-2:1.5g           Maintaining or Using Any Vehicle While That Insured Is Employed or Otherwise Engaged in a Business
                                                6-2:1.5h          Using a Vehicle Without a Reasonable Belief That the “Insured” Is Entitled to Do So 
                                                6-2:1.5i            Driver Exclusion 
                                                6-2:1.5j           Bodily Injury to a Family Member of the Named Insured
                                    6-2:1.6 Limits of Liability
                                                6-2:1.6a           No Stacking of Limits; Wrongful Death and Consortium
                                                6-2:1.6b          Offset for Loss Covered under Medical Payments and Uninsured Motorist Coverage
                                    6-2:1.7 Out of State Coverage
                                    6-2:1.8 Financial Responsibility
                                    6-2:1.9 Other Insurance
                        6-2:2    Medical Payments Coverage (First Party)
                                    6-2:2.1 Purpose of Coverage
                                    6-2:2.2 Insuring Agreement
                                    6-2:2.3 Key Terms Defined
                                                6-2:2.3a           Bodily injury 
                                                6-2:2.3b          Insured
                                                6-2:2.3c           Occupying
                                    6-2:2.4 Exclusions/Limitations
                                                6-2:2.4a           Public Livery or Conveyance 
                                                6-2:2.4b          Occurring During the Course of Employment if Workers Compensation Benefits Are Required or Available
                                                6-2:2.4c           Expenses Sustained While Occupying or When Struck by Any Vehicle (Other than “Your Covered Auto”) Which Is Owned, Available for the Regular Use or Furnished to the Named Insured or Any Family Member 
                                                6-2:2.4d          Incurred While Occupying Any Vehicle Located for Use as a Residence or Premises 
                                    6-2:2.5 Limits of Liability
                                    6-2:2.6 Other Insurance
                        6-2:3    Uninsured Motorists Coverage
                                    6-2:3.1 Purpose of Coverage
                                    6-2:3.2 Insuring Agreement
                                    6-2:3.3 Key Terms Defined  
                                                6-2:3.3a           Insured
                                                6-2:3.3b          Uninsured Motor Vehicle 
                                                6-2:3.3c           Bodily Injury
                                    6-2:3.4 Exclusions/Limitations
                                                6-2:3.4a           By an Insured or Any Family Member While Occupying or When Struck By an Auto Which Is Not Insured for Uninsured Motorist Coverage Under the Policy          
                                                6-2:3.4b          Settlement with Carrier’s Consent
                                                6-2:3.4c           Public Livery or Conveyance 
                                                6-2:3.4d          Use Without a Reasonable Belief that the Insured Is Entitled to Do So 
                                    6-2:3.5 Limits of Liability
                                    6-2:3.6 Other Insurance/Anti-Stacking Provisions
                                                6-2:3.6a           Offset Payments
                                                6-2:3.6b          No Stacking of Benefits 
                                    6-2:3.7 Arbitration
                        6-2:4    Physical Damages Coverage (Coverage for Damage to Your Auto) (First Party)
                                    6-2:4.1 Purpose of Coverage
                                    6-2:4.2 Insuring Agreement 
                                    6-2:4.3 Key Terms Defined
                                                6-2:4.3a           Your Covered Auto
                                                6-2:4.3b          Non-Owned Auto 
                                                6-2:4.3c           Collision
                                                6-2:4.3d          Comprehensive
                                    6-2:4.4 Transportation Expenses 
                                    6-2:4.5 Exclusions/Limitations
                                                6-2:4.5a           Public or Livery Conveyance 
                                                6-2:4.5b          Wear and Tear, Freezing, Mechanical or Electrical Breakdown 
                                                6-2:4.5c           Loss to Any Electronic Equipment 
                                                6-2:4.5d          Use of Rental Vehicle
                                    6-2:4.6 Limits of Liability 
                                    6-2:4.7 Payment of Loss 
                                    6-2:4.8 No Benefit to Bailee 
                                    6-2:4.9 Other Sources of Recovery
                                    6-2:4.10           Appraisal
            6-3       DUTIES AFTER ACCIDENT/LOSS
            6-4       GENERAL PROVISIONS
                        6-4:1    Bankruptcy
                        6-4:2    Changes 
                        6-4:3    Fraud 
                        6-4:4    Legal Action Against Us 
                        6-4:5    Our Right to Recover Payments
                        6-4:6    Policy Period and Territory
                        6-4:7    Termination
                                    6-4:7.1 Cancellation
                                    6-4:7.2 Non-Renewal 
                                    6-4:7.3 Automatic Termination 
                                    6-4:7.4 Other Termination Provisions
                        6-4:8    Transfer of Insured’s Interest in Policy 
 
Chapter 7
Homeowners Policies
 
            7-1       PURPOSE OF HOMEOWNERS INSURANCE
            7-2       TYPES OF COVERAGE INCLUDED
                        7-2:1    Property Coverage
                        7-2:2    Liability Coverage
            7-3       PROPERTY COVERAGE[external URL]
                        7-3:1    Property Declarations Page
                        7-3:2    Key Terms Defined
                        7-3:3    Coverages Afforded
                                    7-3:3.1 Dwelling
                                    7-3:3.2 Other Structures
                                    7-3:3.3 Personal Property
                                    7-3:3.4 Property at Other Residences
                                    7-3:3.5 Loss of Use/ALE
                                                7-3:3.5a           Additional Living Expense (“ALE”)
                                                7-3:3.5b          Fair Rental Value
                                                7-3:3.5c           Civil Authority Prohibits Use
                                    7-3:3.6 Special Limits of Liability
                        7-3:4    Property Not Covered
                        7-3:5    Additional Coverages
                                    7-3:5.1 Collapse
                                    7-3:5.2 Ordinance and Law
                        7-3:6    Perils Insured Against
                                    7-3:6.1 Coverage A and B Insuring Agreement (Dwelling and Other                                                      Structures)
                                    7-3:6.2 Coverage C Personal Property Insuring Agreement
                        7-3:7    Exclusions and Limitations under Coverage A and B
                                    7-3:7.1 Application of Exclusions
                        7-3:7.2 Loss Resulting from Single Cause or Peril
                        7-3:7.3 Efficient Proximate Cause Doctrine
                        7-3:7.4 Section I—Exclusions—A
                                    7-3:7.4a           Ordinance or Law
                                                7-3:7.4b          Earth Movement
                                                7-3:7.4c           Water
                                                            7-3:7.4c(1)      Flood, Surface Water
                                                            7-3:7.4c(2)      Water Backing Up from Sewer or Drain
                                                            7-3:7.4c(3)      Water Below The Surface
                                                7-3:7.4d          Neglect
                                                7-3:7.4e           War and Military Action
                                                7-3:7.4f           Governmental Action
                                    7-3:7.5 Section I—Exclusions—B
                                                7-3:7.5a           Weather Conditions
                                                7-3:7.5b          Acts or Decisions
                                                7-3:7.5c           Negligent Work
                                    7-3:7.6 Other Limitations to Coverage—Perils Not Insured
                                                7-3:7.6a           Collapse
                                                7-3:7.6b          Vandalism/Malicious Mischief/Vacancy
                                                7-3:7.6c           Mold/Fungus/Wet Rot
                                                7-3:7.6d          Loss Caused by Any of the Following:
                                                            7-3:7.6d(1)      Wear and Tear
                                                7-3:7.6d(2)      Mechanical Breakdown, Latent Defect,                                                                                         Inherent Vice
                                                7-3:7.6d(3)      Pollution
                                    7-3:7.6d(4)      Settling, Shrinking, Bulging, Cracking
                                                            7-3:7.6d(5)      Birds, Vermin, Rodents, Insects
            7-3:8    Conditions
                                    7-3:8.1             Insurable Interest and Limit of Liability
            7-3:8.2 Duties in the Event of Loss or Damage
                                                7-3:8.2a           Notice of Loss
                                    7-3:8.2b          Protection of Property from Further Loss
                                    7-3:8.2c           Cooperation with Investigation
                                    7-3:8.2d          Provision of Inventories
 
                                    7-3:8.2e           Production of Damaged Property, Records, or                                                                             Documents
                                    7-3:8.2f           Examination Under Oath
                                    7-3:8.2g           Proof of Loss
                        7-3:8.3 Loss Settlement
                                    7-3:8.4 Appraisal
                                    7-3:8.5 Other Insurance
                                    7-3:8.6 Suit Against Us
                                    7-3:8.7             Mortgage Clause
                                    7-3:8.8 Policy Period
                                    7-3:8.8a           Discrete Loss
                                    7-3:8.8b          Continuous and Progressive Loss
                                    7-3:8.8c           Manifestation Rule
                                    7-3:8.8d          Delayed Discovery Rule
                        7-3:8.9 Concealment or Fraud
                        7-3:8.10           Loss Payable Clause
            7-4       LIABILITY COVERAGE
                        7-4:1    Insuring Agreement
                        7-4:2    Key Terms Defined
                                    7-4:2.1 Insured
                                    7-4:2.2 Bodily Injury
                                    7-4:2.3 Property Damage
                                    7-4:2.4 Occurrence
                                    7-4:2.5 Personal Injury
                        7-4:3    Exclusions
                                    7-4:3.1 Motor Vehicle Exclusion
                                    7-4:3.2 Watercraft Liability
                                    7-4:3.3 Aircraft Liability
                                    7-4:3.4 Hovercraft Liability
                                    7-4:3.5 Personal Liability and Medical Expense Exclusions
                                                7-4:3.5a           Expected/Intended Acts
                                                7-4:3.5b          Business
                                                7-4:3.5c           Professional Services
                                                7-4:3.5d          Premises Owned by Insured But Not an Insured                                                                          Location
                                                7-4:3.5e           War
                                                7-4:3.5f           Communicable Diseases
                                                7-4:3.5g           Sexual Molestation
                                                7-4:3.5h          Controlled Substances
                                    7-4:3.6 Personal Liability Exclusions
                                                7-4:3.6a           Loss Assessment
                                                7-4:3.6b          Contractual Liability
                                                7-4:3.6c           Owned Property
                                                7-4:3.6d          Workers’ Compensation
                                                7-4:3.6e           Nuclear Energy Liability Exclusion
                                                7-4:3.6f           Bodily Injury to an Insured
                                    7-4:3.7 Medical Payments Exclusions
                                                7-4:3.7a           Residence Employee Exclusion
                                                7-4:3.7b          Workers’ Compensation
                                                7-4:3.7c           Nuclear Energy
                                                7-4:3.7d          Persons Regularly Residing
            7-5       ADDITIONAL COVERAGES
                        7-5:1    Claim Expenses
                        7-5:2    First Aid Expenses
                        7-5:3    Damage to Property of Others
                        7-5:4    Loss Assessment
            7-6       CONDITIONS
                        7-6:1    Limit of Liability
                        7-6:2    Severability of Insurance
                        7-6:3    Duties After Occurrence
                                    7-6:3.1 Notice           
                                    7-6:3.2 Cooperation
                                    7-6:3.3 Voluntary Payments
                        7-6:4    Duties of Injured PersonMedical Payments to Others 
                        7-6:5    Payment of Claim—Medical Payments to Others
                        7-6:6    Suit Against Us
                        7-6:7    Bankruptcy of an Insured
                        7-6:8    Other Insurance
                        7-6:9    Policy Period
                        7-6:10  Concealment or Fraud
            7-7       SECTION I AND II CONDITIONS
                        7-7:1    Liberalization Clause
                        7-7:2    Waiver or Changes of Policy Provisions
                        7-7:3    Cancellation
                        7-7:4    Nonrenewal
                        7-7:5    Assignment
                        7-7:6    Subrogation
                        7-7:7    Death
 
Chapter 8
Directors and Officers Liability Policies
            8-1       PURPOSE OF DIRECTORS AND OFFICERS LIABILITY COVERAGE
8-2       INTERPRETATION OF D&O POLICIES
8-3       INSURING AGREEMENTS
8-3:1    Coverage for Directors and Officers
8-3:2    Coverage to Entity for Indemnification Reimbursement
8-3:2    Insured Entity Coverage
8-4       WHAT CONSTITUTES A “CLAIM”?
8-5       IS THERE A CLAIM FOR COVERED “LOSS” OR “DAMAGES”?
                        8-5:1    Requirement of “Loss”
8-5:2    Some Policies Require Claim for “Damages”
8-5:3    Application of Insurance Code Section 533  
8-6       WHAT CONSTITUTES A “WRONGFUL ACT”?
8-7       CLAIMS MADE TRIGGER OF COVERAGE
                        8-7:1    Claims Made Coverage: Temporal Trigger
8-7:2    Critical Reporting Requirements
8-7:3    Notice Prejudice Rule Not Applicable To Claims-Made and Reported D&O Policies
8-7:4    Extended Reporting Periods
8-7:4    Notice of Circumstance or Potential Claim
8-7:5    Other Temporal Limitations
8-7:5.1  Retroactive Date
8-7:5.2 Application of Interrelated Wrongful Acts Provisions
                        8-8:6    Event Trigger
                                    8-8:6.1 Date on Which the Wrongful Act First Commenced
            8-8       DEFENSE OF D&O CLAIMS
8-8:1    Duty to Defend or Duty to Pay Defense Costs?
8-8:2    Eroding Limits Policies– Payment of Defense Costs Reduces Available Limits of Liability
            8-9       EXCLUSIONS PARTICULAR TO DIRECTORS AND OFFICERS                                      LIABILITY COVERAGE
                        8-9:1    Claims for Bodily Injury or Property Damage
                        8-9:2    Breach of Contract Exclusion
8-9:3    Insured Versus Insured Exclusion
                                    8-9:3.1 Exceptions for Derivative Lawsuits
                                    8-9:3.2 Carve-Backs Excluding Coverage for Derivative Lawsuits                                                          Brought by Former Directors and Officers
                                    8-9:3.3 Other Exceptions to Insured Versus Insured Exclusion
                        8-9:4    Dishonesty Exclusion
                        8-9:5    Prior Acts Exclusion
                        8-9:6    Regulatory Exclusion
                        8-9:7    Personal Profit/Improper Gain or Advantage Exclusion
                        8-9:8    Professional Services Exclusion
                        8-9:9    Employment Practices Claims Exclusion
8-9:10  Pollution Claims
8-10     ALLOCATION AND REIMBURSEMENT ISSUES
8-10:1  Allocation
8-10:2  Reimbursement
 
Chapter 9
Employment Practices Liability Policies
9-1       PURPOSE OF EMPLOYMENT PRACTICES LIABILITY COVERAGE
9-2       INSURING AGREEMENTS
9-3       WHAT CONSTITUTES A “CLAIM”?
9-4       IS THERE A CLAIM FOR COVERED “LOSS” OR “DAMAGES”?
                        9-4:1    Requirement of “Loss” or “Damages”
9-4:2    Application of Insurance Code Section 533  
9-5       WHAT CONSTITUTES AN “EMPLOYMENT WRONGFUL ACT” / “EMPLOYMENT PRACTICES ACT”?
9-6       CLAIMS MADE TRIGGER OF COVERAGE
            9-7       DEFENSE OF EPLI CLAIMS
9-8       EXCLUSIONS PARTICULAR TO EMPLOYMENT PRACTICES                           LIABILITY COVERAGE
9-9       ALLOCATION ISSUES PARTICULAR TO EMPLOYMENT LIABILITY PRACTICES POLICIES
9-9:1    Allocation
9-9:2    Reimbursement
 
Chapter 10
Excess Insurance
            10-1     DIFFERENCE BETWEEN EXCESS AND UMBRELLA POLICIES
10-2     KEY PROVISIONS
10-2:1  Insuring Agreements
                        10-2:2  Following Form Provisions
                        10-2:3  Drop Down Provisions
                        10-2:4  Exclusions/Limitations
                        10-2:5  Other Insurance Provisions
10-3     DUTY TO DEFEND UNDER EXCESS POLICIES
            10-4     EXHAUSTION
                        10-4:1  Horizontal Versus Vertical Exhaustion
                        10-4:2  How Primary Policies May Exhaust
            10-5     INSOLVENCY OF A PRIMARY INSURER
            10-6     DUTY TO INDEMNIFY UNDER EXCESS POLICIES
            10-7     DUTY TO SETTLE UNDER EXCESS POLICIES
10-7:1  Excess Carrier’s Obligations
10-7:2  Primary Carrier’s Right to Enter Into Reasonable Settlement That Invades Excess Layer
10-7:2  Excess Carrier’s Right to Recover Settlement or Other Indemnity Payment from Primary Carrier Through Equitable Subrogation

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Gail Ann Y Stargardter
Rand L Chritton
Andrew J King
Erin M Gallagher
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