July 2014 Intro Page

Dec Page

he article of the month in the Dec Page deals with the effect of the insureds' declarations or statements. An insured's misrepresentation in obtaining coverage or fraud involving the policy can void coverage, and in fact, due to the phrasing of many misrepresentation and fraud clauses, the acts of any insured, and not just the named insured, can have the effect of voiding insurance coverage. Courts generally uphold these policy provisions.

This article reviews examples of misrepresentation and fraud clauses and state statutes regarding such clauses. Also discussed are innocent misrepresentations and the effect of material misrepresentations, along with the options available to insurers in instances of insured misrepresentation or fraud. Court cases involving the misrepresentation and fraud provisions are also noted.

See the designated article in the Bulletins.

The court cases cited in the Dec Page come from various courts and deal with several subjects. The U.S. District Court for the Eastern District of Pennsylvania discusses the applicability of an exclusion to the additional insured. The U.S. Second Circuit Court of Appeals examines the pollution exclusion and its effect on coverage under a pollution and remediation legal liability policy. The duties of the additional insured after a loss were reviewed by the Appellate Court of Illinois, First District, and whether the failure of the named insured to follow the notice requirements prevented coverage for the additional insured. Finally, the business pursuits exclusion in a homeowners policy was the subject of a case handled by the Supreme Judicial Court of Maine.

Questions and Answers

Is damage to a home from pressure of the roadway covered? See Pressure on Roadway Damages Foundation. If an insured lets a friend use a jet ski and another person is injured, is there coverage for those injuries? See Residence Next to Lake. If a stolen ring is worth more than the limits of the policy and the ring is recovered, can the carrier retain the recovered property? See Scheduled Limits and Value of Stolen Ring.

If the insured doesn't repair damage from one loss but has a second loss and files a claim for those damages, is there coverage? See Secondary Loss. If an insured's in-laws rent a dwelling from the insured, are they covered as relatives of the insured? See Tenant Relatives are not Insureds. If the utility company's power box on the insured's premises damages the insured's property, is there coverage? See Utility Company Power Failure on Premises.

Commercial Auto Program

The business auto policy (BAP) was recently revised and the articles discussing parts of the new form are presented this month (the rest of the BAP revisions will be presented in future monthly Bulletins). For an update on the BAP definitions, see Business Auto Definitions. See Business Auto Form for an analysis on the declarations page and the symbols for covered autos.

Third Party Over Actions

When an injured employee files a lawsuit against some third party, such as a project owner or general contractor, the third party will often sue the employer for being at least partially at fault. These kinds of actions are commonly referred to as third party actions or third party over actions. For an examination of the nature of third party over actions and a review of some court cases on the subject, see Third Party Over Actions.

Dwelling Property Forms

SO has filed a new dwelling program effective July 1, 2014. This article reviews changes in the program to the perils, exclusions, and certain endorsements to the policies. See Dwelling Property Forms Perils, Exclusions, Endorsements. 

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