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Words (and Clauses) Matter

A recent report published by RIMS highlights the importance for risk professionals—or the person within the organization tasked with the responsibility—to fully understand the language included in their insurance policies.

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The report A Common Language: Aligning Third-Party Contracts with Insurance Policies, suggests that there are “clauses in contacts that may not be understood as well as others, and some people may be tempted to skim past those to move work along.”  But, in this haste, deciding to “skim” past those clauses may activate exclusions, limitations and even, unknowingly, nullify the transfer of risk to a third-party.

Authored for RIMS by Brenda Tappan of United Educators, the report defines key insurance terms that should be understood by contract reviewers, as well as common contract clauses that impact the validity of both the contract and insurance policies.

“At any given time, an organization could have hundreds of contracts with external stakeholders,” Tappan said. “With in-depth knowledge of coverages held by the organization, risk professionals can play an integral role in ensuring terminology is understood and that discrepancies between third-party contracts and insurance policies are identified.

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The report advises risk managers to be aware of the following insurance contract elements:

  • Indemnification Clauses – This clause delineates whether the parties of a contract wish to retain, transfer or share responsibility from a potential third-party. Be aware that not all “bodily injury” or “property damage” will be covered, even if you have stipulated everything correctly in the indemnification clause.
  • Additional Insured Status – This status provides proof of financial capability to cover what is assumed in the indemnity clause. Keep the additional insured provision separate from indemnification clause because if the latter is found unenforceable, the additional insured clause might be unenforceable as well.
  • Waivers of Subrogation – This says that the insurer has the right to stand in the place of the insured and go against the responsible party to make themselves whole. Risk professionals might consider requesting a Waiver of Transfer of Rights endorsement. Also, get as much in writing as possible – don’t leave anything up to chance or interpretation.
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  • Primary and Non-Contributory – Essentially, the insured will not seek contribution from any other insurance available. When named an additional insured, you are afforded coverage as provided by the other insurance policy.
  • Excess and Umbrella Coverage – Organizations buy this coverage to increase the limits. It can be used for commercial general liability, commercial auto, employers liability, and other primary liability policies. As an indemnitor, you will want to ensure that for any coverage that taps into the policies that provide the upper limits, there is a specified cap to the coverage contractually offered to the indemnitee.
  • Limitation of Liability – It’s an attempt by third-party contractors to cap the amount of liability they will be responsible for to a set amount prior to an incident. Be on the lookout for these limitation of liability clauses. Generally, they are found toward the end of the contract, but can have a significant impact on indemnification.

8 Legal Developments You Need to Know About

In a new RIMS Professional Report, attorneys Mark Plumer and Xandra Bernardo (of Pillsbury Winthrop Shaw Pittman LLP) and Patrick Walker, a risk professional at mining company Rio Tinto Group, shed light on the top risk management legal developments of 2017.

According to the authors, risk managers “must be familiar with the legal principles that underlie claims that are asserted. A successful resolution will turn on the policy wording, the company’s business relationship with the affected insurers and the strength of the  coverage argument under the law.”

In The Top 8 Legal Developments You Need to Know About in 2017, the authors lay out the notable rulings on insurance law relating to rights of coverage, rescission, cyber coverage and more. Here is a quick look at their findings:

  1. Rights to Coverage: There were important developments to rights of coverage under historic occurrence-based policies. These relate to “long-tail” liabilities such as environmental exposures.

“The best practice now is to assign the right to make claims on historic policies for such exposures, where such transfer of rights is intended. Legal counsel should assure that the law in the affected jurisdictions allows for the transfer of insurance rights.”

  1. Rescission: It’s an insured’s worst nightmare: you have a claim that you believe should be covered, and the insurance company finds a way to rescind coverage. It’s a growing trend. “In particular, insurers are requiring more disclosures during the application process and may seek rescission if full and accurate disclosures are not provided.”

The authors focus on H.J. Heinz Co. v. Starr Surplus Lines Ins., a trial decision that was reached in New York’s Third Circuit. The court ruled that Heinz was not entitled to its purchased coverage because of historic loss information that was mistakenly withheld by the company’s risk manager.

“The Heinz case highlights the importance of answering questions thoroughly and truthfully in connection with applying for insurance. Applying for insurance is an increasingly challenging process, particularly with respect to specialty policies that require answers to many questions and call for considerable data. Risk managers must assume that insurers will be emboldened by Heinz and other, similar cases.”

  1. Consent to Settle: In case you needed to be reminded: risk management and corporate counsel need to work together!

“Some courts may simply void coverage where there is a voluntary payments provision and advance consent from an insurer for a settlement was not requested regardless of whether the insurer was prejudiced.

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It is rare that insurers will stand in the way of a settlement. Thus, asking for consent often is no more than a technical requirement. Insurers should not be allowed to escape coverage your company has paid for based on a technicality.”

  1. Notice: Your coverage can be voided if you don’t give prompt notice of a claim. There were two important developments on this front in 2017 that the authors describe in detail in the report.

“The best way to avoid an insurer ‘late’ notice argument is to provide notice at the earliest reasonable date, even if this requires later supplementation and clarification. Of course, this is often easier said than done. You should learn the law affecting notice in your home jurisdiction and consider treating occurrence-based policy and claims-made policy notification procedures differently…”

  1. Cyber Claims: This is obviously a hot area in risk management and in insurance. It seems like we constantly hear about new entrants into the insurance market on this front, with new firms specializing in cyber also popping up almost every day. Risk managers need to exercise caution in this field: cyber insurance is still relatively new and untested, and the claims history for this subfield is short.
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The policies are also potentially confusing. For example, “many cyber policies specifically provide coverage for credit card association assessments for an additional premium. These policies are quite complicated and may contain dozens of cross-referenced definitions.”

  1. Construction Claims: The authors dive into key decisions coming out of New Jersey and Iowa on this familiar risk management topic. They caution risk managers to “make certain your CGL policy has a subcontractor exception in the ‘your work’ exclusion. Policies containing a ‘your work’ exclusion that do not also include a subcontractor exception to that exclusion place your company at greater risk.”
  2. Additional Insured: Access to additional insured endorsements is getting narrower, according to the authors. A decision from New York continues this trend: the June 2017 decision from New York’s high court in Burlington Ins. Co. v. NYC Transit Auth.

The report cautions that the Burlington decision “may come as a surprise to many policyholders who expect courts to interpret additional insured endorsements broadly, particularly ISO’s standard form endorsements. Risk managers concerned about this potential reduction in coverage can follow the advice of the Burlington court: ‘Of course, if the parties desire a different allocation of risk, they are free to negotiate language that serves their interests.’”

  1. Scope of Coverage: It’s important to understand your home jurisdiction’s philosophy on long-tail general liability claims. There are two types of jurisdictions, according to the authors: “all sums” and “pro rata.” In 2017, there were several decisions that complicated this well-understood legal dynamic.

“If your company faces a long-tail claim, be proactive and understand the scope of coverage law applicable to your historic policies. If the jurisdiction applies the ‘all sums’ principle, make sure your counsel is aware of it. If not, confirm whether your historic policies contain non-cumulation clauses or if the applicable jurisdiction has considered the ‘unavailability’ exception to pro rata allocation.

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For more information on “all sums” versus “pro rata,” as well as detail for all of the top legal developments, please visit www.rims.org and download the paper. All RIMS papers are members-only for the first 60 days of their release.

Paying it Forward: Industry Leaders Celebrate at Spencer Gala

Every year in September, leaders in the insurance world celebrate the profession and show their support for the next generation of risk management and insurance professionals. This year, close to 700 executives made their way to the Spencer Educational Foundation’s 9th Annual Gala on Thursday night at the New York Hilton Midtown. Nearly million in donations were accepted at the event, a critical fundraising initiative for the Foundation.

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Proceeds will directly fund grant, scholarship and internship programs for undergraduate and graduate students who are pursuing careers in the field.

“The Gala is a wonderful reminder of just how generous and passionate professionals in this industry are,” said Ron Davis, executive vice president at Zurich and Spencer Educational Foundation chairman. “Tonight we’re celebrating the profession that has afforded us so much by giving back and creating meaningful opportunities for future risk professionals.”

The Gala honored 2017 Spencer Scholars Jayde Lim Ah Tock, a junior from Temple University, and James Pappas, a senior at St. John’s University. “Being a Spencer Scholar has allowed me to focus on my university’s program,” Tock said. “I want to thank the donors for allowing me to pursue something that is so important to me.”

When speaking about the support Spencer provided, Pappas said he is now “confident, optimistic and energized” about his future and knows he is “joining an amazing industry that truly makes a difference.”

Among the industry leaders in attendance were honorees Joseph Tocco, chief executive, north America insurance at XL Catlin, and Michael Rice, chief executive officer at JLT Specialty USA. Both are longtime Spencer supporters and were recognized for their efforts to move the Foundation’s mission forward.

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The night’s festivities concluded with remarks from the honorees whose comments focused on the industry’s talent gap and the aging risk management workforce.

“The world needs our industry and our industry needs to attract and develop new talent,” Rice said. “Spencer is a wonderful conduit that allows us to celebrate this talent and the future of the profession.”

Tocco added, “I’m proud to be in an industry that places so much energy on education. Enlisting the next generation of risk professionals is more imperative now than ever before. We need to make “risk management” students’ first choice and not a profession by accident.

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Students around the world have benefited from Spencer funding. Since its inception, the charitable nonprofit has awarded 970 scholarships totaling about $4 million, and $3.25 million in grants to universities and professional institutions for educational programs and conferences.

Beware of Fire Ants During Hurricane Cleanup

While Texas, Florida and other states dry out from the trillions of gallons of water dumped by Hurricanes Harvey and Irene, there is much to be done and many hazards to watch out for when clearing trees and removing soggy remains from homes and offices.

While cleaning up outdoors, people should keep in mind that many animals are also displaced. These include 20 species of snakes (in Texas), alligators, deer and raccoons, according to the Washington Post.

What they may not be on the lookout for, however, are floating rafts of fire ants, which have a painful, itchy sting, Smithsonian reported. The ants, which send some 25,000 people to the hospital each year, can be found in a number of states, including Texas, Florida, Alabama, Mississippi, and California. They have a way of coping with large amounts of water by clinging to each other and forming floating rafts that can contain 500,000 or more fire ants.
Photo: ScienceNews

These rafts are actually floating colonies protecting the queen, which is in the middle. They can survive for weeks until they find a dry surface—any dry surface.

According to Popular Science:

Normal ants bite and then spray acid on the new wound, but fire ants are much worse. They bite, hold on, and inject a venom containing 46 different proteins, including poisons that sometimes affect the nervous system. They also have a more brutal attack pattern than many social insects. If you knock over a beehive, not all the bees will come after you—most colonies have a few dedicated warriors to protect the clan. When fire ants are disturbed, however, they all attack. About one in every hundred people will have a full-body response to the stings, such as an allergic reaction or even hallucinations.

As Eric Chaney at the Weather Channel warns, the ants can remain a problem even after the floodwaters recede and it is easy to accidently happen upon them, hunkered down amidst debris piles. According to the Imported Fire Ant Research and Management Project, “Laundry piles are convenient places that present lots of tunnels for the ants. They may be attracted to moisture or food residue or oils on soiled clothing. Often, reports of ants in laundry occur following a flood.”

Those venturing into flood waters are advised to wear rubber boots, cuffed gloves and protective rain gear to keep ants off their skin. Popular Science recommends spraying ant rafts with their kryptonite—soapy water—which can cause them to sink.