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Policyholders Beware: New York Court Finds Policyholder Forfeited Excess Coverage By Settling With Underlying Carriers For Less Than Full Limits

By Nathan Lander & Proskauer Labor and Employment Department on May 13, 2014
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Many excess insurance policies provide that coverage is not available unless all underlying insurers have first paid the full limits of their policies. Relying on such language, excess insurers argue that when a policyholder settles a claim with an underlying insurer for less than the full limits of their policy, the policyholder forfeits any coverage under the excess policy. In recent years, many courts have begun accepting this common excess carrier argument, including most recently a New York appellate court in Forest Laboratories v. Arch Insurance Company. In the wake of this appellate decision, it is important for New York policyholders to understand the risk the decision presents, and what they can do to avoid it.

In Forest Laboratories, the policyholder was covered by an $80 million insurance tower, consisting of eight separate $10 million layers, with insurance company RSUI providing the “top” layer of coverage. Under the RSUI policy, coverage did not “attach” until the underlying limits of coverage had been exhausted by “actual payment of a Covered Claim pursuant to the terms and conditions of the Underlying Insurance.” The policyholder incurred more than $80 million to defend against and ultimately settle a securities action, looked to its insurance to cover these costs, but settled with some of the underlying insurers for less than their full $10 million limits. Given that the full limits of underlying insurance had not been paid by the insurers, RSUI argued that coverage under its excess policy did not attach.

The trial court agreed with RSUI.  Although the attachment language at issue did not, as some excess policies do, explicitly state that the underlying limits must have been “paid by the insurer” (as opposed to the insured), the trial court held that this requirement was implicit in the policy language which provided that the underlying limits must be paid “pursuant to the terms and conditions of the Underlying Insurance.” The appellate court unanimously affirmed.

This case joins a growing list in which courts, considering attachment language similar to that at issue in Forest Laboratories, have found that when a policyholder chooses to accept less than 100 cents on the dollar in a settlement with an underlying insurer, it may forfeit coverage from an insurer higher in the tower.

Most in the policyholder bar strongly disagree with the reasoning in Forest Laboratories and other similar decisions. Reading into excess policies a forfeiture of coverage when the policyholder settles with underlying insurers for less than the full policy limits serves only to create delay and uncertainty, impede settlement and promote litigation. Nevertheless, these decisions cannot simply be ignored. Instead, policyholders should focus on practical solutions to avoid the risk presented by such decisions. For example:

  • When purchasing excess coverage, policyholders should try to procure language that explicitly provides that coverage attaches after the underlying policy limits have been paid by the insurers or by the insured. Under such language, excess coverage would attach as soon as the insured has paid defense costs or settlements reaching the particular excess layer.
  • If a policyholder receives a claim covered by an excess policy that does not include the more expansive attachment language, the policyholder should develop and implement a settlement strategy with decisions like Forest Laboratories squarely in focus.  If a global settlement with all carriers is not feasible, policyholders might avoid the risk of forfeiture by employing a “top down” settlement strategy, negotiating a settlement with the highest level carrier first, then working down the tower as each higher level settles.

Excess coverage – which exists to protect policyholders against the largest and financially perilous claims – is of no value if it does not attach. Forest Laboratories and other similar decisions risk making excess coverage far less valuable, but through informed policy language negotiation and creative settlement strategies, policyholders can take steps to ensure they avoid forfeiture of their excess coverage.

Photo of Nathan Lander Nathan Lander

Nathan Lander is a partner in the Insurance Recovery & Counseling Group who represents clients in high-stakes disputes with their insurance companies as well as counseling them regarding a wide array of insurance issues.  Clients have praised Nate in Chambers and The Legal…

Nathan Lander is a partner in the Insurance Recovery & Counseling Group who represents clients in high-stakes disputes with their insurance companies as well as counseling them regarding a wide array of insurance issues.  Clients have praised Nate in Chambers and The Legal 500 as being “responsive, knowledgeable and creative,” a “zealous advocate” and “absolutely amazing to work with.”

During the course of his career, Nate has assisted clients in recovering more than $1 billion in disputes with their insurers through litigations, arbitrations, mediations and negotiations.  Nate prides himself in helping clients reach favorable resolutions with their insurers where possible, but when insurers refuse to pay, Nate has aggressively litigated coverage disputes against them in courts and arbitrations throughout the country.

Although Nate has represented a wide range of policyholder clients – including Fortune 500 companies and professional sports teams, among others – Nate is particularly well-known for his representations of asset management clients in insurance disputes.  Nate has represented numerous private equity firms and portfolio companies, hedge funds, registered funds, venture capital firms, and other asset managers in disputes with insurance companies, including claims for coverage under D&O, E&O, crime, life, property, and other policies.  For example, Nate was recently lead counsel for a private equity firm in a litigation over $100 million of coverage its insurers refused to provide for claims against the private equity firm arising from the bankruptcy of a portfolio company.

In addition to his litigation practice, Nate also regularly advises clients on risk management issues, including structuring of insurance programs and the negotiation and drafting of policy language, in order to help protect clients in the event of a claim or loss.  Nate has particular experience with respect to the insurance markets and products for asset management clients.  He has assisted numerous asset managers of all types and portfolio companies in reviewing and negotiating potential insurance policies or programs, including D&O, E&O, EPL, fiduciary, crime, cyber, reps & warranties and other specialized products.

Read more about Nathan LanderEmail
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  • Posted in:
    Insurance
  • Blog:
    Risk and Recovery
  • Organization:
    Proskauer Rose LLP

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