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Insurance in the Know (Part 2): Settlement Offers Within Policy Limits Heighten Scrutiny on Insurers

By A. Kate Margolis on April 1, 2024
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Insurance in the Know (Part 2): Settlement Offers Within Policy Limits Heighten Scrutiny on Insurers

Table of Contents

  • Standoff at the Settlement Corral
  • Reasonableness Is the Watchword
  • A Formal Demand in Favor of Settlement Can Expedite Resolution

Parties to a lawsuit may have vastly different perspectives on the validity and value of a claim, but as a matter of course, the issue of settlement will arise. Trial is an exceedingly expensive endeavor with an uncertain result. From a risk management perspective, the decision to settle is critical. Yet under liability policies that give the insurer sole control of the defense, the settlement decision often rests exclusively with the insurer as well.

The insurer’s exercise of this control becomes problematic when (1) the insured’s liability could exceed the policy limits, and (2) a settlement offer within the policy limits is on the table. Like an insurer providing a defense under a reservation of rights (discussed in Part 1), in this recurring situation, the insurer and the policyholder have conflicting incentives. The insurer may prefer to roll the dice for a judgment that’s less than the limit of liability. Settlement within the policy limits, on the other hand, is often in the policyholder’s best interest because it eliminates the risk of incurring uninsured liability.

Link to Standoff at the Settlement Corral Standoff at the Settlement Corral

Tensions between the policyholder and the insurer about a policy-limits settlement demand intensify as the trial date inches closer. At this point, the evidence and analysis developed in the litigation should be sufficient to fully assess whether uninsured liability is a real possibility. If the plaintiff’s demand is time limited, the policyholder-defendant’s window of opportunity for settlement could be missed. The potential impact of an excess verdict is suddenly front and center. What is the policyholder’s recourse?

With the stakes this high, the insurer’s duty to the policyholder rises to a fiduciary level in many jurisdictions. The insurer must seriously consider a settlement offer within policy limits as if the insurer itself would be liable for any excess judgment. The kicker is, if it fails to do so, the insurer actually can be held liable for the excess judgment, as well as consequential damages. In other words, the duty to settle within policy limits when warranted is backed up by a very big stick that can provide the policyholder with needed leverage at a time when it may feel most powerless.

Link to Reasonableness Is the Watchword Reasonableness Is the Watchword

States have different formulations of the level of insurer failure required to succeed on what’s known colloquially as a bad-faith-failure-to-settle claim, ranging from negligence to recklessness to intentional wrongdoing. However, in every case, reasonableness is the watchword. Was there a reasonable probability of an excess judgment based on the facts, applicable law, and what’s known about the jurisdiction? Given those circumstances, was the plaintiff’s policy-limits settlement offer reasonable? Did the insurer conduct a reasonable (i.e., good faith) evaluation in response to the offer? These are fact-intensive questions that generally cannot be decided as a matter of law and place the insurer’s conduct under a microscope.

Link to A Formal Demand in Favor of Settlement Can Expedite Resolution A Formal Demand in Favor of Settlement Can Expedite Resolution

When faced with an insurer’s recalcitrance or delay in deciding whether to accept a pending settlement offer within policy limits, policyholders should make a formal demand in favor of settlement. Appointed defense counsel should provide any analysis and documentation generated during the litigation that the policyholder may need to show the insurer that the risk of an excess judgment is real, and that settlement is prudent. Reminding the insurer of its heightened duty to accept a reasonable settlement offer within policy limits can expedite a resolution that benefits all parties involved.

Photo of A. Kate Margolis A. Kate Margolis

Kate Margolis provides insurance coverage advice for policyholders. She knows that insurance coverage is essential to the long-term viability of any business. Kate helps policyholders preserve coverage both before and after a claim arises. She advises regarding terms and conditions and potential gaps…

Kate Margolis provides insurance coverage advice for policyholders. She knows that insurance coverage is essential to the long-term viability of any business. Kate helps policyholders preserve coverage both before and after a claim arises. She advises regarding terms and conditions and potential gaps in coverage when clients are evaluating their insurance programs.  For example, cyber insurance has fast become a crucial part of any insurance program. Kate recently co-authored the Guide to Cyber Insurance: Building a Program, Procuring Coverage, Managing Claims and Litigating Disputes, published by RIMS, the Risk Management SocietyTM.

When coverage disputes do arise, Kate is committed to cost-effective and creative solutions to achieve a satisfactory business resolution if possible and unrelenting advocacy when litigation is warranted. Kate has helped clients navigate roadblocks to coverage for nearly 20 years.

Read more about A. Kate MargolisEmail
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  • Posted in:
    Insurance
  • Blog:
    It Pays to Be Covered TM
  • Organization:
    Bradley Arant Boult Cummings LLP
  • Article: View Original Source

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