Arizona Auto Injury Attorney
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The Duty to Defend
The Duty to Indemnify
Jeff Lynn
The States of the 9th Circuit
Alaska
Arizona
California
Hawaii
Idaho
Montana
Nevada
Oregon
Washington
Duty to Defend
The duty to defend entails the rendering of a
service: the mounting and funding of a defense.
Where there is a duty to defend, there may be
a duty to indemnify; but where there is no
duty to defend, there cannot be a duty to
indemnify.
The duty to defend has as its purpose to avoid,
or at least minimize, liability before liability is
established.
The duty to defend may arise as soon as
damages are sought in some amount.
The duty to defend is very broad.
Certain Underwriters at Lloyd's of London v. Superior Court, 16 P.3d 94 (2001)
The Duty to Defend
Liability insurer’s duty to defend arises when
there is potential for indemnity, and may exist
even when coverage is in doubt and ultimately is
not established.
Montrose Chemical v. Admiral Ins 10 Cal.4th 645, 913 P.2d 878
An insurer may have a duty to defend even when it
ultimately has no obligation to indemnify, either because
no damages are awarded in the underlying action
against the insured or because the actual judgment is for
damages not covered under the insurance policy.
Delgado v. Interinsurance Exchange of Auto. Club of Southern California,
61 Cal.Rptr.3d 826 (2007)
Woo v Fireman’s Fund
164 P.3d 454, Wash., 2007, July 26, 2007
Patient’s alleged bodily injury from practical joke played on her by
her dentist, who was patient’s employer, and from taunting about
patient’s potbellied pigs could have been caused by accident
within meaning of dentist’s general liability policy, and, thus
insurer owed duty to defend.
Dentist’s liability for playing practical joke on patient/employee under
anesthesia, by inserting boar tusks in mouth, photographing her,
removing the tusk flippers, and inserting temporary partial bridges
was conceivably within coverage of professional liability policy,
and, thus, insurer owed duty to defend; even if the dentist’s actions
were outside definition of practice of dentistry as diagnosis or
treatment, the definition included ownership, maintenance, or
operation of office for the practice of dentistry, and the joke involved
interaction with employee, was intertwined with dental practice, and
was integrated into and inseparable from the overall procedure.
Professional liability insurer improperly relied on an equivocal
interpretation of case law to give itself the benefit of the doubt in
determining that it owed no duty to defend dentist against liability for
playing practical joke on patient under anesthesia.
Woo v Fireman’s Fund
duty to defend
A liability insurer’s duty to defend arises at the time an action
is first brought and is based on the potential for liability.
A liability insurer has a duty to defend when a complaint
against the insured, construed liberally, alleges facts which
could, if proven, impose liability upon the insured within the
policy’s coverage.
A liability insurer is not relieved of its duty to defend unless
the claim alleged in the complaint is clearly not covered by the
policy.
If a complaint is ambiguous, a court will construe it liberally in
favor of triggering the liability insurer’s duty to defend.
The insured must be given the benefit of the doubt if it is
unclear from the face of the complaint that the policy does not
provide coverage; if it unclear that the complaint does not
contain allegations that are not covered by the policy, the
insurer has a duty to defend.
Woo v Fireman’s Fund
Face of the Complaint
If it is not clear from the face of the complaint against the
insured that the policy provides coverage, but coverage
could potentially exist, the liability insurer must
investigate and give the benefit of the doubt that there is
a duty to defend.
Extrinsic Facts
If the allegations in the complaint against the insured
conflict with the facts known to or readily ascertainable
by the liability insurer or if the allegations are ambiguous
or inadequate, facts outside the complaint may be
considered to determine duty to defend.
The liability insurer may not rely on facts extrinsic to the
complaint to deny the duty to defend-it may do so only to
trigger the duty.
Woo v Fireman’s Fund
Reservation of Rights
If the liability insurer is uncertain of its duty to
defend, it may defend under a reservation of
rights and seek a declaratory judgment that it
has no duty to defend.
Although the insurer must bear the expense
of defending the insured, it may do so under a
reservation of rights while seeking declaratory
relief as to coverage.
Woo v Fireman’s Fund
Liability for Breach -Duty to Defend
Liability insurer’s breach of duty to defend
entitled insured to attorney fees and costs on
appeal.
In a duty to defend action, an insured is entitled
to fees on appeal pursuant to RAP 18.1,
because the insurer “compels the insured to
assume the burden of legal action, to obtain the
full benefit of his insurance contract.”
(Olympic Steamship v. Admiral Ins., 117 Wash.2d at 53, 811 P.2d 673)
Woo v Fireman’s Fund
duty to indemnify
The liability insurer’s duty to defend is triggered
if the insurance policy conceivably covers the
allegations in the complaint, but the duty to
indemnify exists only if the policy actually
covers the insured’s liability.
The liability insurer’s duty to indemnify hinges on
the insured’s actual liability to the claimant and
actual coverage under the policy.
California
insurer’s duty to defend
Liability
arises when there is potential for
coverage, and may exist even
when coverage is in doubt and
ultimately is not established.
Montrose Chemical v. Admiral Ins 10 Cal.4th 645, 913 P.2d 878
California Insurance Code §533
The insurer is not liable for loss caused by willful act of
insured is an implied exclusionary clause which must be
read into all insurance policies.
The insurer has the burden of proving that the loss was
caused by willful act of insured and is excluded from
coverage.
Requires more that negligence, recklessness, or even
the intentional doing of an act constituting ordinary
negligence of the violation of a statute; the statutory
exclusion is intended to preclude indemnification for
conduct that is clearly wrongful and necessarily harmful.
Precludes indemnification for liability arising from
deliberate conduct that the insured expected or intended
to cause damage.
General Consensus
The states of Alaska, Arizona, Hawaii,
Idaho, Montana, Nevada, Oregon, and
Washington all tend to follow the same
guiding principles established in California
when it comes to the duty to defend and
the duty to indemnify.
Construction Defect Exclusions
“Damages to Your Work”
Property damage due to the insured’s own work
Precludes coverage for liability for damages to and deficiencies in the
insured contractor’s defective work product.
Work “by or on behalf of” Insured
Provides insured contractor with coverage for his completed work when
the damage occurs due to the work of a subcontractor
Insured’s “own product”
Does not typically apply to construction liability therefore faulty
construction or defective materials in a building are not barred
Applies to subcontractors
Premises Alienated
Denies coverage to an insured who failed to repair or to disclose defect
prior to sale
Contractual Liability
Does not allow for coverage where the insured has contractually
assumed the tort liability of another person
except where the contract has to do with the insured’s business (the
insured contract exception to the exclusion)
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