Legal Developments and Risk Management Tips Impacting the Professional Liability Community.
Clearly, it is the specific terms of an insurance contract that dictate whether certain claims are covered or denied. In an interesting decision out of Illinois, the court faced the question: when is an attorney practicing law “in the service of another” and how does that impact coverage. This distinction was critical to whether a claim against an attorney would be covered by a commercial general liability (“CGL”) policy.
What is a “professional liability” claim? Most definitions would include a claim involving a skilled professional – such as an attorney, accountant, doctor or broker – sued in her professional capacity, based upon allegations of negligence in the performance of professional services. The easiest example is a claim for legal malpractice: a client gets a negative or unexpected result, believes that this result is due to failings on the part of hired counsel, and subsequently brings a claim against his attorney for damages. Pretty cut and dry, right? Nope.
The doctrine of concurrent causation can apply in many different insurance coverage scenarios. The doctrine provides that if two causes – one covered by an insurance policy and the other excluded by the policy – both contribute to a loss, then coverage should be afforded under the policy. The doctrine would seem to expand coverage in scenarios where a potential exclusion might otherwise preclude it. Seems simple, right? Not always. Take for example the following APL case where the court found the concurrent causation doctrine did not apply and coverage was denied.
Lawyers wear many hats; the key is not to wear them all simultaneously. Many lawyers are well versed in areas outside of the law and can be a source of non-legal knowledge for clients. However, lawyers need to be mindful when their services extend beyond the traditional landscape of legal advice. Mixing business interests and legal advice can easily get you in hot water if the transaction goes awry. Take for example the case of Burk & Reedy, LLP v. Am. Guarantee & Liab. Ins. Co., in which a professional liability insurer denied coverage for an attorney that was involved in both the legal and business aspects of a transaction.
Insurers are entitled to make decisions as to the professionals they will insure and the terms of the relationship. To that end, insurers expend considerable energy evaluating risks and assessing the likelihood of a potential claim. The scope of underwriting and the key metrics may vary from carrier to carrier but without exception each insurer relies upon some form of insurance application. Insurers are entitled to rely upon the representations of their applicants and, when faced with a misrepresentation in an insurance application, have the right to deny coverage. Accordingly, we’ve cited previous examples of applicants caught in a lie in their insurance applications. Don’t do it. Consider another recent example.
Friends of PL Matters know that maintaining malpractice insurance is a must, regardless of your profession. Clients count on professionals to get things done right. When things don’t go exactly as planned, clients get unhappy, lawsuits are filed, and malpractice insurance kicks in to protect the professional. But what if the professional lacks insurance? May the client maintain a cause of action for lack of insurance?
Obtaining malpractice insurance is an essential component of risk management for professionals. But, the obligations continue beyond the purchase. Like any contract, both sides are bound to comply with the contractual terms: the insurer and the insured. Accordingly, professionals must take the time to familiarize themselves with the scope of policy coverage and specific policy exclusions. Failure to fulfill the requirements of a policy provision could mean the loss of coverage and individual exposure.
Professionals maintain professional liability insurance to protect their assets. Provided that the insured and insurer comply with the obligations set forth in the insurance contract, the exposure arising from a malpractice claim shifts from insured to insurer. Yet, about the only thing worse than getting slapped with a malpractice suit is learning that your firm is not covered despite the professional’s belief that insurance was in place. Consider the possibility that the actions of one of your colleagues could result in a firm-wide declination of coverage. A scary thought. A recent decision demonstrates how the actions of one colleague could result in a denial of coverage for everyone.
The majority of professional liability lawsuits target attorneys, accountants, and physicians. But, there are a series of so-called “miscellaneous professionals” who also face malpractice exposure: marketing consultants, recruiters, travel agents…and even leg waxing professionals. Many professionals are licensed by the state to practice in their chosen field and the failure to obtain such a license may void any professional malpractice coverage.