Coverage Disputes

Individuals and businesses purchase insurance policies to protect themselves from losses that may arise from liability and/or on their property and/or to their belongings. The various types of policies issued to individuals and businesses (such as Homeowners Insurance Policies, Commercial General Liability Insurance Policies and Professional Liability Insurance Policies) vary greatly in the amount and type of coverage they provide. Many of these insurance policies contain various exclusions and endorsements that modify or eliminate coverage for certain losses.

It is common for insurance companies to refuse paying for a particular loss by arguing there is no coverage for a particular loss. For example, insurance companies will refuse coverage by arguing that certain policy language and/or exclusions in the policy are applicable and limit or exclude coverage for your loss. A few common losses for which an insurance company may attempt exclude coverage for include:

• Loss for which the insurance company believes was intended or expected by the insured;
• Loss for which the insurance company believes was the result of a catastrophic event (such as nuclear exposure, war, or terrorism);
• Loss for which the insurance company believes was the result of ordinary wear and tear;
• Loss for which the insurance company believes was the result of mechanical breakdown or failure;
• Losses for which the insurance company believes was the result of the earth “moving” or “shifting”;
• Loss for which the insurance company believes was the result of a contractor or subcontractors own faulty work or faulty product;
• Loss for which the insurance company believes was the result of an intentional act by a third party, such as theft by an employee;
• Loss for which the insurance company believes is excluded under an applicable pollution exclusion;
• Loss for which the insurance company believes is excluded under an applicable mold exclusion:
• Loss for which the insurance company believes was known by the insured before the loss occurred;
• Loss for which the insurance company believes the insured voluntarily made payments on without their involvement;
• Loss for which the insurance company believes occurred outside the applicable policy period; and
• Loss for which an insurance company believes it provides secondary and not primary coverage for.

The losses for which an insurance company may attempt to exclude coverage for are numerous. Insurance companies may issue a letter to you, citing policy language, stating coverage is limited and/or excluded under your insurance policy. However, the insurance company may be simply implementing scare tactics to limit the amount of coverage they must provide. It is possible that the specific policy exclusion language has been overruled by the courts, is ineffective due to other language in the insurance policy, is unlikely to be upheld by a court, or is altogether inapplicable.

In insurance coverage matters it is imperative that you, the insured, retain competent counsel that understands the complex area of insurance coverage. At the Berniard Law Firm, our goal is to protect your rights and to make sure insurance companies meet their obligations as is required by their insurance policy. We seek to maximize coverage for you while minimizing or eliminating any exclusion argument that the insurance company will argue is applicable to your claim.

We have experience dealing with complex insurance coverage matters and have the experience necessary to understand your complex insurance policy. We have a substantial knowledge base of insurance coverage and understand the importance of these matters. The innovative hands-on approach taken by our firm ensures that your rights under the insurance policy are protected.