(July
2019)
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Since Law Enforcement Liability (LEL) Coverage is
not standardized, care has to be taken when using a particular insurance
company’s form. The following analysis is of a form that is representative of
such coverage.
This particular form advises that “you” and “your”
references the law enforcement entity that is the named insured under the
policy and the “we,” “us” and “our” is the company providing the insurance
protection. The introduction also specifically refers to Section II – Who is an
Insured for an explanation as to who is meant when the term insured is used in
the policy. A final recommendation is made to refer to Section VI–Definitions
in order to understand terms in the policy that have special meanings.
a. This portion of the policy obligates the insurer to pay on behalf of
an insured that has to pay another party who has been harmed by the insured.
The payment obligation is only created by the named insured committing a
wrongful act which is defined by the policy.
The insurer uses this section to establish both a
duty to defend the named insured against wrongful act claims as well as reserve
its right to investigate and, if necessary, settle such claims and incidents.
It also points out that any payment obligation is subject to the policy’s
applicable deductible and the listed policy limits. Paying either a judgment or
settlement ends the insurer’s obligation to provide the named insured a legal
defense.
The only other, valid payment obligation under
this policy exists only within the policy’s supplementary payment section.
b. Coverage under this policy is triggered by qualifying wrongful acts.
Such acts that have eligible coverage are those that happen somewhere in the
policy’s coverage territory and that happen during the applicable policy
period.
Related Court Case: Taser Use Determined
To Be Excessive Force
This section is precisely where one needs to go in
order to determine what occurrences are covered. Typical Law Enforcement
Liability forms bar coverage for the following:
a. Claims covered under the insured’s workers compensation, unemployment
compensation, disability benefits, or similar insurance policies
b. Loss or injury to any of a named insured’s law enforcement officers,
employees, or auxiliary or voluntary personnel. However, this exclusion only
applies when the loss or injury is tied to duties they perform for the named
insured.
c. Claims arising out of ownership, maintenance, management, operation,
use, control, loading or unloading of autos or motor or propelled vehicles of
any kind, including watercraft or aircraft if owned or operated by, rented or
loaned to any insured, or operated by any person on an insured's behalf
Note: These should be covered on the insured’s business auto, watercraft, or
aviation coverage form or policy.
An interesting point is the trend of local law
enforcement making use of drones in their activities. Policies may bear
revising as such use becomes more popular.
Example: Officer Landon had just begun training several cadets
in operating a small fleet of drones that were donated to the department.
Initially they are to be used for surveillance and missing person searches.
During one training session, a cadet loses control over a drone which falls
and strikes a civilian. This loss is not eligible for coverage under the LEL
policy. |
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Related Article: Aircraft Insurance
Coverage Analysis
d. Losses related to the named insured voluntarily taking on liability
by way of any contract or agreement. There is an important exception. The
exclusion exempts losses involving political subdivisions that make mutual law
enforcement assistance agreements.
Example: After a major traffic accident occurs on a road
located in |
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e. Losses stemming from occurrences involving parties other than the
named insured, except for acts that are approved by a named insured. Once
again, an exemption applies to incidents involving political subdivisions that
make mutual law enforcement assistance agreements.
f. Claims that arise from the insured’s employment policies or practices,
including refusal to employ, termination of employment, coercion, demotion,
evaluation, reassignment, discipline, defamation, harassment, humiliation,
discrimination or violation of civil rights.
Related Court Case: Sheriff’s Office May
Control Moonlighting Activities
Note: These should be covered on the insured’s employment practices
liability coverage form or policy.
Related Article: Employment-Related
Practices Liability Coverage Analysis
g. Claims arising out of any criminal, dishonest, bad faith, fraudulent
or malicious act, error or omission as well as any deliberate violation of, or
knowledge of any deliberate violation of, a federal, state or local statute,
ordinance, rule or regulation. However, the named insured’s intent regarding
these actions must be legally determined. Further, other persons who are
insureds under this policy, if they are judged not to be complicit or aware of
such acts, are still eligible for coverage.
Related Article: Innocent Insureds
h. Property damage to property the insured owns occupies or rents.
Neither does coverage under this policy extend to loss to property in the
insured’s care, custody or control. There is an important exception. It does
not apply to property held by persons when they are arrested or detained
i. Any type of nuclear exposure. Specifically, coverage is barred for
losses where an insured has provided equipment, parts or services to efforts to
plan, build, run or even facilitate a nuclear reactors, nuclear devices or waste
storage. Any handling or transportation of nuclear materials or byproducts is
also excluded.
j. Claims seeking relief or redress in any form other than monetary
damages the form references injunctive (terminating an activity), mandamus (ordered
to perform a specific duty), declamatory (ordered to make a specific statement)
or equitable relief. Further, damages that, in any manner, involve employee pay
are ineligible for coverage. The latter instance is barred even when the
liability exists in the form of liquidated damages and even when created due to
any laws, regulations or collective bargaining situations.
k. Claims made against an insured by another insured
l. Claims
involving pollution. Pollutants are any solid, liquid, gaseous, or
thermal irritant or contaminant, including smoke, vapor, soot, fumes, acids,
alkalis, chemicals and waste. The terms also applies to any forms of radiation or
ionization as well as genetically engineered, teratogenic (agents that harm
embryo development), carcinogenic and mutagenic (agents that cause or increase
the chance of mutation) materials. Waste also includes materials intended for
recycling, reconditioning or reclamation.
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Example: The
Yellingtown Police Department responds to a hostage situation. The situation
is resolved when the hostage-taker is subdued after tear gas canisters are
lobbed into the building. Later, several rubber-necking citizens who are
hospitalized due to escaping fumes sue the department. The claims are denied
under the policy’s pollution exclusion. |
Neither does coverage extend to losses related to pollution
clean-up, monitoring, and testing or assessment activity, even when mandated by
authorities.
This policy also bars coverage or payment for any
investigation, settlement or other expenses related to pollution claims
(includes suits, allegations or proceedings).
Related article: Pollution
Exclusion and Limited Coverage
If additional pollution liability coverage is
needed, a separate pollution policy should be considered.
Related Court Cases: Environmental
Cleanup Costs Held Not Covered By CGL Insurance
m. Liability arising out of a member of the medical profession rendering
or failing to render professional services
n. Civil or criminal fines or penalties levied by any federal, state or
local governmental regulatory agency or court. Damages that, by law, are
classified as ineligible for reimbursement or indemnification are also excluded.
o. A claim for damages relating to a communicable disease. There is no
coverage if the allegations are that there was actual transmission of or merely
exposure to a communicable disease. An example of such a disease is Acquired
Immune Deficiency Syndrome (AIDS). Damages claimed because of negligent
training, supervision, recruitment, policies or procedures are also not
covered.
Again, exclusions do differ among insurers
offering the coverage. For instance, carriers may also exclude losses involving
the following (or similar activities):
·
Misuse of the named
insured’s funds
·
Any form of moonlighting
·
Acts outside of described
job duties
Under this policy the insurance carrier pays all
of the following costs in addition to the protection provided by this policy’s
applicable liability limit.
Note: Read each item carefully because there are
exceptions.
1. All expenses the insurance company incurs to investigate, defend and
settle claims
Note: This category of expense is subject to the policy deductible that
applies to a given wrongful act.
2. Cost of bail bonds required because of a covered injury. The maximum
amount payable is $250.
3. Cost of bonds to release attached assets. The costs are limited to
those needed to supply a bond within the policy limits. However, it is NOT the
insurance company’s responsibility to secure release bonds.
4. Expenses caused to an insured while attending hearings, trials or
other claim-related activities in which the insurer requests participation.
This coverage includes up to $100 per day for an insured’s loss of earnings.
5. The costs that are taxed by the court against an insured. However,
eligibility for such expense only applies to lawsuits that the insurance
company chooses to defend.
6. Pre-judgment interest awarded against the insured on the part of the
judgment the insurance company pays. The insurance company’s pre-judgment
payment obligation does not extend to such interest that accumulates after the
date it offers to pay the policy’s applicable limit.
Related Court Case: "WYO"
Insurer Liable for Prejudgment Interest – demonstrates that this obligation can
be broadly applied.
7. Subject to the policy’s limit, the insurance company will pay interest
that mounts on a judgment that is made from the date the award is announced
until the day the amount is paid, offered or deposited.
8. Premiums on appeal bonds, but only for lawsuits in which the insurer
provides a defense.
9. First aid expense for bodily injury to others that occurs when and
where a covered loss takes place.
1. The entity or organization named on the declarations is an insured.
2. All of the following are insureds but they are insureds only while
acting on behalf of the named insured and within the scope of assigned duties:
a. The named insured’s law enforcement officers. It also refers to estates,
heirs, legal representatives or assigns of such law enforcement officers if deceased,
bankrupt or incapacitated.
b. The political entity or subdivision to which the named insured law
enforcement agency belongs including that entity’s public (elected or
appointed) officials. However, the entity or subdivision must have been in
existence at the inception date of the applicable policy period.
c. Other law enforcement agency employees and any volunteers who are
actually authorized as such by the law enforcement agency.
Examples:
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Notes:
Coverage does not apply to any entity not listed.
As a result, entities to be covered must be named, such as current and past
partnerships and joint ventures.
Some carriers may specifically list other entities
that have insured status such as authorized commissions, boards (such as discipline
or inquiry), or administrative departments. However, as is the case with other
insured parties, such status usually exists only when entities are acting
within their permitted duties.
Example: The
Upper Hinterland Sheriff Department’s Discipline Board is sued by an employee
and arbitration results in an award of $15,000 in damages. However, the department’s
insurer rejects the claim for paying the damages. The dispute was over wages
lost while the employee was suspended for failing to comply with procedures
in running the department’s evidence room. It did not involve an eligible
loss. |
1. The most the insurance company pays as a result of wrongful acts is
the limit of insurance on the declarations. This limit is not affected by the
number of insureds, the number of claims filed, suits brought or by the number
of persons or organizations that file claims or bring suits.
Example: The Aberdeen Police Department and its Regulatory
Commission have Law
Enforcement Liability coverage. Officer Sandra Smith arrests an armed robbery
suspect witnesses identify in a police line-up. The suspect is later cleared
of wrongdoing based on DNA evidence. The suspect sues Smith, the Aberdeen
Police Department and the Regulatory Commission separately. The Law
Enforcement Liability coverage responds and defends each insured separately
but the maximum payout on this claim is limited to a single limit of
Insurance. The limit does not apply separately to each insured. This instance
is treated as a single, wrongful act. |
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2. The Aggregate Limit is, during a given policy period, the maximum
amount of coverage available to pay for eligible losses that occur in that
period.
Example: The
Aberdeen Police Department purchased Law Enforcement Liability coverage with
a $1,000,000 Wrongful Act Limit and a $3,000,000 Aggregate Limit. Twenty-two
separate claims were filed on 22 separate alleged incidents of civil rights
abuse, with damages ranging from $100,000 to $2,000,000 per claim. Since the
limit for any one covered claim is the $1,000,000 Wrongful Act Limit,
coverage applies only to any liability award made against the insured up to
$1,000,000. Awards in excess of $1,000,000 during the policy period are |
3. The policy’s Wrongful Act Limit is the maximum amount available to pay
a single claim but is always subject to the Aggregate Limit. Therefore,
regardless what appears as the Wrongful Act Limit, it is subject to an Aggregate
Limit that is reduced by payment of other, eligible claims.
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Example: The Kursed County Sheriff’s
Department had horrendous losses during the LEL policy year of 1/13/18 - 1/3/19.
Their policy had a $750,000 Wrongful Act Limit and a $2,000,000 Aggregate
Limit. As of: |
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3/20/18 the policy paid out $750,000
in an $800,000 judgment on a loss involving a settlement of an improper
high-speed pursuit involving a crime that fell outside of department’s
pursuit guidelines. |
7/8/18 a judgement awarded $950,000
in a class action loss involving excessive forced used during multiple arrests
at a wedding reception fight. The policy paid out $750,000. |
9/8/18 a settlement resulted in
a a $600,000 payment for a loss involving false arrest and false
imprisonment. The policy paid out $500,000 because aggregate limit had been
reached. |
Wrongful Act Limit = $750,000 |
Wrongful Act Limit = $750,000 |
Wrongful Act Limit = $750,000 |
Policy Payments to date: $750,000 (capped by wrongful
act limit) |
Policy Payments to date: $1,500,000
(2nd loss ALSO capped by wrongful act limit) |
Policy Payments to date:
$2,000,000 |
Aggregate Limit remaining = $1,250,000 |
Aggregate Limit remaining = $500,000 |
Aggregate Limit = $0 |
Department’s out of pocket cost,
year-to-date $50,000 |
Department’s out of pocket
cost, year-to-date $250,000: $50,000 from 3/18 Loss $200,000 from 7/18 loss |
Department’s out of pocket
cost, year-to-date $350,000: $50,000 from 3/18 Loss $$200,000 from 7/18 Loss $100,000 from 9/18 Loss |
Note: After payment of 9/18 Loss,
the policy’s Aggregate Limit is exhausted and no coverage is available for
losses for the remainder of the policy period. |
4. Deductible
a. The Wrongful Act Limit, as described in item 3 above, is paid only
when in excess of the policy’s applicable deductible. The policy specifically
advises that the deductible represents an uninsured financial threshold that is
the named insured’s responsibility for any loss paid within the Wrongful Act
limit. An unusual twist in this form is that the deductible is warranted to not
be covered by any other type of insurance. The deductible amount must be the
responsibility of only the law enforcement agency
b. No other terms or policy provisions affect the application of the
stated deductible. Regardless the situation, the deductible applies.
c. For various reasons, the insurance company may decide to pay the
deductible either in part or in total. However, the insured is obligated to
reimburse the insurance company as soon as requested to do so.
5. Multiple claims that arise out of a given,
wrongful act, related wrongful acts or from a single, official declaration, are
treated as a single occurrence. This is good news for the named insured
because that means only one deductible applies. The downside is that only a
single Wrongful Act Limit applies in those same circumstances.
An official declaration must be triggered by
rioting or similar activity. The declaration is used to declare one or more of
the following:
·
States of emergency
·
Curfews
·
Martial law
Both the Wrongful Act and Aggregate Limits apply,
in full, to each, applicable annual policy period. They also apply separately
to any period of less than 12 month that may remain (usually due to a policy
cancellation or termination). However, if after a policy has been issued, the
coverage period is extended, then both limits apply over that extended length
of time.
Example: Provemtowne’s Police Dept. has
an LEL policy with an effective date of 2/1/18 to 2/1/19. and Wrongful
Act/Aggregate Limits of $2,000,000/$4,000,000 |
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Scenario 1: The policy is
cancelled on 4/1/15 to establish a different policy period. The policy is
rewritten to 4/1/18-4/11/19. One set of $2,000,000/$4,000,000 limits apply from
2/1/18 through 4/1/18 A new set of
$2,000,000/$4,000,000 limits apply from 4/1/18-4/1/19 |
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Scenario 2: The policy is
extended to 4/1/19 in order to have coverage track with Provemtowne’s fiscal
year. The $2,000,000/$4,000,000 limits apply from 2/1/18 through 4/1/19 |
1. Bankruptcy
The insurance company’s obligation to provide
coverage and defend the insured is not affected if the insured becomes bankrupt
or insolvent.
2. Cancellation
a. The first named insured on the declarations can cancel at any time by
providing the insurance company with advance written notice of its intent to do
so.
b. The insurance company can cancel at any time by providing the first
named insured with written notice of the cancellation. Cancellations because of
non-payment must give at least 10 days advance notice. At least 60 days advance
notice is required for any other reason.
c. The insurance company must mail or deliver its notice to the mailing
address of the first named insured. The address used is the one that is last
known to the insurance company.
Note: This makes it critical that the address on the
coverage form be kept current.
d. The notice of cancellation states the cancellation date. This is the
date that the policy period and coverage both end.
e. In case of cancellation, the insurance company sends the return
premium due to the first named insured. If the company cancels, the refund is
calculated on a pro rata basis. If the named insured cancels, the refund may be
calculated on a different basis. In any case, the cancellation is effective
even if a refund has not been made or offered.
f. The only documentation that is needed to show that the cancellation
was sent to the first named insured is a proof of mailing.
Note: Most states have
different periods that replace the ones in this condition.
3.
Changes
The coverage form contains all agreements between
the insurance company and the named insured. The first named insured is the
only insured authorized to request changes and such changes are not effective
until and unless the insurance company actually adds it to the policy by
endorsement.
4.
Duties In The Event Of Incident, Wrongful Act, Claim or Suit
The named insured has a number of duties to
perform if a claim or demand for coverage occurs:
a. The named insured must inform the insurance company of any wrongful
act that may result in a claim as soon as possible. As a minimum, the notice
should include information concerning how, when and where the event took place
and the names and addresses of all injured parties and any witnesses. It should
also indicate the types of claim that may result from the particular wrongful
act.
Note: If a claim or lawsuit related to a reported incident is later filed,
the named insured has a separate obligation to also report that development to
the insurance company.
b. Concerning claims made or suits brought, the named insured or any
insured must immediately record its details, the date it was received, and
notify the insurance company as soon as possible. This is in addition to
providing the company with timely written notice of the claim or suit.
c. Every insured involved in or with the claim must:
·
Immediately send the
insurance company copies of demands, notices, summonses and legal documents it
receives in conjunction with the claim or suit
·
Authorize and grant
approval for the insurance company to obtain records and other needed
information
·
Cooperate with the
insurance company in investigating or settling the claim or defending against
the suit
·
When the insurance company
requests, assist it in enforcing any right against any person or organization
that may be liable to the insured for injury or damage covered by this
insurance.
·
Take care not to proceed
in a manner that endangers the insurance company’s rights with regard to the applicable incident or act
d. No insured may voluntarily make any payments, assume any obligations,
or incur any expenses other than first aid without the insurance company's written
consent, unless it does so at its own cost or expense.
Related Court Case: Ten Year Delay of
Claim Relieved Insurer of Defense And Indemnification Of Housing Authority
5.
Examination of Your Books And Records
The insurance company may examine, audit, and copy
the named insured’s books and records. However, the insurance company is
limited to only those which actually relate to the coverage provided. This
right applies during the policy period and for up to three years after
expiration.
6. Governmental Immunity
Law enforcement agencies may be entitled to
governmental immunity as public institutions. The coverage provided does not
constitute a waiver of any governmental immunity available to the named insured.
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Example: A Harmville police officer hears an emergency
dispatch for a fire department to an address that is only a couple minutes
away from his location. He arrives on the scene. A child and mother who fled
the burning home tell him that the father is in the home with a garden hose,
trying to extinguish the flames. The officer enters the home and forces the
father out. The fire department was delayed by a minor traffic accident. By
the time they arrive, the flames have spread substantially. The home’s a
total loss by the time the fire is extinguished. The homeowner later sues the
police officer claiming that he could have put out the fire earlier and saved
most of the home. The police department opens a file and begins to provide a
defense against the lawsuit even though the insurer is aware that Harmville
has a law that will shield the officer from the lawsuit. |
7. Inspections and Surveys
The insurance company has the right to make
inspections and surveys at any time, report its findings to the named insured,
and recommend changes it feels should be made. However, it is not obligated to
do so. Anything it does in this regard relates only to its findings of the
risk's insurability and the premiums to charge. It does not make safety
inspections or attempt to perform duties of parties that provide for the health
or safety of workers or the public. It does not warrant that conditions are
safe or healthful or comply with any law, regulation, code or standard.
This condition applies to the insurance company as
well as to any rating, advisory, rate service or other organization that also
makes insurance inspections, surveys, reports, or recommendations for insurance
purposes.
8. Legal
Action Against Us
Legal action cannot be brought against the
insurance company until the insured has performed its duties as required within
the policy.
A person or organization cannot name the insurance
company as a party in any type of suit or action that is requesting damages
from any insured. They can also not sue the insurance company unless terms and
conditions of the policy have been satisfied.
The insurance company can be sued to recover on an
agreed settlement or on a final judgment against the insured. However, the
insurance company is not liable for damages that are not subject to payment
under the terms of this policy or that are for more than the limit of insurance
that applies.
Note: For a settlement to be considered, agreed upon, and include a valid
release of liability, all interested parties plus the insurance company must
sign.
9.
Other Insurance
This condition explains how this coverage applies
if other insurance also applies to a claim
a. This policy applies on an excess basis, except when the other source
of coverage was bought specifically as excess coverage over this policy’s
protection. Otherwise, coverage does not apply until the other insurance is exhausted.
The excess application is operational over all other collectible sources,
including deductibles and self-insured retentions. No other programs affect the
application of this policy’s stated deductible.
b. When this policy acts as an excess source of protection, the insurance
company has no obligation to provide a defense against the applicable claim or
suit that is another insurance company’s responsibility. However, this
insurance company has an option to provide a defense if none is provided by another
insurer. In such instances, the insurance company takes over the named
insured’s rights of action against any other insurance company.
c. When this policy acts as an excess source of protection, the
insurance company only pays the share it owes that exceeds the total amount
that would be paid by all other sources of coverage if this protection did not
exist. The excess payment obligation includes all deductible and self-insured
amounts contained in all other sources.
Note: This part of the other insurance provision is to prevent expectations
that this policy respond on anything but an excess basis when primary sources
of coverage exists. Deductibles and retentions are legal parts of primary
levels of protection, so this provision keeps those financial obligations
intact.
d. This subpart takes effect when coverage is NOT provided on an excess
basis. The insurance company’s response depends on how the other source of
coverage responds.
(1) If the other insurance permits contribution by equal shares, this
insurance does as well. Each insurance company contributes equal amounts until
it exhausts its limit of insurance or the loss is paid, whichever occurs first.
(2) If the other insurance does not include contribution by equal shares,
contribution is by limits. With this approach, each company's share is the
ratio of its applicable limit of insurance to the total applicable limits of
insurance by all companies.
Example: The
Aberdeen Police Department has its primary coverage under Policy A with
limits of $500,000 and also coverage under Policy B with limits of
$1,000,000. A bystander hurt during a raid sues the department and is awarded
a $750,000 judgment. ·
If Policy B applies on an excess basis, Policy A pays $500,000 and
Policy B pays $250,000. ·
If Policy B applies on a pro-rata equal shares basis, Policy A pays
$375,000 and Policy B pays $375,000. ·
If Policy B applies on a pro-rata ratio method, Policy A pays
$250,000 (1/3 of the total limits available) and Policy B pays $500,000 (2/3
of the total limits available). |
10.
Premium Audit
This provision applies only when the Declarations
Page indicates that the policy is auditable.
a. The advance premium on the declarations is only a deposit premium. At
the end of each audit period, the insurance company determines the actual
earned premium for the period.
b. The date on the billing notice is the date
the company expects to receive the premium billed. However, if the advance and audit premiums are more than the
earned premium, the insurance company refunds the excess to the Named Insured
that is listed first on the policy.
c. The Named Insured that is first listed on the policy is responsible
for keeping the records and information the insurance company needs to do the
premium calculations and must send copies of them to the company when it
requests.
Note: Audit period is not clearly defined or explained. It can be monthly,
quarterly, annually or any reasonable period that’s agreed upon by the Named
Insured and the insurance company.
Example: Harmville’s LEL policy is subject to a quarterly audit and the deposit premium charged at inception is estimated to approximate the final annual earned premium. An audit is performed at the end of each quarter to determine that period’s exposure. The actual earned premium for that quarter is deducted from the deposit premium and a statement is sent to the Named Insured. After the policy’s last audit is completed, it’s determined that the actual earned premium exceeds the deposit. The policy year’s final quarterly statement includes a bill for the additional premium owed. Once notified by the statement, Harmville is obligated to make the additional payment. |
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11.
Premiums
The First Named Insured pays the premium and also
receives any return premiums the insurance company pays.
12. Representations
This condition states that the insurance company
relies on the insured's complete and accurate representations, statements,
information, and other material stated in the insurance application. It also
states that, based on being supplied with both true and complete information,
the policy was issued by the insurance company.
Note: The effect is that, for all intents, the application may be treated as
part of the policy and, if information proves to be either materially
incomplete or false, the insurance company has greater justification for taking
adverse underwriting action. The company may also have the right to void
coverage and deny claims because of information that is inaccurate or
fraudulent.
13. Separation of Insureds
Other than the limits of insurance and any rights and duties that apply
to only the first named insured, this policy treats and responds to each named insured as though it is the only named
insured on the policy. In addition, each insured is treated on a separate basis
with respect to eligible claims and lawsuits.
14. Settlement
The named insured can refuse to consent to a
negotiated settlement with the insurance company. They can insist that the
claim be contested or that legal proceedings continue. However, there is a
potential penalty. The insurance company will pay no more in any action or
settlement than the amount it could have settled the claim for plus the cost of
defense it incurred up to the date the insured refused to settle.
Note: This provision is also
referred, unofficially, as a hammer clause and is usually seen in professional
liability policies for physicians and lawyers.
Related Court Case: Physicians
Professional Liability Insurer Had Sole Discretion to Settle Malpractice Suit
15. Transfer of Rights of Recovery Against Others to Us
Any rights the insured has against others to
recover all or part of any payment the insurance company made transfer to the
company. The insured must preserve those rights and not do anything after the
loss occurs to impair them. If and when a request is made by the insurance
company, the applicable insured is obligated to either file a lawsuit on its
behalf or transfer the policy rights over to the insurance company.
16. Your Authority and Duties
In certain instances, such as with handling
premiums, filing reports and receiving termination notices, it would be
inefficient and prone to error for all of the insureds under a policy to share
policy obligations. Therefore, as a stipulation for providing this insurance,
it is the First Named Insured’s duty to act as proxy for all other insureds.
Further, this provision both obligates the policy’s other insureds to accept
the status of the first Named Insured and to notify the same party of any
incidents or acts which may trigger coverage. The notification to the first
Named Insured has to be in writing.
Defined words are used
throughout the coverage form. Restricting the meanings of certain terms
provides a way for everyone to have a clearer understanding of the policy’s
coverage intent.
1. Auto is a land motor vehicle, trailer or
semi-trailer. It must be designed for travel on public roads. This does not
mean that it is used on public roads – the statement is that it is designed for
such travel.
Note: This definition makes
no consideration for various state laws that deem other types of vehicles as
motor vehicles nor does it address mobile equipment.
2. Bodily injury is bodily injury, sickness or disease sustained by a person. It includes death as well as mental injury that is directly related to any physical injury.
3.
Coverage territory is generally limited to
the
4. Defense expenses are legal fees and expenses incurred
in investigating, defending, arbitrating, mediating or appealing a claim, or in
any alternative dispute resolution process.
5. First aid refers to providing emergency medical treatment
by an officer or employee of the named insured’s law enforcement agency. This
applies only if a licensed medical professional is not immediately available.
6. Injury refers collectively
to bodily injury, personal injury or property damage that is related to law
enforcement and similar activities the named insured approved. However, such
injury or damage only qualifies as injury if such instances were not intended
or expected from the standpoint of the named insured.
Note: An exception exists for intended acts that involve reasonable force
use in defending either persons or property.
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Law Enforcement Liability Insurance
Held Not To Cover Injuries Resulting From High Speed Chase
7. Personal injury. This term
applies to any injury, with the exception of bodily harm, that arises out of
one or more of the following offenses.
Related Court Case:
Releasing Accident Victim Photos Invaded Privacy
8. Property
damage is physical injury to
tangible property. This term also applies to loss suffered due to the property
being inaccessible. The inaccessibility could be due to the property being
damaged or to it being stolen.
9. Suit is a civil proceeding
that alleges damages covered under by this insurance. It includes arbitration or
any other alternative method of dispute resolution in which the insurance
company agrees to be a participant.
10.
Wrongful act applies
to both allegations as well as confirmed acts involving misstatements, errors,
omissions (nonfeasance), neglect, and breach of duty. Such acts performed by
parties other than the named insured qualifies if the acts were performed while
working or acting on the named insured’s behalf.
Wrongdoing by a public
official (malfeasance) is covered only when such an act is an allegation. Once
malfeasance is determined to have occurred, it no longer qualifies as a
wrongful act.
Note: At least one other carrier used defined term, “law enforcement wrongful act” to more narrowly control how coverage form responded to eligible losses.