D&O and E&O - How Not To Report A Claim Redux

In our May 25, 2011, blog post [see here], we reported on the lower court decision in this matter. Now the Third Circuit has affirmed that decision in Atlantic Health System, Inc. v. National Union Fire Ins. Co. of Pittsburgh, PA, No. 11-2060, (3d Cir. March 22, 2012).[see here]

This is another cautionary tale of what can go wrong when an insured, directly or through its broker, ignores the claim reporting instructions in the policy form or on the Declarations and sends its notice of claim to an incorrect address. Some commentators will complain that this is another insurance company “gotcha” and there is no big deal in sending notice of a claim to the address for an underwriting unit. Why can’t they just walk it across the street or down the hall to wherever the claims unit may be?

The Third Circuit relied heavily upon its earlier decision in American Cas. Co. of Reading, Pennsylvania v. Continisio, 17 F.3d 62 (3d Cir. 1994), quoting from that decision as follows.

[T]he only reasonable interpretation of the policy provision is that the insureds mustvregard the information they possess as a potential claim and formally notify their insurervthrough its claims liability department that a claim may be asserted . . . . [N]otice mustvbe given through formal claims channels because we recognize that the information needed, or at least the perspective utilized in reviewing it, varies when predicting the probability of future losses and recognizing the need to investigate a claim that may be made based on past occurrences. (emphasis added)

Continisio, 17 F.3d at 69.

In my view, this matter was well-decided and well-reasoned both at the District Court level and upon appeal before the Third Circuit. It is certainly not a classic situation of a denial of coverage based upon a hyper-technicality. Rather, it shows a keen judicial understanding of the nature of underwriting and claims responsibilities within an insurance company. Hopefully, word of this decision is disseminated widely among policyholders and their brokers. Forewarned should be forearmed.

What is the Life Expectancy of a D&O Securities Class Action Claim?

I am asked this question many times by claims, underwriting and brokerage clients and, dependent upon at what point in history the question is asked dating back to the passage of the Private Securities Litigation Reform Act (PSLRA) in December 1995, my answer varies. A somewhat typical “life span” range would be two to five years.

While admittedly an outlier, a recent decision of the United States District Court for the District of Arizona granting class certification and appointing a union pension fund as lead plaintiff, illustrates just how long a securities class action can last from first filing to final disposition. Siracusano vs. Matrixx Initiatives, Inc., No. CV 04-00886-PHX-NVW (Order of February 27, 2012).

You might recall this is the same case that previously wound its way to the Supreme Court of the United States on a pleading issue after the same court in Arizona had granted defendants’ motion to dismiss. Specifically, the case concerned the drug Zicam manufactured by the defendant and allegations that Matrixx concealed reports that the drug could cause anosmia, a loss of the sense of smell.

The Supreme Court ruled that any adverse event reports concerning Zicam that alter the “total mix” of information otherwise disclosed or available to the market, also had to be disclosed. The Court remanded the case to the District Court for further proceedings consistent with its ruling. Matrixx had argued that only “statistically significant” studies or reports must be disclosed.

This case was commenced in the District of Arizona by filing of a Complaint on April 27, 2004, so it is now approaching its eight-year anniversary. Although I am not privy to any details of the litigation, including the limits of any tower of D&O insurance for Matrixx, one can easily imagine defense and appellate expenses already totaling at the seven- or eight-figure levels.

What could lie down the road in the Matrixx litigation?

With dismissal and class certification already ruled upon in favor of the plaintiff class, discovery should now begin in earnest. It may in fact have already begun after the Supreme Court decision in March 2011 and subsequent remand to the trial court. It is also possible that at some point during or after discovery defendants could move for summary judgment. Ultimately, there could be a trial on the merits or appeals from any summary judgment or trial judgment ruling. Of course, it is always possible, if not likely, that the litigation will settle at some point through direct negotiations or facilitated by mediation.

Given all of these possibilities, it is not entirely out of the realm of reasonable conjecture that this case will reach its 10th anniversary, and possibly extend beyond that point.

CONCLUSION:  An underwriter’s and actuary’s nightmare.

D&O Insurance - Why The Chinese May Not Be Buying (Yet)

Failure to adopt good corporate governance practices, investor non-disclosure leading to securities fraud suits and enactment of legislation similar to the U.S. Foreign Corrupt Practices Act in the People’s Republic of China[1] have all arisen over recent months to cause substantial exposures to Chinese companies and their directors and officers so as to warrant the purchase of a comprehensive program of D&O insurance. Yet, the anecdotal evidence appears to indicate that these companies are thus far largely without this insurance.[2]

As the McCarter & English authors (see footnote 2) aptly note, the widespread purchase of D&O insurance will usually follow the development of good corporate governance practices. While the Chinese are studying and quickly implementing the best of these practices that they have studied globally, the litigation risks and exposures are already here, particularly in the case of companies undergoing the reverse merger transactions and subsequent IPOs that we discussed in my May 25 post.

The Chinese have made many societal and economic changes with lightning speed over the past two decades, and this is one area that they need to quickly tackle. Here are some of the key points for both the buyers and sellers to be aware.

  • Good corporate governance does not preclude, or perhaps even mitigate, the possibility of a securities fraud class action. Indeed, among U.S. companies, while those with excellent corporate governance practices may fare well in shareholder derivative litigation involving alleged breaches of fiduciary duty to the corporation, there seems to be little correlation between those practices and avoiding securities fraud litigation based upon non-disclosure or inadequate disclosure to the investment community. Moreover, although settlement values in derivative actions are rising, it is still the securities fraud class action that poses the largest monetary risk to directors and officers and the corporation.
  • Even where suits with relatively little merit are brought, significant defense expenses and a possible plaintiffs’ fee award or settlement may be incurred before the litigation is concluded. These exposures can easily exceed $1M even in meritless cases.
  • Care needs to be taken in putting together a program that will adequately insure a Chinese company’s domestic exposures in China and those internationally in jurisdictions such as the U.S. Only a handful of insurers have established presences on an international basis and there may be a need to coordinate various layers of primary and excess insurance written by a large number of insurers to ensure that no gaps result.

My educated guess is that the landscape with respect to D&O insurance for Chinese companies will rapidly change, and there will soon be little need for articles and broking efforts to educate companies as to the wisdom of the purchase. In the interim, it appears millions of dollars are being borne in defense expenses alone that could have been covered under a well-structured D&O insurance program.


[1] See my earlier posts on D&O and China on March 15, 2011 and May 25, 2011. Suffice it to say that a few short years ago one would not hear D&O and China mentioned in the same instance, let alone now having a D&O blog address the topic three times over a four month period.

[2] An excellent article, “Chinese Businesses Should Not Overlook D&O Insurance”, in the New York Law Journal of July 7, 2011 by J. Wylie Donald, Harley Lewin and Zhenggui Li of McCarter & English discusses the apparent lack of interest in D&O insurance on the part of Chinese companies and reasons therefore.

D&O Insurance Coverage - Second Circuit Rules Special Litigation Committee (SLC) Costs and Expenses Are Covered Defense Expenses Under Policy

On July 1, 2011, the Second Circuit issued its much awaited, and now sure to be controversial among insurers, decision and opinion in MBIA, Inc. v. Federal Ins. Co. and ACE American Ins. Co., No. 10-0355 (2d Cir., July 1, 2011). The Court’s decision was fully favorable to the insured, MBIA, with respect to coverage under the policies for (i) costs incurred in response to a subpoena from the New York Attorney General (“the AG”), (ii) voluntarily incurred costs in response to informal requests from the Securities Exchange Commission (“SEC”) and the AG, (iii) costs of independent consultants retained to conduct investigations in connection with settlements with the SEC and the AG, and (iv) costs incurred by a Special Litigation Committee (“SLC”) formed to investigate allegations of wrongdoing on the part of MBIA directors and/or officers set forth in shareholder derivative litigation. We will analyze the full impact of the decision in our next issue of the Specialty Lines Advisory, but the focus in this post will be confined to the issue of coverage for the SLC costs.

The policies at issue were two D&O policies – one a primary D&O policy in the amount of $15M issued by Federal; the other a $15M excess policy issued by ACE. Of pertinence to the Court’s ruling was the fact that the Federal policy provided a $200K sublimit for investigative costs related to a shareholder derivative demand.

Prior to the filing of the shareholder derivative litigation, MBIA received demand letters from the soon-to-be shareholder plaintiffs asking the MBIA board to bring suit against certain directors and officers for alleged breaches of fiduciary duty and other wrongful acts. MBIA formed a Demand Investigative Committee (“DIC”) in response. Such committees are often also called Special Investigative Committees or simply Investigative Committees. In any event, the DIC did not take timely action and shareholder derivative action followed. MBIA then organized a SLC in response to the litigation and, after the SLC completed its investigation, it (the SLC) concluded that maintaining the derivative suits was not in MBIA’s interests and the litigation should be dismissed. The litigation was in fact thereafter dismissed.

The Court found that the costs incurred by the SLC were covered essentially because it was an “Insured Person” under the policy formed by MBIA pursuant to applicable Connecticut corporate law. Although the Court did not elaborate, it is presumed that the SLC was determined to be an “Insured Person” rather than an insured entity because it was composed solely of various independent directors of MBIA.

The controversial aspect of the Court’s ruling on this issue, in my opinion, lies not so much in determining whether or not the SLC’s interests were congruent with those of MBIA. That should not have been the issue in light of the fact that MBIA was simply a nominal defendant in the derivative litigation. As such, there were no “claims” made against MBIA and its interests were arguably aligned with those of the derivative plaintiffs to a certain extent. Indeed, that is what gives MBIA the power and ability to ultimately have the litigation dismissed.

What the Court did not do, unfortunately, is examine this coverage issue as it should have been from the perspective of the insured defendants, i.e., MBIA’s directors and officers. They are the insured parties against whom a claim is asserted. While the SLC investigation ultimately succeeded in having the litigation dismissed, that was not the purpose of the SLC. If anything, the SLC was adverse to the interests of the defendant directors and officers, particularly because the SLC might, at the conclusion of its investigation, recommend that MBIA assume a vigorous, direct prosecution of the claims asserted derivatively on its behalf. Thus, the costs incurred were not at all covered defense expenses under the policy, even if they were arguably incurred on behalf of the insured MBIA. MBIA, as nominal defendant, did not require a defense in derivative litigation; only do the defendant directors and officers. The fact that the work of the SLC may have incidentally benefitted the directors and officers at the end of the day, should not be the test for determining whether these costs are covered.

The insurers also argued alternatively that, if the SLC expenses were covered, they should nonetheless be subject to the $200,000 sublimit for shareholder demand investigations. The Court, however, held that the sublimit would only apply to the pre-litigation costs incurred by the DIC and not to the litigation-related costs of the SLC. Left unanswered is whether the costs of a DIC would be covered at all in the absence of such sub-limited coverage grant. It would appear that this Court would have applied the same reasoning as it did to the SLC costs.

Barring a petition for rehearing en banc and/or the even more remote possibility of successfully seeking certiorari for an appeal to the Supreme Court, this ruling would appear to be final. While it arguably is confined to simply the Second Circuit’s interpretation and application of Connecticut law, the decision will likely have important ramifications in the D&O insurance community. Brokers will no doubt strive to be sure that policy language unequivocally covers SLC cost and is in no way sub-limited.* Further, given continuing soft market conditions, it is doubtful that insurers can effectively refine or clarify policy language to more effectively extend the application of the investigation demand sub limits to ensuing derivative litigation.

----------------------------------------------------

*Typical sub limits for this type of coverage rarely exceed the level of $250,000. Such amount will not cover completely the costs of a SLC in most instances, which are commonly at levels of at least seven figures.

Willis Darcstarâ„¢ - Innovative New D&O Policy Form

We do not do product reviews here at The DandOEandO Monitor, but occasionally a new product comes to the market that should make everyone step up and take notice. We saw that recently in the U.S. with Chartis’ Executive Edge product, which was widely copied by way of enhancement endorsements to competitor forms. While that certainly does not dictate what is the coverage of choice, at least some kudos are due Chartis for their innovation and market leadership.

Darcstar™ appears for now to be a form available, at least initially, in marketplaces outside the U.S., but that is not to say that U.S. insurers could not learn a lot from this product.[1] The following, although by no means exhaustive, are some of the more notable features and attributes of the policy form.[2]

First, is its drafting simplicity and brevity (8 pages), positive attributes I might add that are disappointingly missing from the aforementioned Executive Edge.

Second, although it is marketed as an “all risk cover”, the policy does contain an exclusions section with six enumerated exclusions plus additional exclusions contained, as is typical of most D&O policies, in the Loss definition.

Third, and perhaps the most remarkable and innovative feature, Darcstar™ takes disputes over permissible indemnification for the most part out of the coverage analysis. This is done with a single insuring clause, with multiple subparts, but all triggered solely by a claim against an insured person without regard to corporate indemnification. Further, the insurer waives any right to subrogate against the company or any subsidiary as a result of any failure of these entities to lawfully indemnify the insured persons. This latter provision is particularly unusual, and one has to wonder whether this could reasonably be a feature in a U.S. policy where the scope of both permissible and mandatory indemnification is very broad in virtually all states.

Fourth, the policy is written without use of deductibles or retentions, except in the case of a securities claim. This securities coverage is provided to the entity by way of an extension clause in the policy, and is the sole extent of entity coverage granted. In my opinion, deductible or retentions, even relatively large ones, do not give the insureds the requisite “skin in the game” that insurers often seek. Only meaningful coinsurance percentages can accomplish that. Darcstar™ simplifies the issue by dispensing with these amounts and presumably subsuming the resultant earlier exposure points in the premium.

Fifth, although many U.S. insurers might be somewhat loathe to offer these, Darcstar™ provides that the insurer must state its coverage position within thirty days of receipt of the claim notice and indicate whether it consents to defense costs within seven days.

Sixth, the policy’s loss mitigation extension offers a sublimit for what is somewhat similar to U.S. E&O policies for financial institutions with a “costs of correction” cover for trade errors.

Seventh, the policy’s approach to inquiries and investigations is somewhat unique and straightforward. The coverage for these events - whether external or internal; formal or informal – is rather broad. Unlike most U.S. policy forms, investigations and inquiries do not constitute a Claim, and coverage can be triggered for these events as soon as there is the potential for a claim or “notifiable circumstances.” As such, the trigger of their coverage would be in the event that the company fails to pay them on behalf of the insured person due to a conflict in interest or company financial insolvency. Otherwise, these expenses are expected to be covered by the company without recourse to the insurance policy.

Finally, there is one other feature that insureds may not necessarily find favorable. Darcstar™ provides for mandatory arbitration of coverage disputes, in the event of a failure of settlement negotiations or mediation, applying the laws of England and Wales in an arbitral proceeding administered by ARIAS (UK). One would imagine, however, that this clause might be amended to accommodate different choice of law.


[1] Darcstar™ is marketed as a product of Willis FINEX Global in association with the insurers, Allianz, Beazley, Liberty Mutual, Munich Re, QBE and XL.

[2] Darcstar™ contains no explicit territorial limitations, but it does not appear to be a form intended for policyholders incorporated in the U.S. or with publicly-traded U.S. subsidiaries.  By way of example, the insured person definition provides for a degree of outside directorship extension, except with respect to a publicly-traded subsidiary in the U.S. Nonetheless, the form is otherwise quite suitable for companies based outside the U.S. but having U.S. exposures by virtue of a subsidiary company.

What Me Worry? I'm a Corporate Director in the U.S.

Alfred-E.-Newman.jpgAt least that is what Steven M. Davidoff appears to suggest to directors and officers in an article appearing in The New York Times on June 7, 2011.

The article has stirred up a bit of a tempest in insurance and legal circles, and it is still too soon to conclude whether or not such will be confined to the proverbial teapot.

From my perspective as counsel to D&O insurers, I agree with much of what Davidoff said in his piece, but I do want to share some additional observations.

Davidoff’s article gives the implication that personal liability for these individuals is rare. Au contraire, the personal liability is very real and frequently imposed or at least threatened. The actual payment responsibility for this liability, however, is often successfully passed back to the corporation by way of an indemnification provision in the corporate by-laws or else directly to a D&O insurer.

Since the mid to late 1980s, the scope of permissible corporate indemnification greatly expanded in Delaware and virtually all other states. Thus, there should always be corporate indemnification available without any monetary limit or cap except in the following circumstances.

  • The corporation becomes financially insolvent. Indeed, this is one of the principal reasons to assure that the corporation procures ample limits of insurance to protect its directors and officers, including separate limits available to the independent directors only.
  • There is some legal prohibition against indemnification. These instances are rare and generally limited to situations such as very egregious conduct by the director or officer, disgorgement of ill-gotten gain, and breach of the duty of loyalty to the corporation. One notable exception in most states, however, lies in a settlement or judgment amount in a shareholder derivative action alleging mismanagement and breaches of fiduciary duty to the corporation. Again, the backstop here is the D&O insurance policy.

While insurance is the backstop when indemnification fails, the following should nonetheless be noted.

  • Insurance policies have finite limits of liability and the exposures can exceed those limits, particularly when legal defense costs are considered.
  • An insurance policy is not a financial guaranty. Policies have exclusions and other limitations that may result in a loss becoming wholly or partially not covered.
  • Egregious conduct that may result in disgorgement of ill-gotten gain is often not covered under insurance contracts or uninsurable as a matter of law, as well as being outside the scope of permissible indemnification.

One of the comments online that followed the Davidoff article noted the possibility of unpaid corporate tax liabilities of officers after a company becomes insolvent. Yes, indemnification is no practical remedy there, but a few D&O insurance policies are now being endorsed to provide that coverage. When it comes to disgorgement of ill-gotten gain, directors and officers receive little sympathy from this quarter. Why should the corporation or insurers pay for what you should not have had in the first instance?

The bottom line is that the legal liability for directors and officers is very real but, given the prevalence of liberal indemnification and broad coverage under D&O policies, the financial exposure or consequences are relatively small and/or infrequent.

Thus, if there are any corporations with an independent director opening, I am ready, willing and able to serve. I will, however, give careful scrutiny to your indemnification provisions and D&O insurance structure.

Mind the Gap: The Difference Between Awareness Provision Reporting Criteria and Prior Knowledge and Application Disclosure Requirements in Professional Liability Policies

A recent New York case illustrates the potential perils in sequential claims-made policies when one insurer takes a position that an attempt to report a potential claim did not satisfy the specificity requirements of the policy’s “awareness provision”, and the successor insurer (when the actual claim was reported) takes the position that the circumstances leading to the claim was something that should have been disclosed in response to a warranty question on the application.

In Liberty Ins. Underwriters v. Perkins Eastman Architects, Supreme Court, New York County, New York, Docket No. 113946/06 (Decided May 3, 2011), the conundrum was avoided and the court decided the facts supported sufficient notice of circumstances to the first insurer and, consequently, no coverage under the successor insurer’s policy because of breach of the application warranty. Yet, a slight variation in the wording of the original notice and the other pertinent facts could easily have led to the matter not being covered under either policy.

The policies at issue were successive architects and engineers professional liability policies. The awareness provision in the first policy stated as follows.

“If during the Policy Year you become aware of a Circumstance that may reasonably be expected to give rise to a Claim against you, and if you report such Circumstance to us during the Policy Year in writing, then any Claim subsequently arising from such Circumstance duly reported in accordance with this paragraph shall be deemed under the Policy to be a Claim made during the Policy Year. Such written notice to us shall include:

  1. particulars as to the reasons for anticipating such a Claim; and
  2. the nature and dates of the alleged Circumstances; and
  3. the alleged injuries or Damages sustained; and
  4. the manner in which you first became aware of the specific Circumstance.”

The second policy posed the following question in its application form.

“”[Does the firm have any knowledge of] any act, error, omission, unresolved job dispute, accident or any other circumstances which might reasonably be expected to give rise to a claim under this insurance?”

On or about January 16, 2004, the insured answered “no” to this question. On February 13, 2004, three days before the first policy expired, that insurer was advised that the contractor on the project that ultimately became the subject of the later claim was “looking to pursue major claims and is alleging some design errors.” On March 17, 2004, after a request for more details from the first insurer, the insured responded with sufficient particulars to ultimately persuade the court that coverage was triggered under the first policy for the claim that was ultimately made and reported to both the first and second insurers.

Thus, this is not one that fell through the cracks. But, query what would be the case had the insured simply stuck with the simple February 13, 2004 notice. Did that simple notice provide enough particulars and specificity to satisfy the awareness provision? The Court did not have to reach that question because the later notice cured any deficiencies that might have lied with the February 13 notice.

Yet, the application question for the second policy requires no disclosure of particulars or any degree of specificity. In this case, the insured at its ultimate peril in the view of the Court answered that question in the negative. Were it not for the “cure” on the notice to the first policy, this claim could well have fallen into the gap.

Is there a solution? In my view, yes, but not one that is easily effectuated. The industry would have to adopt uniformity of language between awareness provision requirements and the warranty questions commonly found on applications, as well as the prior knowledge provisions typically incorporated in the insuring agreements of many professional liability forms by way of some variation of the warranty question. Because there are no industry standardized forms in these areas, this would be a monumental task for brokers to achieve.

Any takers?

D&O Policies - Entity vs. Insured Exclusion - Bankruptcy Carvebacks

One of the finest sources of useful and practical information about D&O, E&O and professional liability policies – among other insurance and risk management topics – is the International Risk Management Institute (“IRMI”).* I particularly enjoy their D&O MAPS updates (paid subscription required) prepared periodically by Bob Bregman. A recent update on April 29 contained the “D&O Practice Tip” column entitled Improve Bankruptcy Carve-Back of the Insured versus Insured Exclusion.

It should be noted that what used to be a much broader insured versus insured exclusion has today evolved in most policy forms or by way of endorsement into an entity vs. insured exclusion, i.e. one which will preclude coverage for any claim brought by or on behalf of an entity insured under the policy against any other insured entity or an insured person. This has eliminated the need for many carve-backs, but a few key ones remain for the protection of the insureds such as for claims brought by any bankruptcy trustee, receiver, liquidator, conservator, rehabilitator or similar official or legal entity. While an argument can be made that any claim brought by a committee of secured or unsecured creditors is not within the scope of the exclusion, the column wisely suggests that it would not hurt to add these committees to the bankruptcy carve-back.

The column suggests that an ideal carve-back to the exclusion from the insureds’ perspective might read as follows:

            This exclusion does not apply to 

  1. a Claim by the Examiner, Trustee, Receiver, Liquidator, or similar official appointed for the Insured Organization (or any assignee thereof),
  2. a Claim by a Creditor Committee, Bondholder Committee, Equity Committee, Noteholder Committee, or similar committee established for the Insured Organization (or any assignee thereof), or
  3. a Claim by the Insured Organization as Debtor-in-Possession (or any assignee thereof), provided that such Claim is made without the solicitation, assistance, or active participation of any Director and/or Officer.

Like any good lawyer, I can suggest alternative wording, but I have little conceptual quarrel with (1) and (2). It is (3), however, that troubles me from both an insured and insurer perspective, particularly when coupled with the column’s suggestion that the policy definition of insured organization should not include the company as a debtor-in-possession.**

When a company operates as a debtor-in-possession (“DIP”) under the Bankruptcy Code it continues to manage its own affairs without the supervision of any outsider such as a trustee. That is not to say, however, that it is not under considerable supervision from the bankruptcy court itself. For purposes of D&O insurance coverage by virtue of the Company definition, the DIP is the Company. Nonetheless, there is a wealth of bankruptcy jurisprudence as to whether the DIP is legally the same as the pre-petition entity.

Brokers typically insist on including it in the Insured Organization definition so that the DIP continues to enjoy any entity coverage that the policy may provide and that entering into DIP status does not trigger any “change in control” condition in the policy. On the other hand, precisely because the DIP is in a real sense the same as the company, insurers will not want to carve it back from the insured vs. insured exclusion lest they run the risk of de facto converting a liability policy to first party coverage or potentially exposing themselves to collusive claims. Indeed, the court decision that triggered the concerns expressed in the D&O MAPS column, Biltmore Assoc., LLC v. Twin City Fire Ins. Co., 572 F. 663 (9th Cir. 2009), recognized the legitimate interests of the insurer in avoiding these situations. Biltmore held that an assignee of the DIP stands in the shoes of the DIP, and its claims are thus barred by the I v I exclusion because the DIP is in turn the same entity as the original company that became a DIP. This was a well-reasoned decision of a respected federal appeals court and, with my admitted bias, I have no quarrel with it.

Thus, I would be reluctant to recommend to a client, whether insured or insurer, that they amend the definition and exclusion in the way that my friends at D&O MAPS suggest. Of course, insureds should welcome the carve-back in (3) above, so long as it is not coupled with a removal of the DIP from the definition of Insured Organization. Insurers, however, should strongly resist this for all of the reasons discussed above.

I welcome creative ideas and suggestions from the readership for a potential resolution.

 _________________________

*I highly recommend that readers visit the IRMI website at www.irmi.com to learn more about the organization and what it offers.

**I suggest that the “provided that” clause at the end of (3) is not necessary if the exclusion itself is of the entity vs. insured variety and does not apply to claims brought by or on behalf of any insured person.

Claims-Made and Reported Insurance Policies - How Not To Report A Claim

Countless insurance coverage disputes can be avoided by simply reporting claims timely and in accordance with the notice provisions found in the insurance policy.  Yet, some broker personnel and insureds seemingly fail to read the rather explicit policy language or deliberately choose to ignore it.

A recent federal court decision in New Jersey illustrates the peril of failing to comply with a policy’s claim notice provision. Atlantic Health System, Inc. v. National Union Fire Ins. Co. of Pittsburgh, PA, 2011 U.S. Dist. LEXIS 39797 (D. N.J., April 11, 2011).  A Notice of Appeal to the Third Circuit was filed in this case on April 20, 2011.

The facts in this case are rather straightforward.  The insured first became aware of a draft complaint to be filed against it in February 2004, and suit was ultimately filed in April 2004.  They reported the matter, which is not disputed to constitute a claim, in July 2004 during a claims-made and reported D&O policy effective May 1, 2004 – 2005.  The insurer denied coverage as the claim was not first made against the insured during the policy period. Going back to the drawing board, the insured one month later in August 2004 tendered the claim under the policy in effect for the period May 1, 2003 – 2004.  This time, the insurer denied coverage because the claim was not timely reported within that policy’s 30-day reporting extension, which expired on June 1, 2004.

Coverage litigation was initiated by the insured, initially in a New Jersey state court and ultimately removed by the insurer to the federal District Court.

The Court upheld the denial under the 2004-2005 policy period and then turned to the insured’s argument that there was timely reporting under the 2003-2004 policy by virtue of the fact that the underlying litigation was disclosed in a renewal application for the 2004-2005 policy, which was received by the insurer’s underwriters during the 2003-2004 policy period.  The Court, however, noted that the policy clearly required written notice to the claims department at an address different from that of the underwriting personnel and that the reporting deadline was indisputably 30 days after policy expiration and the claim was not sent to the claims department by the insured until July 2004.

The Court observed that litigation matters reported as part of a renewal process should not constitute notice of a claim for coverage under the policy and that the underwriters had no reason to have to pass such on to the claims personnel.  Indeed, the Court briefly noted that underwriters need to know of litigation to alert them of matters that should be excluded.

A renewal application sent to an underwriter for the purpose of identifying possible claims for the exclusion of coverage from a future policy period ostensibly serves a different purpose than a notice-of-claim, which seeks coverage under an existing policy. (emphases added)

In this case there was continuous coverage with the same insurer from May 1, 2000 through May 1, 2005 and many brokers and policyholder lawyers will argue that this should be a classic case of “no harm, no foul” because the claim was both first made and first reported during this continuum.  The Court, however, properly recognized that there were separate contracts for the two periods in which the claim was first made (2003-2004) and properly first reported (2004-2005).  To fall within the scope of the insuring agreement, both events must take place during the same policy period.*

*Many commentators use the term “claims made and reported” to refer only to policies where both events must take place during the policy period. Most policies over the past several years have evolved to contain some extension period for reporting ranging from 30 days (as here) to as many as 100 days.  Nonetheless, the reporting deadline is fixed with a bright line and operates similarly to the so-called true claims made and reported policies, as opposed to “pure claims made” policies that typically require only that claims be reported as soon as practicable.

D&O - The Rapid Emergence of Securities Fraud Class Actions and Derivative Claims against Chinese Companies

Almost every D&O commentator and source of information on emerging trends has noted that over the past twelve (12) months there has been a remarkable growth in securities fraud litigation against U.S. companies that are subsidiaries or affiliates of companies incorporated in the People’s Republic of China (“PRC”).

Much of the current wave of litigation in the U.S. against PRC companies arises from initial public offerings (“IPO”) as a result of a so-called “reverse merger” wherein a privately-held operating company in the PRC is acquired by a public shell entity in the U.S., which is also under control of the owners of the PRC operating entity. The owners and executives of the private entity assume voting and operational control over the combined entity resulting from the reverse merger. This transaction enables the private entity in the PRC to skirt the registration requirements of the Securities Exchange Commission (“SEC”), which apply only to the public shell in the U.S. While PRC companies are not the primary users of the reverse merger mechanism, they do constitute about 25% of such transactions over the past three years. Plaintiffs in the U.S. litigation typically allege inadequate disclosure because the only publicly-audited company is the PRC shell and the U.S. auditors rely heavily on auditors of the operating company in the PRC or other sources without any independent analysis. As a result, the private operating component allegedly escapes any heightened scrutiny from U.S. auditors. Since these suits only began to emerge in significant numbers about a year ago, few, if any, have been disposed by settlement or dismissed by motion.

One recent case that has drawn both a securities fraud class action and a derivative suit in the U.S. is that involving Puda Coal, Inc. In addition to the fraud allegations in the class action, the derivative suit alleges blatant breaches of fiduciary duty by the Puda board and in particular its chairman, Ming Zhao, in that Mr. Zhao was permitted to sell off the operating unit in the PRC to a private equity firm without the knowledge of the U.S. shareholders. Without the operating entity, which was a coal processor, the U.S. shell was relatively worthless.

Before turning to the insurance coverage issues, it is important to note that, although PRC companies have been in the forefront of this wave of securities litigation arising from reverse merger transaction, this by no means suggests that all such companies doing business in the U.S. are part of a fraudulent scheme. Indeed, at this early stage of the litigation process, it remains to be developed in many of these cases whether what may appear on its surface to be an intentional and knowing fraud and scam on the investing public, may in fact be the somewhat less culpable genre of reckless behavior due to unfamiliarity with corporate governance structures and desirable transparency in the U.S. Also, one need look no further than the debacles of recent years in Enron, Worldcom and countless others to appreciate that we have our share of Ponzi schemers and other home-grown fraudsters.

Although insurance coverage issues will vary from claim to claim, just as they do in other securities class actions and derivative suits, there may be issues in these cases peculiar to the fact that in these actions you might have claims asserted against the directors and officers of both the U.S. and PRC companies. There could also be overlapping boards with individuals holding insured positions in both companies. Complicating things even further may be the fact that the operations in the PRC may be insured under a policy issued there, while the U.S. company is insured by policies issued in the domestic U.S. market. The coverages may overlap and wordings may clash, giving rise to ambiguities and ultimately disputes.

As stated above, this genre of claims is still in an embryonic stage. Time will tell how liability, causation and damages, as well as coverage, issues emerge and are resolved.

D&O - Can a Reservation of Rights Letter Create a Contract Between Defense Counsel and Coverage Counsel or Insurer?

R. Allen Stanford, the alleged Ponzi schemer, and the various entities he wholly or partially controls has certainly generated a number of interesting coverage disputes as a result of the various litigation and claims brought against him and others in his companies.

One of the latest involves not Mr. Stanford, but rather one of a series of law firms he at one time retained to defend his interests in the pending actions against him. The Sydow Firm, LLP was one such firm that, after apparently not being paid by Stanford, attempted to proceed directly against his primary D&O and E&O insurer and its coverage counsel. The Sydow Firm, LLP v. Akin Gump Strauss Hauer & Feld and Certain Underwriters of Lloyd’s of London, USDC. S.D. Texas, Case No. H-10-5072.

The firm sought recovery for $652,818.70 in unpaid legal fees and disbursements from both the insurer and the coverage counsel on the basis of breach of a contract created by a reservation of rights letter issued by counsel on the insurer’s behalf and also under a theory of quantum meruit, i.e. services were accepted from the law firm without compensation. In this action, the firm made no claims against the policy itself because jurisdiction over these claims was retained by the federal court in the Northern District of Texas for Stanford’s coverage dispute with his insurers and other Stanford-related actions.

The Court here in its Memorandum and Order of February 25, 2011, while not stating that the reservation of rights letter in and of itself could not constitute a contract, held that it is not a separate contract creating rights not contained in the insurance policy. The Court also held that there was no basis for a quantum meruit recovery against the insurer’s coverage counsel because it was not the recipient of any legal services. The same reasoning applied to the claims against the insurer because services were provided to Stanford, not the insurer.

The decision here by Judge Nancy Atlas seems to this observer to be an obvious one based upon the facts and law. Both insurers and their erstwhile coverage counsel can now rest easier, if indeed there was ever a due cause for alarm.

Directors May have More Personal Liability than they Think

This is the first guest blogger post on The D&OandE&OMonitor site and we are pleased to give that honor to my north of the border friend, Wency Keast. Wency is a Vice President at Directors Global in Toronto and most knowledgeable in international D&O issues and, in particular, those in Canada. The article first appeared in in the “Eyes on Governance”, an EMagazine for the members of the Institute of Corporate Directors ( Canada ), in the May 2011 issue. Wency’s observations are remarkably applicable not only to directors’ liability in Canada, but also under U.S. law and regulation as well. Wency can be reached at wency.keast@directorsglobal.com or 416.241.6100 x 203.

Although most directors are aware that their liability with respect to the execution of duties on behalf of the corporation is a personal risk, the impact of this personal liability is often placed on the back burner as day to day activities take precedence. Today, I request you join me for a few minutes to examine the personal risks and some consideration of the remedies that are available to you in the execution of your duties as directors of corporations. In the mitigation of some of the personal risk, you can draw comfort from the protections afforded to you through the governing acts of the jurisdiction where the company is incorporated, the bylaws of the corporations, and the insurance purchased by the corporations on whose boards you serve.

Governing acts generally permit corporations to indemnify and advance defence costs to directors for certain types of loss. Corporations are required to indemnify their directors, only as provided in the bylaws or certificate of incorporation. Hence the By-Laws of the Corporation that you serve on must contain language that allows the corporation to advance defence costs to you in the broadest terms that are possible in law. In derivative actions, the corporation may make an application to the courts to grant you indemnification or advancement of funds to defend yourself in suits brought against you by the corporation or any other entity to procure a judgement in favour of the corporation. The Act makes a provision for your right to indemnity from the corporation, provided you have been exonerated by a “court or other competent authority” (Ref: CBCA Subsection 124). You would have expended your personal assets in your defence before seeking such reimbursement.

In all circumstances, such indemnification or advancement of costs cannot be made to you unless you “(a) acted honestly and in good faith and with a view to the best interests of the corporation, or, as the case may be, to the best interests of the other entity for which [you] acted as director or officer or in a similar capacity at the corporation’s request and (b) in the case of criminal or administrative action or proceeding that is enforced by a monetary penalty, [you] had reasonable grounds for believing that [your] conduct was lawful” Ref: CBCA, Subsection 124, Limitation.

These provisions should allow for a certain amount of your peace of mind.  To disturb this tranquility, what if your corporation was not forthcoming in advancement of costs in your defence or in indemnification of costs already incurred? What if your corporation was insolvent?  If the corporation purchased insurance to transfer the risk do you know how to access this insurance? Do you have obligations to engage the insurer in your defence in order to be able to collect insurance? Do you know and understand the language of the Insurance Contract purchased by your corporation? Under what circumstances will the Insurer exclude coverage for suits brought against you? What factors make the policy null and void? Under what circumstances can the Insurance Contract be rescinded in its entirety, or against specific directors? Is the limit available for your defence shared by others, e.g. other directors, officers, the corporation itself, and other management?  Are the risks insured by the contract widened to include other liabilities, e.g. Employment Practices Liability for the corporation and its management? What is an adequate limit of insurance for your personal comfort zone and does your corporation carry this insurance solely for your benefit? These are areas that you must investigate. In most corporations, the purchase of insurance resides with the CFO or the Risk Manager, both good areas for the delegation of corporate risk – but yours is a personal risk.

The purchase of  Directors’ and Officers’ Liability Insurance is often corporate-centric, with corporations requiring coverage for the reimbursement of indemnification provided to directors and officers and for coverage for suits brought against the corporation itself by shareholders and others. These liability policies are not uniform in content and scope. Some features to look for are Dedicated Limits for Directors and Officers, Dedicated Limits for Independent Directors, a Priority of Payments Endorsement in favour of the Directors and Officers, and the broadest possible amendment or, preferably, the total removal of the Insured vs. Insured exclusion.  The Insured vs. Insured exclusion would not cover you should the corporation take action against you, or other directors and officers initiate action against you.  Policies are available for the sole protection of the Directors and Officers of a corporation – Side A.  This is an important consideration.  Today most Directors’ and Officers’ policies will cover the director following the bankruptcy of the corporation for certain statutory liabilities which are unique to directors. Even though insurance has been purchased, issues that remain include: Are the limits of liability unimpaired or adequate at the time when you need coverage? Is the policy still in place, e.g. was it cancelled for non-payment of premium?  Was coverage bound with an unfulfilled subjectivity?

A few Insurers offer a Personal Director’s Liability policy; however, at this point in time, these are follow form on underlying policies and serve primarily as an Excess Policy, or as a Difference in Conditions policy in the event of the insolvency of the corporation, there could be features in the programme that allow the director access to a defence where the insurer would be subrogated to the rights of recovery of such costs from the corporation.

The corporation is a separate legal entity and individuals who serve the corporation are insulated from personal liability for wrongful acts committed by the corporation   however, Federal and Provincial laws pierce the corporate veil and impose substantial personal liability on directors - it is estimated that there are approximately 100 such laws that apply in Ontario alone! Of significance are laws pertaining to employment, taxation, and the environment.

Where a corporation is unable to meet certain obligations, Statutory Law makes directors personally responsible for unpaid wages, vacation pay, corporate pension plan contributions, unremitted health insurance premiums and health taxes, source deductions e.g. Canada Pension Plan and Employment Insurance, obligations imposed under the Occupational Health and Safety Act, corporate obligations imposed on the individual Directors under the Income Tax Act, Sales Tax, Fuel Tax Act, Gasoline Tax Act, Federal Customs Act, the Canadian Environmental Protection Act.

Legislation allows for “joint, several, and solidary” liability against Directors with respect to many corporate obligations that are imposed on the Directors by statute. You could be the individual charged with the shortfall of unpaid wages etc.  You would be out of pocket for all of the upfront defence costs and judgements. In this situation, you would have the right to receive proportionate payment in reimbursement from other directors on the board, should a director be unable to meet the mandate, you would have met his/her proportionate payment as well as your own. 

Fiduciary responsibility imposed on directors is onerous because the stakeholders have granted and directors have accepted discretionary and unilateral power over the corporate holdings. Stakeholders are vulnerable to the effect of the exercise of this discretionary and unilateral power. They rely on their directors to exercise this power with prudence and diligence in the design and implementation of the governance of the corporation, the selection of competent officers to whom they delegate certain powers and duties, and in their continued oversight of the governance of the corporation’s affairs. To fulfil the mandate directors must, at all times be mindful of their duties of loyalty, of care, and be active in the design, oversight and enforcement of good governance on behalf of the corporation.

In summary, directors incur more personal liability than they think they do! This personal liability continues to be extended by legislation. It is important to make time for ensuring your personal protection, for continuing your education in respect to changing corporate legislation, and keeping up-to-date on what constitutes good governance. Your obligation to protect your personal assets, your family’s wellbeing, and the corporation’s assets and its competitive edge is a fine balancing act – don’t underestimate the importance of maintaining the balance.

Directors’ action: 

  • Take personal responsibility for the protection of your assets, not only those that belong to the corporation(s) you serve.
  • Examine the Corporate By-Laws, make amendments if necessary, to ensure that you receive the broadest possible protection from the corporation.
  • Ensure that you are familiar with the governing legislation and keep up with legislative changes that affect you.
  • The purchase of insurance in this regard is the protection of your personal liability and assets, get involved in ensuring that the programme is the best available for you.
  • Always act with the key principles of loyalty, diligence, and care in the performance of your duties to the corporations you serve.

Much Ado About Nothing or Forewarned is Forearmed: Judge Rakoff Decides SEC v. Vitesse Semiconductor Corp., (SDNY, March 21, 2011)

This decision has garnered much attention in both legal and insurance circles over the past two weeks.

What has caught everyone’s attention is not so much the decision itself – a somewhat ordinary approval of a proposed consent judgment between the SEC and a corporation and certain of its officers – but rather the dicta of Judge Rakoff expressing concern over allowing the defendants to neither admit nor deny liability in entering into the consent judgment. The settlement underlying the consent judgment was in the amount of $3M and was likely not insured under any D&O policy because it constituted a civil penalty and/or represented disgorgement of ill-gotten gain. An educated guess, however, is that it may well have been indemnified or indemnifiable by the corporation. Hence, the settlement at this amount could have been very attractive to the corporation and the individuals.

Despite Judge Rakoff’s somewhat understandable harangue over the liability disclaimer issue, he did approve the settlement and consent judgment. Nonetheless, he clearly indicated that he might not approve one of these again under similar circumstances. Undoubtedly, other courts may take note of this issue as well, but it is purely speculative and premature to conclude that SEC settlements without any admission of liability will now go by the wayside. Judge Rakoff contrasted what he perceived as the SEC’s unwarranted complicity with defendants in these cases with the posture of the Department of Justice (DOJ) in similar situations. However, it should be noted that the DOJ operates in the sphere of criminal charges, not civil wrongdoing. Is pleading to a lesser criminal charge than arguably could have been proven by the DOJ any less disingenuous than these liability disclaimers in civil matters before the SEC?

Putting aside whether or not this may be a harbinger of a change in practice, I would certainly agree with the commentators, who have opined that requiring an admission of liability will have a chilling effect upon the willingness of defendants to settle with the SEC. If they do proceed to settle with the SEC with such an admission of liability, it could certainly have an adverse impact on any pending shareholders and other investor litigation involving the same operative facts as before the SEC and where the monetary exposure is likely much higher.

All of this makes for an ever stronger case for insureds and brokers to be sure that they are procuring policies on the market with the narrowest conduct exclusions so that an admission of liability before the SEC does not automatically engender a denial of coverage. Optimal exclusion wording would be substantively similar to the following.

The Insurer shall not pay the portion of Loss in connection with any Claim that is for:

(1) deliberately fraudulent, or deliberately criminal act or deliberately fraudulent or deliberately criminal omission or any deliberate violation of any statute, rule, or law by an Person; or

(2) profit or remuneration gained by any Insured Person to which he or she is not legally entitled.

provided that the foregoing exclusions in this section are determined by a final adjudication, after exhaustion of all appeals (including petitions for rehearing), solely in the underlying Claim and shall not be applicable to that part of Loss, which is comprised of Defense Expenses.

Neither the intent, knowledge nor Wrongful Act of any Insured Person or the Company shall be imputed to any other Insured Person to determine the application of the exclusions set forth in this section. (my emphasis)

Using this wording should obviate any argument that a consent judgment entered into with the SEC could operate to preclude coverage for any parallel private securities class action or derivative litigation.

Professional Liability Insurer Loses Benefit of Policy's Mandatory Arbitration Clause: Reasons to Reconsider Benefits of Arbitration

In a recent Missouri appellate decision, the Court invalidated a mandatory arbitration provision in a professional liability insurance policy leaving the parties to resolve their coverage differences by other means despite the clear wording of the policy. Sturgeon v. Allied Professionals Ins. Co., Case No. ED 94605, Missouri Court of Appeals (Decided March 8, 2010).

The underlying dispute was one of coverage under a professional liability policy issued to a Missouri licensed massage therapy practice. The underlying claim was brought in Missouri, which was the location of the insured risk, and the insurer was a risk retention group domiciled in Arizona and conducting business in California. The arbitration provision was mandatory as to all disputes arising under the policy and provided for an arbitration to be venued in Orange County, California.

The Court invalidated the provision based upon Missouri law and public policy that prohibits mandatory arbitration provisions in insurance policies. The insurer argued unsuccessfully that the Missouri law should not apply because (i) the Court found that Missouri had the greater interest for purposes of a conflicts of law analysis and declined to enforce the policy’s California choice of law provision, (ii) Federal Arbitration Act (FAA) preemption of Missouri law in this area was barred by the McCarran-Ferguson Act which otherwise exempted insurers from federal antitrust law, and (iii) the fact that the insurer was actually a risk retention group did not result in the federal Liability Risk Retention Act (LRRA) operating to provide it with protection that an insurer would not enjoy.

Arbitration is not necessarily a panacea for insurers to efficiently resolve coverage disputes in a favorable forum. While Sturgeon is illustrative of reasons why in at least one jurisdiction a mandatory arbitration provision may not be enforced, there are several other issues and factors that an insurer should consider even where arbitration may be somewhat voluntary.

  • Arbitration may be as costly, as perhaps even more costly, than litigation for several reasons.
  1.  
    1. There can often be formal document and deposition discovery in arbitration with preliminary and final hearings similar to court conferences and a trial on the merits.
    2. Arbitrators are typically compensated on an hourly basis at rates typically in excess of what an insurer’s own lawyers are being paid. Generally, the insurer will pay for its own party-appointed arbitrator plus half the fees of the neutral in the quite common three-member arbitration panel.
    3. Court costs are typically minimal, but administrative costs of the American Arbitrative Association (AAA) or similar administrator can be significant.
  • Arbitration might, but not always, be a quicker process than litigation before a court with a crowded docket, including criminal matters that must take precedence because of constitutional rights to a speedy trial.
  • Except in rare circumstances, there is no appeal from an arbitral award.
  • While not an issue in Sturgeon, many courts may look unfavorably, based upon equitable considerations, upon enforcing an arbitration provision that forces a local business to arbitrate in another state. Here the Missouri insureds, apparently a small business and its employed masseuse, would have had to retain counsel and arbitrate over a thousand miles away in California.

Perhaps for many of the above reasons, as well as marketability, the landscape is currently somewhat varied as between insurers that have arbitration clauses in their professional liability policies and those that do not.

Supreme Court Upholds Ninth Circuit Decision Re Materiality in 10b-5 Cases in Matrixx Initiatives, Inc. v. Siracusano

On March 22, 2011, the Supreme Court of the United States decided Matrixx Initiatives, Inc. v. Siracusano, No. 09-1156, 563 U.S. ___ (2011), holding that plaintiff investors had satisfied both the materiality and scienter requirements under Rule 10b-5 in their class action pleading. We will review and analyze this decision in greater detail in the April issue of our Specialty Lines Advisory.

In brief summary, the matter before the Court was a securities class action against a pharmaceutical company which sold a well-known cold remedy called Zicam. The key allegations of securities fraud asserted by the plaintiff investors concerned failure to disclose material information regarding the potential harmful effects of Zicam, particularly that it could cause anosmia, a loss of the sense of smell. It was alleged that Zicam was perhaps the company’s most important product, accounting for about 70% of the company’s sales, and that the company was aware of several cases of anosmia among Zicam users.

The United States District Court for the District of Arizona had granted the defendants’ motion to dismiss applying the pleading requirements of Section 10 (b) of the Securities Exchange Act of 1934 and SEC Rule 10b-5. In particular, these requirements state that plaintiffs must allege in their Complaint,

• A material misrepresentation or omission of fact;

Scienter;

• A connection with a purchase or sale transaction in the securities at issue

• Transactional and loss causation; and

• Economic loss.

The district court held that materiality could only be met by establishing that there were a “statistically significant” number of adverse events known to the company, which were not disclosed to the market. In reversing the lower court on the requirement of materiality, the Ninth Circuit applied the standard set forth in the Supreme Court decision in Bell Atl. Corp v. Twombly, 550 U.S. 544 (2007), which arose from an underlying antitrust action, not securities fraud. Twombly holds that dismissal is inappropriate unless the pleading is so deficient as to fail to state a claim to relief that is plausible on its face, as opposed to being merely conceivable.

In upholding the Ninth Circuit, the Supreme Court noted that disclosure of all reported adverse events was not required. While something more than the “mere existence” of these events is necessary, the Court stated that “statistical significance” was not a necessary threshold.

With regard to the scienter requirement, the Court, like the Ninth Circuit, held that a complaint can survive dismissal only if a reasonable person would deem the inference of scienter cogent and at least as compelling as any other inference. In other words (but not those of Justice Sotomayor, the avid Yankee fan who wrote the opinion for a unanimous Court), and to use a baseball analogy, a tie goes to the plaintiff runner if his foot hits the bag at the same time as the throw is caught by the defendant fielder at the base.

Matrixx is a win for the plaintiffs bar, but really breaks no new ground in reaffirming the Ninth Circuit below. As such, it is not a cause for those involved in D&O insurance to fear any heightened or new exposure, or to warrant any changes in the state of the art policy wordings on the market today.

The Foreign Corrupt Practices Act (FCPA), D&O Insurance and the People's Republic of China - Oh, My!

All three of these subjects sometimes scare those who know little about them, at times rightfully so and at others without just cause. Recently, developments with respect to each have raised some common issues.

First, let us turn to the Far East.

On February 25, 2011, the People’s Republic of China (“China”) enacted a law providing criminal sanction for the payment of bribes to government officials outside* China and to officials of international public organizations. The law is slated to take effect on May 1, 2011. The new law appears to provide only for imprisonment and not for awards of any fines, penalties or other monetary amounts. Prison terms can range up to a maximum of ten (10) years dependent upon the amount of the bribes at issue.

Although much remains to be seen as to how this new law will be implemented and enforced, the law should definitely have an impact on companies doing business in China because it specifically applies to a joint venture between a Chinese and non-Chinese company formed pursuant to Chinese law. At least at this juncture, it may be that this new law may be as major a cause of concern to foreign companies as is the case with the FCPA in the U.S. or similar laws in the U.K. and Canada for companies with shares traded on their securities exchanges or even merely doing business there, as the case may be.

Second, earlier this month Chartis, a major D&O insurer, introduced a new insurance policy product called Investigation Edge™. Based upon a review of the policy language and some of the Chartis promotional literature, the policy is intended to provide coverage to a company, but not for any of its directors or officers,** for various investigations undertaken by securities law enforcement authorities. The coverage is limited essentially to the costs of defending against or responding to an investigation, and specifically does not include coverage for any fines, penalties or other amounts that may be awarded or have to be paid in a settlement.

With regard to FCPA and similar violations, however, the new policy form contains the following exclusion.

The Insurer shall not be liable to make any payment for Loss in connection with any Investigation . . . of any actual or alleged bribery or violation of the U.S. Foreign Corrupt Practices Act of 1977, U.K. Bribery Act 2010, Canadian Corruption of Foreign Public Officials Act or any similar state, local or foreign law, rule or regulation.

Chartis marketing material notes, however, that optional FCPA coverage with a sublimit of $5M can be purchased.

Most D&O policies contain coverage for FCPA fines and penalties and the costs of defending against the investigations by the Securities Exchange Commission (“SEC”) or Department of Justice (“DOJ”) with language similar to the following found in Chartis’ Executive Edge™ product. The language is usually contained in the Loss definition in the policy form or added thereto by way of endorsement, and is limited solely to directors or officers of the company, but not the company itself.

. . . civil penalties against any Insured Person pursuant to Section 2 (g) (2) (B) of the Foreign Corrupt Practices Act, 15 U.S.C. § 78dd-2(g) (2) (B).

Unfortunately, the $5M limit will prove woefully inadequate in a barnburner of a FCPA investigation such as that ongoing against Avon Products where the company has disclosed that its own costs have reached approximately $100M.***

Nonetheless, the Chartis product is innovative and begs a number of questions as to what may ultimately follow.

  • Will other insurers introduce similar products and, perhaps more importantly, be willing to write layers of excess insurance over it?
  • Will Chartis consider increasing the $5M FCPA sublimit?
  • Will other insurers incorporate this new investigation coverage for the entity into their existing D&O forms? At what premium?
  • What is left to potentially cover? FCPA civil penalties awarded against a company? Costs of remediation or future compliance that is presently not covered?****

If all or most of these questions are answered affirmatively by many insurers, there may be a number of unintended consequences. As a prime example, little, if any, of this is of real benefit to independent directors. Corporations and brokers will have to consider buying significant additional excess limits and/or separate independent director liability (IDL) coverage to protect against the potential dilution by expanding coverage.***** Also, from the perspective of excess insurers, their attachment points will be more readily within reach with expansive underlying coverage and they will need to more closely monitor developments and expenses paid in underlying litigation and investigations in order to protect their interests.

____________

*It should be noted that so-called domestic bribery, i.e. bribes paid to Chinese government officials were already actionable prior to the enactment of this new law.

**Coverage for investigations targeting such individuals is already provided under most D&O policy forms available in today’s market.

***It was also reported on March 12 that a British lawyer was ordered to pay an amount of nearly $150M under the FCPA for bribery activity on behalf of Halliburton to Nigerian government officials. While D&O policies have the coverage enhancements discussed in this post, such broadening of coverage has been largely absent in the area of lawyers professional liability insurance.

****Despite the express lack of coverage for these costs in many policies, these types of costs were recently reported to have been borne by D&O insurers as part of a settlement of derivative litigation against Pfizer.

*****On top of all of this is the release within the last few days of the Cornerstone Research data on 2010 settlements in securities class actions. While mean settlement values dropped slightly from $37.2M in 2009 to $36.3M in 2010, the median settlement value increased drastically by over 41% to $11.3M. Settlements now often rip through many layers of excess insurance when coupled with covered defense and investigative costs.

The "Other Insurance" Clause In D&O Policies - When It Applies And When It Does Not

In this month’s issue of Tressler’s Specialty Lines Advisory, we summarized an important decision from the New York Court of Appeal (the high court in New York) holding that the “other insurance” clause in a D&O policy rendered it excess to a CGL policy for the same insured homeowners association because both policies had in common coverage for allegations of “injurious falsehood”.* Fieldston Property Owners Ass’n, Inc. v. Hermitage Ins. Co. (view March 2011 Specialty Lines Advisory here)

Fieldston was decided on February 24, 2011. Fifteen days earlier, a federal court in Maryland decided another D&O vs. CGL insurance dispute centered on application of the policies’ other insurance clauses and relying in part upon a lower court decision in Fieldston that was ultimately overruled by the Court of Appeal. Federal Ins. Co. v. Firemen’s Ins. Co. of Washington, DC, 2011 WL 503185 (D. Md. February 9, 2011).

In the Federal case, the common insured was a home repair and handyman services company that was contracted by a homeowner to do a major renovation and additions project. In an arbitration brought by the homeowner, it was alleged in an amended complaint document that the insured failed to perform work which they had been contracted and paid to perform and that the work that they did perform was not done properly and/or up to industry standards. The CGL insurer disclaimed coverage on the basis that its coverage was limited solely to claims for bodily injury or property damage. The D&O policy, which covered the insured company and apparently did not contain any professional liability exclusion, broadly covered “wrongful acts”, i.e. any error, misstatement, misleading statement, act, omission, neglect or breach of duty.

Supplementing the allegations in the formal complaint document, however, the homeowner had introduced into evidence a letter listing numerous incidents of allegedly sustained property damage. This letter convinced the Court that there was in fact applicable CGL coverage, but nonetheless found the other insurance clause in the D&O policy inapplicable. Unlike in Fieldston where there was a common covered risk in the nature of “injurious falsehood”, the Federal court hound that the D&O and CGL insurers covered entirely separate risks. Thus, instead of the D&O insurer walking away with a complete win as in Fieldston on the basis of their excess other insurance clause, here the best that they could achieve was a ruling that the CGL insurer must “contribute” to defense costs.**

Fieldston and Federal are not inapposite, but rather can readily be reconciled. In Fieldston, both policies covered the common risk of injurious falsehood. In Federal, although not stated so explicitly by the Court, the CGL insurer covered the property damage risk and the D&O insurer apparently covered everything other than property damage.

 

* The other insurance in this D&O policy provided as follows.

If any Loss arising from any claim made against the Insured(s) is insured under any other valid policy(ies) prior or current, then this policy shall cover such Loss, subject to its limitations, conditions, provisions, and other terms, only to the extent that the amount of such Loss is in excess of the amount of such other insurance whether such other insurance is stated to be primary, contributory, excess, contingent or otherwise, unless such other insurance is written only as specific excess insurance over the limits provided in th[is] policy.

This “excess” language is fairly typical in D&O policies.

 

** This is typically the result when the other insurance clauses in the respective policies are found to be inapplicable or mutually repugnant. Both policies are treated as primary insurance and contribution may be had on a pro-rata basis either based upon the respective policy limits, time on the risk or some other method of calculation.

Community Bank D&O: The Crisis Cometh and Insurers are Ill-Prepared

Closed Sign.jpgAlthough the current wave of bank failures began in earnest in 2008 and about 325 institutions have failed and been shuttered by the Federal Deposit Insurance Corporation (“FDIC”) to date, the proverbial nasty stuff has yet to hit the fan.

Thus far, the FDIC has sued the directors and officers of only two of the failed banks and those suits did not come until 2010.  Rest assured, however, by way of a very educated guess that, with regard to the other 323 institutions, their executives have already received well-crafted “threatened claim” letters, which in turn have been passed on to their respective D&O insurers as a notice of circumstances that may give rise to a claim.  Thus, the coverages should be locked in and await only the formal filing of suit.  It should be noted that, although the FDIC has been relatively quiescent, private investors have already filed thirteen (13) class action lawsuits in federal courts and there are likely many others filed in state courts.

The last banking crisis of this magnitude was the so-called “S&L crisis” from about 1986 through 1992 when over 700 institutions, mostly savings and loans, failed.  At that time, the principal regulator was the Federal Savings and Loan Insurance Corporation (“FSLIC”), which brought numerous claims against directors and officers and parallel coverage actions against their insurers.

The major coverage issues then involved the insured vs. insured exclusion, as the FSLIC was suing as a successor in interest to the failed institution, and a regulatory exclusion specifically precluding coverage for claims brought by the FSLIC and other federal or state banking regulators.  Years of coverage litigation ensued and, while insurers were generally unsuccessful in having the insured vs. insured exclusion upheld, they ultimately enjoyed widespread judicial success in enforcing the regulatory exclusion.

What happened in the interim between the end of the S&L crisis and the looming crisis now facing community banks and their D&O insurers?

Most importantly, the insurers became complacent and largely dropped the regulatory exclusion from their policies despite its judicial validation. 

Will the number of claims increase in 2011 and coming years?  Consider the following.

  • Well over 800 institutions are currently identified as “problems” by the FDIC.  Historical data has shown that such institutions rarely improve in their financial condition.  In fact, over 80% ultimately fail.
  • Is the FDIC battle-ready?  In 2010, the agency hired 1,500 new employees and had a 55% budget increase.  You be the judge.

In any case where effective notice of circumstances has already been given to incumbent insurers, it may be too late to do much to avoid or minimize the exposure.  In other instances where new insurers may be coming on risk, careful consideration must be given to reintroducing the regulatory exclusion and eliminating prior acts coverage for troubled banks.  Yes, this vitiates the core coverage when it is most needed, but the alternative is to leave these banks and their directors and officers completely without coverage. 

It is not a pretty picture for community bank directors and officers, particularly those that now serve on failed or “problem list” institutions.

Settling The Underlying Claim While Continuing The Coverage Dispute

money, settlement blog14.jpgVery often in complex claims, such as securities class actions under D&O policies, an opportunity to settle the underlying claim arises while a number of coverage issues remain open that may ultimately result in no or reduced coverage for the settlement amount.

Many jurisdictions have well-developed case law governing whether and how an insurer can proceed to fund the settlement amount and then litigate or continue to litigate the coverage dispute with the insureds.  While it might appear fair on its face to simply have the insurer fund the settlement and then proceed to litigate coverage with the insured, the practical ramifications of so proceeding are not so fair and simple.

For example, this solution affords little peace to an insured, knowing that it does not quite have this exposure resolved and behind it.  From the insurer’s point of view, what if the insured ultimately becomes insolvent or are individuals or entities of limited financial means?  A coverage victory down the road then might be quite Pyrrhic.

In California, the leading case in this area is Blue Ridge Ins. Co. v. Jacobsen, 25 Cal. 4th 489 (Cal. 2001).  Blue Ridge essentially holds that an insurer may seek recoupment of non-covered payments that it contributed to a prior settlement, so long as it timely and expressly reserved the right to do so.  As long as the insured accepted the insurer’s payments under this condition, the insurer can enforce its right to recoup.  The perils of an insured accepting this condition were recently highlighted in Genesis Ins. Co. v. Magma Design Automation, Inc., U.S.D.C., N.D. Cal., No. C 06-05526 JW (Decided December 20, 2010).

Although both the insurer and the insured were represented by very competent coverage counsel, the insured in Magma contended that it believed the insurer was only reserving its right to seek recoupment from another insurer in whose policy period it believed the loss was covered.  The Court did not see it that way and the evidence recounted in the Opinion certainly supports the insurer’s and the Court’s viewpoint.  While the other insurer may have at one time been the insurer’s primary focus for recovery (and might still be as they were a party to this litigation), nothing should have given the insured legal comfort that they would not have to pay back to the insurer any amounts that prove to be uncovered.

Magma serves as a cautionary tale to all who practice in this area to exercise extreme care in both reserving rights and in responding to reservations, and not to rely upon perceived intent or vague representations as against whom recoupment might be sought.

Coverage For "Whistleblower" Claims Under D&O Policies

Although not frequent occurrences, D&O policies have always afforded coverage for so-called whistleblower claims.  Historically, the first claims in this genre were the qui tam claims filed under the federal False Claims Act.  They typically involved a company receiving government Thumbnail image for whistleblower5.bmppayments, e.g., a healthcare provider receiving Medicare payments as a result of fraudulent billing practices.  The whistleblower there was typically an employee of the provider organization and the reward or “bounty” was a sharing in whatever the government collected through a prosecution of the provider.  The D&O policy afforded coverage to the extent one or more officers and directors of the provider company were defendants in the action, although coverage could be somewhat limited to the extent certain conduct exclusions might ultimately apply to any settlement or judgment amount.

Next, and within the past ten years, came specific policy language providing coverage for whistleblower claims under Sarbanes-Oxley.

The latest, and perhaps most significant development in terms of potential frequency and exposure, may be the new SEC whistleblower initiatives proposed as Regulation 21F to Section 21 F of the Securities Exchange Act of 1934 as a result of the enactment of the commonly-called Dodd-Frank Act earlier this year.  Whistleblowers would get an award so long as the SEC could be successful in collecting monetary sanctions exceeding $1,000,000. 

The whistleblower must provide original information that leads the SEC to a successful enforcement, i.e. the information causes the SEC to commence an investigation or provides information about a matter already under investigation.    The whistleblower’s award can range from 10 to 20 percent of the monetary sanctions collected.  The SEC would appear to be the sole arbiter of the amount of the award.  The proposed rule is still open to public comment, and it is likely that enactment will not occur until sometime in 2011.

Although this new regulation may lead to additional claim activity and hence defense costs exposure under D&O policies, it is not likely that either the total sanctions or the whistleblower’s cut of them would amount to covered loss under the policy.  But, because these whistleblower claims are apt to be occurring somewhat contemporaneously with shareholder class actions and derivative litigation, they may well provide an undesired enhancement to the settlement value of those otherwise covered actions.

Quota Share Insurance - An Idea Whose Time Has Come Again

pie chart.JPGOne of the most controversial issues in D&O insurance in recent years has been disputes arising from the excess/primary insurer relationship.  These occur most frequently with large risks where more than one “layer” of insurance is placed, notably in large D&O programs.

One type of dispute centers around the extent to which an excess insurer should be bound by the claims-handling and coverage decisions of underlying insurers, even where the excess insurer issues an essentially follow-form policy.  Perhaps the leading case in this area is the Massachusetts decision in Allmerica Financial Corp. v. Certain Underwriters at Lloyd’s, London, 871 N.E.2d 418 (Mass. 2007).  In short summary, that decision held that a following form excess insurer was not necessarily bound to adopt the same coverage positions as the underlying insurers and was free to independently interpret and apply the policy language.  Much controversy has since ensued with many brokers and policyholders asserting that this was causing inconsistent results and excess insurers unfairly (in their view) taking a “second bite at the apple”.

The second area of heightened concern involves whether an excess insurer must “attach” and pay loss where the underlying insurance has not been fully exhausted by actual payments by the underlying insurers under their policies.  Among the leading reported decisions here are Qualcomm, Inc. v. Certain Underwriters at Lloyd’s, London, 73 Cal. Rptr. 3d 770 (Cal. Ct. App. 2008) and Comerica Inc. v. Zurich American Ins. Co., 498 F. Supp. 2d 1019 (E.D. Mich. 2007).

Even more recently, courts have followed Comerica and Qualcomm in Great American Ins. Co. v. Bally Total Fitness Holding Corp., 2010 U.S. Dist. LEXIS 61553 (N.D. Ill., June 22, 2010) as well as in Citigroup, Inc. v. National Union Fire Ins. Co. of Pittsburgh, PA, 2010 WL 2179710 (S.D. Tex., May 28, 2010) and Schmitz v. Great American Assur. Co., 2010 Mo. App. 739 (Mo. Ct. App., June 1, 2010).

Bally, a case in which this firm successfully represented the interests of the topmost layer of excess insurance, is the most recent in a line of cases holding that, in light of an appropriate provision in an excess policy requiring such, that an excess D&O insurer has no legal obligation to make payments under its policy until such time as the full amount of the underlying insurance limits have been exhausted by payments by the insurers providing those underlying limits.  In Bally, certain individual insureds sought coverage from remaining excess insurers after underlying insurers had settled with all insureds after partial payment of their limits.  The Court there held that the underlying limits cannot be exhausted by payments from alternate sources, including the insureds, in order for the excess insurer’s obligation to attach. 

The argument against these pro-excess insurer decisions is essentially one of “no harm, no foul”.  Specifically, what is the detriment to the excess insurer if some other party, typically the insured itself, funds part of the payment obligation of the underlying insurer?

Rather than belabor the pros and cons of the positions taken by the partisans, we pose the suggestion that quota share insurance structures would resolve much, if not all, of the controversy in this area.  The quota share concept is certainly not novel and is essentially how the London market has written insurance through its “slip” arrangements throughout its history.

In a quota share arrangement, there would be no layering of the risk among a primary and several excess insurers.  Rather, there would be a single contract in which each participating insurer assumed a percentage share of the same risk.  Typically, the insurer taking the largest percentage would be denominated as the “lead insurer” and control the claims handling, including settlement, process.  Each participant would be contractually bound to follow the lead.  If they become disenchanted with the lead’s handling, their sole recourse would be to get off the risk at renewal or lobby at that time for the designation of a different lead.

For these arrangements to work properly, it is critical that the claims control language be explicit in the policy.  Past and current attempts to quota share have all too often failed in this regard with resultant bickering among the participants.  The attendant transactional costs with the retention of multiple coverage counsel and advocacy of different, if not conflicting positions among the participants, has been wasteful and replete with instances of protracted coverage and bad faith litigation.

The key potential detriment to the participating insurers in these arrangements is a relinquishment of their “sovereignty” in the claims decision-making process.  Is this too high a price to pay if there can be assurance that a competent lead will be in place, which will accept input (but not veto power) from the various participants?