What's In A Claim? A Lot, Depending On Policy Language

Law360, New York (June 18, 2012, 1:33 PM EDT) -- Most professional liability policies contain an exclusion for dishonest acts. Many also include provisions giving the insurer a right, but not a duty, to defend against covered claims. Almost all use the word "claim" both to specify a triggering event and as a subject for exclusionary provisions.

A recent decision of the California Second District Court of Appeal, Health Net Inc. v. RLI Insurance Co., --- Cal.App.4th ---, authored by Justice H. Walter Croskey, who is regarded as the California judiciary's leading expert on insurance coverage issues, addressed all three issues.

The court concluded "claim," when used in an exclusion, referred...

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