Worn-Out Lawyer Cliches

When a word is used too often, it wears out, and becomes insignificant, unconvincing, and ignored by the listener or the reader. Some terms used by lawyers are like that. Important terms become distractions of no interest. Some even become laughable when used.

Ordinary LifeThere are a number of clichés, which have invaded our language, of which I am sick. Here are two examples from ordinary life. “Amazing” is one of them. If someone has lost 10 lbs in a month, it is said, by some, to be “amazing.” If someone usually gets a grade of C on tests and gets a B, that is said to be amazing.

Alternatively, some say that they are amazed. With respect to me, if an essay contains very few typos, that is said to be amazing. (Well, maybe the last one is true.)

Here is another example: “awesome.” It seems to me that every child who participates in a ballet recital is told (usually) by her parents and their friends, that her performance was exactly that, “awesome.” Each of the parents of each of the children tells every other child and every other parent, that their particular child’s dance was “awesome.”

Deep down, I suspect that the children are on to the practice and ignore ‘awesome.’ At the same time, if they do not get the meaningless adulation, they recognize that fact.—MSQ

Language of LawyeringSimilarly, there are a number of worn-out cliches lawyers regularly use and misuse. Sometimes they are to be found in pleadings; sometimes they are found in reactions to pleadings, often when they have just been filed—or close to it. Some are used in pro-client public rhetoric. Consider the following:

Muckraking:  As in, “The plaintiff’s case is nothing but muckraking.” Like other clichés, it is used excessively both in a single case and for other cases as well. Actually, users might pay attention to the apparently received fact that the term originated as a method of referring to investigative journalists, around the turn of the 19th Century into the 20th. “Everyone” then, knew who they were and that they investigated people such as, “Robber Barons,” “Corrupt Politicians,” and factories manufacturing dangerous food, together with their criminal—or, near-criminal—owners. Many of us who paid attention in American history classes also know this, more or less. Hence, actual muckraking was then, now—and still is—a good thing. It is easy to see that “nothing but muckraking,” is a bad idea to assert, To repeat: some cases of muckraking are a very good idea indeed. Some much need to be raked. There may be shit in the muck. This is illustrated very nicely by some recovers by the U.S. against some businesses.  Consider, for example, the billion-dollar-plus settlement made with Standard and Poor, a supposedly objective company the performance was certainly neither standard nor anything but poor during the period of the later 2000s. 

Outrageous: To say that someone’s legal position is outrageous, is to say that it is completely implausible in every way; hurtfully false, and could not be accepted by any reasonably knowledgeable person.  An assertion is outrageous if it drives–or would drive–the normal person–an otherwise reasonable person–into a rage.  Paradigms of rage are not merely an irritation, a modicum of anger, some anger, or even quite a bit of anger.  Rage involves intense passion, and–at least metaphorically–screaming, shouting, pulling his/her own hair, closing both fists tightly, and/or beating on a table, gritting of teeth, and perhaps a desire for or an acceptance of vengeance accomplished by another person—all this arising from what has been asserted.

Almost nothing in normal legal conflicts, including pre-suit harangues, is actually outrageous, and calling locutions or assertions outrageous too many times, undermines its legitimate and effective use. When I hear or see a lawyer claim that something or somebody is outrageous, I seldom pay much attention. If uses of the term were restricted to the actually outrageous, as opposed to the routinely and perhaps irritating, its use might be meaningful and influential.

It may be too late for appropriate usage to be restored to its genuine status and to do the same for the impact of usage, unless the term (and its linguistic sampling) is given a vacation from use, at least by lawyers.  Instead, we have the destruction of a wonderful, even magisterial word.

Here are appropriate uses of the terms “outrageous” and/or “outraged.” On January 2, 2013, a number of American politicians expressed outrage about the failure of the House of Representatives to pass the relief bill for victims of Hurricane Sandy.

Here is another and very different situation of the term outrageous: what happened in Pakistan recently arising out the terrible rape of a young woman on a bus, followed by her being thrown off the bus and to her death. To be sure, the event in Pakistan is more outrageous than the refusal of the House to pass the relief bill for the victims of Sandy, but both situations were outrageous, and it was appropriate for observers to be enraged. 

One has to admit that there are degrees of being outrageous. At some levels comparing and contrasting different really outrageous incidents is impossible, rationally speaking.  Consider the Pakistan event and the general culture of the country permitting (if not encouraging) damage to women versus the Newtown event and the very different culture surrounding it. Or, compare either of them with the Madoff Ponzi scheme.  Whatever else can be said, there are limits on the “underside,” however, and those are high. Those with common sense about human relationships and those with knowledge of the English language can quickly tell the difference.

Fail & Failure: These words fit the situation. Frequently, any refraining is often described as a “failure to do ‘something.'” “She didn’t give ‘Argument #5,'” is not the same as “She failed to give ‘Argument #5.'” In addition, it does not support the silent and implied assertion, “Since she failed to give ‘Argument #5,'” her whole [complex and multifaceted] argument is a failure, [and so is she]. Of course, this is false.

Scapegoat:  Often, lawyers for defendants say, “The plaintiff is trying to use my client as a scapegoat.” This is supposed to mean that the lawyer’s client has done nothing wrong, so far as the lawsuit is concerned, and that the plaintiff is trying to blame the defense lawyer’s client for the “sins” of the plaintiff. This word and this concept are used often. The expression is far too complex in its history for this use.

In the Old Testament (Leviticus 16:5-10), the people, through Aaron, would bring to the Temple two goats. They are there to provide atonement for the sins of the community. One of them was to be executed in the Temple, virtually then-and-there on the appropriate alter. The other one would be permitted (or forced) to escape into the desert. That goat usually died, just as the first one did, but stayed alive for a while so that the second goat might live, but probably not—indeed, almost certainly not.

I speculate that some of these goats were killed by heat; others were eaten by other animals; and yet others were pilfered by the least honest, killed, and eaten. From time immortal, it has been suggested that the second goat was being sent to Azazel who may have been some sort of demon. The virtual certainty of the death of the scapegoat as atonement is not what the defense lawyer has in mind, nor is the idea that he is playing a legitimate role, selected by a part of the community, in an honored religious practicethat may have lasted (what?) maybe 2000, or so, years.

Frivolous: It is amazing—really, “amazing”—how many lawsuits are called “frivolous,” even before they begin. To be sure, there are rules against filing “frivolous” lawsuits, especially if a lawyer does it too many times, whether regarding a single strand of facts or completely different facts. Nevertheless, anyone experienced in civil litigation knows that many, many more lawsuits are called “frivolous” than are found by judges to be so or which even are. 

Not every lawsuit that is dismissed for failure to state a claim is actually frivolous.  The facts may be shocking and grave, but it is simply not the sort of thing, which is actionable. Governmental immunity sets up this situation, even if an inventive lawyer convinces himself that he can twist, turn, and prevail. 

For now, enough is enough. The reader will have gotten the main idea. As awesome as this topic is, as outrageous and amazing as it is for real lawyers to engage this sort of frivolity, as these “numb skulls” maybe, this essay does not seek to make them into scapegoats, and certainly not in the long-established sense. There may be more later on this topic, for that is the nature of muckraking.

Preposterous: Something is preposterous when it is radically implausible, at striking variance (or strikingly at variance) with what is thought to be commonsensical, very very implausible, “totally implausible,” laughable, deserving of ridicule, something only an “idiot” might suggest.  The trouble is that the law (or the life of the law) is full of the preposterous, starting at such  conceptual places as the idea that a devout monastic priest would be seducing a youngster in the shower, lots of different kinds of ideas of the unexpected, arrests, breaches of  intra-family contracts and/or sacred agreements, some passionate pursuits of self-interest, e.g., by pastors preaching Christian altruism) is full of states of affairs, actions, omissions, situations, and wealth just like this.  

Ludicrous: This one is just like “preposterous” and its cousins.  

Additions and AmendmentsMarch 13, 2015 Maybe there are some words that aren’t used much but convey the same sense of semantic overreach. Or maybe not.  Maybe since there are extensively unused, one might be able to do something with them, under the right circumstances. Obviously, I really don’t know. But here are two: 

Astonish, Astonishing, Astonished, Astonishment, as in “It is astonishing that someone would give this argument.”

Astound, Astounding, Astounded, as in “The court may find it astounding that counsel would rely on a case which was reversed a generation ago.”

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Insurer Bad Faith–Difficulties or Paradoxes?

This entry focuses solely on insurer bad faith (IBF) as it arises out of  disputes as to coverage and therefore how the policy should be determined.  It is not about any other component of IBF, e.g., the adequacy or inadequacy of investigations. Obviously, if an insured alleges that a carrier has performed an inadequate investigation in adjusting the claim, if the dispute rests in any part upon facts about the investigation, the insured will survive summary judgment, so long as there are alleged relevant and non-trivial facts at issue.  Similarly, if the insurer has performed any investigation at all, it too will survive summary judgment. There is at least one disputed fact issue in both of these cases. Now we get to the interesting problem.  Suppose the dispute hinges on “What does the policy say?” “How is the policy to be interpreted?”  “What does “Clause 14(a)(1)(iii) mean?”  Or suppose that contract interpretation dispute are a component of the dispute? It is well established that authoritative interpretations of language are within the judge’s jurisdiction and not within that of any other fact finder.  Thus, in an insurer bad faith case regarding the meaning of a contract of insurance the judge decides (or can decide) the meaning of the policy.  Sometimes, judges ask or the jury’s reaction, but this need not happen, and it does not bind the judge. Now suppose the insurer loses the arguments about interpreting the contract, and the court decides the meaning of the policy in favor of the insured.  Obviously, this fact does not entail that the insurer is guilty of IBF.  The insurer will simply take the view that the matter of contract interpretation was “fairly debatable,” and that its interpretation was reasonable and hence that it was fair to take the position it did and debate the matter.  (Not all courts use the phrase “fairly debatable,” but the alternative criteria are usually conceptually equivalent to it or close to it.) Before going further, it might be a good thing to notice that there are at least three different meaning of the word “fair.”  (1) One of them is about a component of justice, and it usually taken to be formulated in term of treating like cases alike.  The image here is of a judge with litigants before him/her, and the judge has an obligation not only to be reasonable in finding facts and interpreting the law but must treat those two litigants like.  The judge must also treat the next set of litigants the same way he treated the last set, at least usually.   (2) A second one is that an entity like an insurance company, or anything of the like, must treat the interests of an insured at least equal to its own.  It would be unfair for the insurer to place its interests above those of the insured.  Those two sets of interests do not have to match up in their nature.  In other words, fair decision making here is not simply balancing two sets of interests if the same type, if the substantive nature of those interests are different.  Of course, there is usually a set of very similar interests on both sides, to wit: money. Both (1) an (2) involve the idea that fairness is an idea with cloudy edges.  The center of the idea is precise enough, but where the idea leaves off and the idea of unfairness begins is not really very clear.  In fact, opaque. (3) A third one, is just as cloudy as fairness as conceived in categories (1) and (2), but the idea of fairness itself  is quite different as is the idea of cloudy built, as it were, into the concept of fairness itself.  The idea here is that something (X) is fairly thought of as  (Y) if it is fairly similar to Y (a something else). The idea  clearly not mean not the same as, nor does it mean either  somewhat alike or rather similar.  Nor does it mean almost exactly alike.  My hypothesis is that it means reasonably close to being almost alike.   I shall return to this matter later. Both (1) or (2)  centers on one question (as do its “off spring” questions), that question is  obvious enough, though the answer is not.  The issue concerns  who should decide the fairness element of the controversy as to meaning.  Does the judge decide this issue?  After all s/he authoritatively decided the meaning of the policy.  The law requires that s/he decide such issues on the basis of reason, conceptual-analysis-only, or “linguistic analysis,” including language “appreciation.”  Thus, if the judge comes to a conclusion as to the meaning of the  language, surely the judge should decided the issue of the reasonableness of mistaken interpretations. To be sure, the judge decides the semantic issue, but the issue of fairness hinges on facts, morality, ethics, public policy, and custom.  If the judge were to decide the issue of fairness, s/he would be examining his/her own internal consciousness to see how the linguistic decision derived and by what route of thinking the answer arrived.  Isn’t obvious there is a fact issue in here, at least in part, one might vigorously, or at least wonder about? It is easy to conceive how it would go to a jury, sort of.  It would be asked to consider two propositions of interpretation; it would be told which one has  been adopted  and which one has been rejected.  It would then asked whether the person depending on the defeated one was reasonable in adopting it, arguing for it, and relying on it.  It would be reasonable to ask the jury to consider what the carrier’s decision as to meaning had  to do with the carrier’s aim at profits, if anything. The standard for sound  decision would be whether a reasonable and appropriately knowledgeable person  under the circumstances of the case could reasonably adopt the meaning  rejected.  Of course, this is or is very much like the negligence standard of care.  Why should there not be negligence with respect to picking out the meaning of language? What could be called the thoroughly empiricist view of deciding issues of fairness also makes it easy to imagine the types of evidence that might be introduced when deciding those issues. There would be documents, if any, explaining the insurer’s decision and its rationality. There would be fact-witness testimony on that issue.  There would be documents, if any, critical of the insurers thinking, the quality of its arguing with itself.  There might be cases.  There might be various decisions or debates to be found in administrative law processes.  There might be dictionaries and/or histories of language.  There might be expert witnesses.  They might come from a whole variety of different occupations: lexicographers, linguists, some types of philosophers (like J.L.Austin from the last generation), and even some specially educated lawyers. Nevertheless, there are difficulties with both positions.  How should the controversy be decided, assuming there really is a controversy, as I have suggested there is?  One might be inclined to think there is a controversy, since if the conceptual-analysis-only approach  is adopted, the party who wins the meaning-of the-contract-language issue, would then and there be entitled to at least partial summary judgment, assuming that such a Motion is pending.  It also implies that judges are best suited to make these sorts of decisions.  On he other hand, if the empirical view is adopted, juries will be asked to decide the meaning of the term “fair” and/or “fairness.” Of course, this a very novel request, if for no other reason, than that it involves moral values right on the surface, as opposed to being under the surface of the discourse, as in other tort (and even contract) cases.  In addition, there really is another reason: since juries decide this issue, there must be instructions, and–of course–the jury decisions may vary in unpredicted and unpredictable ways.

So should this be thought through?  Or has it already been settled? Or has it, even though not settled and involving a unique issue have a simple solution, which I have just missed.

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Some Relevant Insurance Contracts of Dewey’s

COMPANY
COVERAGE

CNA (and various insurers at Lloyds)*Professional Indemnity
XL Insurance- HartfordManagement Liability
OneBeaconExcess Management Liability
Iron-StarrExcess Management Liability
Great Northern Insurance CompanyGeneral Liability
Employee Benefits Liability
Stop Gap Liability
Federal Insurance CompanyPrimary Property
XL InsuranceExcess Property
Insurance Company of the WestExcess California Earthquake
Great Northern Insurance CompanyForeign Package
General Liability
Employee Benefits Liability
Property
Automobile
Employer’s Liability
Employee Repatriation Expense
Pacific Indemnity CompanyWorkers Compensation
Statutory Benefits as per State
Vigilant Insurance CompanyUmbrella
Nation Surety Corporation
(Fireman’s Fund)

Navigator’s Management Company, Inc.Excess Liability
Dewey & LeBoeuf LLPBusiness Travel Accident
Traveler’s Casualty & Surety Company of America
(St. Paul Travelers)Primary Fiduciary
Federal Insurance CompanyExcess Fiduciary
Twin City Fire Insurance CompanyExcess Fiduciary
Federal Insurance CompanyFidelity (Crime)
XL InsuranceEmployment Practices Liability Insurance
Alterra InsuranceExcess Employment Practices Liability Insurance
XL InsuranceOutside Directors & Officers

*There are 7 excess layers of professional indemnity coverage.

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Dewey, the “Defunct” & Management Liability Insurance

There has been lots of news coverage regarding the collapse of Dewey & LaBoeuf, including the why, the who is responsible, the who is getting hurt (both outsiders and insiders), the how’s of senior management, and the questionable activities of a slew of lawyers. There is not much being said, however, about insurance aspects of the demise and thereafter. The serious (or advanced) press has not gotten there yet, and the popular press is not fit for the job.

Even the American Lawyer is publishing only skimpy and superficial pieces. At least it noted, however, that the primary insurer for the management coverage, has indicated coverage problems in the  bankruptcy.

It appears that the judge has permitted the unsecured creditors to sue the insurer or insurers. He noted, however, that providing a right to sue is not a right to judgment.  Maybe the creditors are trying to put money in the hands of the Firm or someone else with liability so that they can get it from there.  This is extremely unlikely it seems to me.  And the carrier, XL Speciality Insurance Company has tried to avoid coverage by arguing that since the Firm is the policyholder, it is suing itself.   I have no idea what is being said here.

There are lots of important questions that need attention. One might wonder, for example:
how many policies were there, what all do they cover, what is not covered, what are the policy limits, who made the decisions about buying what policies, who advised Dewey about this, what did the intermediaries say, to what extent did Dewey listen to its
agent-brokers, who did risk management at or for Dewey, what did it advise, and so forth. One would expect the insurance press to be “all over” these questions. One would also expect to see references to who is adjusting the claims, and those are likely to be or include specialized, independent adjustment firms, as well as “forensic accountants.” (This often used phrase is simple minded, misleading, and damn near tasteless.)

In addition, the insurers—and there are more than a few of them—will be represented by counsel. One would think that the insurance press would be interested in profiling these lawyers.

Thus, except that which can be derived from this sliver of a remark, there is not much for the insurance junky. Of course,
there is more in the bankruptcy court records. Most of the interesting policies are there—as one might expect, there are a lot of them. There are also argumentative discussions of large parts of them.

Still, even given what
all I have just said, it is still mysterious that it is not discussed further,
in either the newspaper-press or the industry-press.

Consider the following
as a conjectural (or guesswork) introduction. I will probably follow-up in one
or more blogs to come. Here is the partial hypo, which is certainly a variation
on the whole story.

There were three people
in charge of managing the Dewey-show. from the top of the pyramid. One of them
had general authority, Steven David, and he is said to have exercised it
widely and rigidly. Two of them were probably a little more
specialized, e.g., one maybe with more or less daily financial matters, etc., the
other with large-scale financial matters, perhaps. The former may have been
Stephen DiCarmine, while the latter would have been Joel Sanders. There will be
no further reference to these “gentlemen” by name. Probably, their
responsibilities overlapped.

I speculate that one of the
minions might have been in charge of collecting  unpaid fees,   routine billing problems,
and  handling some parts of dealing with bonuses for incoming “rain makers,”
partners, and others. It should be kept
in mind that the “Senior Executive Group” repeatedly
arranged shocking and insolvency-producing, salary-bonus, entry arrangements for some new partners, over what appears to be a considerable time. There will be insurance
coverage problems here. The relevant policies will almost certainly be
“claims made” policies and probably “pure claims made” contracts and they will
also involve the definition of “wrongful acts,” which will (and would have anyway) reeked
havoc on the effects  a whole pattern of idiotic decisions.

(One of the newspaper
articles states that the committee in the bankruptcy says that King-Pin and his
two minions have “‘over-distributed
the Firm’s available cash to select partners; abusively relied on guarantee agreements that bore no
economic rationality; and concealed the Firm’s true financial condition from
its partners, employees and creditors,’ for selfish reasons motivated by greed[.]” Apparently, the bankruptcy judge has noted this passage or part of it in one of its orders, according to the
same source.

One of the jobs that one
of the minions might have performed included the purchase, maintenance, and
replacement of the $1.2M worth of artwork, hanging within Dewey’s easy client-visible pleasing places.

One of them might have
also been in charge of how to avoid paying various retired partners at all.
(Of course, if the firm owed these folks fiduciaries, cutting them off is
probably a breach of fiduciary duties. Interestingly, there is a speculative
insurance policy for this sort of thing.)
I will name these three dedicated
destructioners “Head Knocker,” or just “Knocker,” “Designer
Minion,” or just “Md,” and “Florida Minion,” or just
“Mf.” The minion names are motivated by the fact that, one of them entered
a prominent New York school of design upon being humiliated out of Dewey, while
the other moved to Florida to be a financial something for another law firm. One wonders if
that firm, the Greenspoon Firm, will praise itself for its foresight and wisdom in taking on Mf?

In any case, these three
whip-men, for what may be the greedy-leopards at the circus, are covered by
$50M, or so, of Management Polic[ies?]. (Of course, so might others in the firm with coverage.  D & O policies usually have broad reaching conceptualizations of covered people.) Apparently,
one primary and other excess policy or policies. (That is perfectly customary,
depending on the size of the primary policy, and those excess policies may
be umbrella policies.)

The primary policies are,
no doubt, attached to more than a few filings in the bankruptcy court, even
though there is something like 1000 of them. I have not yet seen the excess
policies at all; indeed, I have not seen any, even remote, descriptions of them. As indicated, all of the
excess policies are, almost certainly, attached to some pleading or brief in
the bankruptcy court. However, I am not aware of serious discussions of meaning
there, although I am certain there are “advocacy discussions”; alas,
they are often distorted. (Some might say that they are always distorted.)

Of course, there are
probably other forms of unusual insurance. One of them will cover the artwork,
whether purchased or rented. This will be a form of property insurance. Another
might cover Dewey’s liability for banquets and the like. Often, the latter is
bought on an event-by-event basis. Likely, there will be insurance covering ransom
demands connected to kidnappings—a very secret form of insurance, for obvious
reasons. No doubt, there will be “Errors & Omissions” insurance,
which used to be called malpractice insurance, and there may be a separate
policy covering nothing but breaches of fiduciary duties. Later there will be a
brief blog covering at least some of the relevant policies.

Therefore, I will begin
by guessing. Management policies, as they are sometimes called, are
probably E&O (“Errors and Omissions”) policies for a variety
of different “professionals.” There is no reason why management teams for
large firms could not have such a thing. The premiums would be enormous.

In addition, D & O
policies cover not only directors but officers as well, and both Knocker and
the Minions were officers. Hence, management liability policies, as these
certainly are, will cover these three “terds” for unintentional
management misconduct, often designated in contracts as “wrongful conduct.”
Given the names of the policies, they will probably not cover the firm.

It is likely that the
excess policy or policies will either be or be like “follow form”
policies. This means that the upper echelon contracts will be identical (or
close to it) in important ways to the primary policy. In addition, it or they
may be umbrella policies, covering some unusual activities, etc., the primary
does not.

So what kinds of
wrongful acts or omissions might be covered and which ones not? The
primary policy, at least, will contain a definition of “wrongful act.” D&O
policies always have them or their equivalent. This definition is of crucial
importance. It may be that the nearly “follow form” policies will vary their
definitions slightly, often expanding coverage a bit. Excess policies usually
make it clear that they really are excess. Such carriers always try an make sure that readers of all sorts know that they are nothing but excess insurers.

All these facts leave
a huge number of questions on the table. Here are statements, which will generate
some of them.
Fifty million is a lot of money. Why so much? What was
said to the underwriters to get them to issue that much? These questions must
certainly be asked, explored, and answered.
The amount of
coverage is so high, that one would expect there to be more than one
excess policy.
One fact that would explain the size of the coverage would be that a lot of lawyers in the firm are also covered under the policies.
Whether the insureds committed actual  separate wrongful acts or
were trying to protect themselves from liability for a string  deliberate acts, may
be partially determined by answering these questions.
Who were the intermediaries; what was said to them by people at the firm; and what
did they say to the underwriters? Policies may be canceled if there are the
“right” sorts of misrepre-sentations in the applications for insurance. Some managers at the Firm may have dreamed false answers up and made them to the underwriters.
If the Firm’s
agent made them up, without the firms consent, mattes are quite different.
How could a ultra-sophisticated company, like the Firm, not realize that the intermediary was engineering  lies, supposedly on the Firm’s behalf and certainly to feather his own nest?
The period
of coverage (the policy period) of D & O policies, among
others, are rather short lived, subject to renewal often
enough and subject to very expensive extension periods that function to
report claims after the end of the policy period.
Usually, the same sorts of representations made in the
first application have to be made in renewal applications. So what did
Knocker and the Minions tell the insurer and/or the intermediaries? What
did they know when they spoke? It seems almost certain to me that there
were misrepresentations involved and maybe fraud.
What was said to the reinsurers about the
applications and who said it? This question may be less relevant.
How long did the cursing sins at Dewey
continue? When was the beginning? The middle is probably relevant to
renewal applications, and the end is perfectly obvious.
Most D & O policies pay for defense and indemnity,
but not always, just as most routine liabilities do. Sometimes D&O
policies permit the insured’s to run their own defenses. In that
situation, the insured may pick its own lawyer from an approved list, and
the insurer pays a reasonable fee to the
firm or attorneys defending the case directly . In addition, in these policies—like other
professional malpractice policies—defense expenses are often deducted from
policy limits.
Granted, $50M is a lot of money, but so will the defense costs of
Knocker and his minions, Md and Mf. And, of course, the amount of fees will go up depending on how many other insureds there are who get sued.  This is especially true since each of them will need separate counsel.  In any case, the members of the Triumverate have just started getting sued. So it must be impossible now to know how
defense expenses work, or how much they will be.
Usually, an ordinary liability insurer must defend a whole
case, if it has to defend any of it. This proposition is not always true
for D & O policies, so it will be interesting to see how that is handled in the coming suits.
One popular source says that policy proceeds are some how  being
diverted into the bankruptcy court for paying unsecured creditors. I
am not sure I understand why this wouldor could be
true.
D & O policies are sometimes geared to cover
directors. An analogy might be involved here. That might make retired
innocent partners prime “beneficiaries” under the
policy.
Most D & O liability policies cover officers, only
if the companies they work for have not indemnified them. That will
almost certainly be true in the case of a “Management Liability Policy,” since they
are likely  pieces of D&O contracts of insurance, lifted out and treated by them selves. I am not
sure what is true if the company has indemnified them, but the company has
gone belly up. I could guess that this is not usually a situation in which
the officers are cut off from coverage.

There is much more to be
said, but that will have to wait for a further blog. The next one will simply be
a list of what may be all or close to the entire Dewey contracts of
insurance, plus a few “footnotes,” maybe.

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ABOUT INSURERS REACHING TOO FAR: SOME FUNDAMENTALS

LECTURE NOTES & EXHIBITS

CLE “LECTURE NOTES” ARE MOSTLY ABOUT PRACTICAL MATTERS PERTAINING TO CONCEPTUALIZING, THINKING, PLANNING, AND EXECUTING.

Insurers can “reach too far,” of course. This is a nice pithy way to talk about bad faith.  What the phrase is really trying to do is to indicate that insurers can reach too far by reaching too far inward toward their own interests and also by reaching out too far (trying, for example) to eliminate a right to coverage.

To put it better, insurers can reach out in two senses, broadly conceived. One of those senses, in which he who reaches, is when trying to establish a more intimate or more charitable relationship. Obviously, insurers can do this, and it is a good thing. The other sense, however, involves “reaching” to push away, to make things crash, or to strangle the one reached for, and those are paradigms of bad faith.  These two forms of reaching are hardly ever confused. Imagine this testimony:

Question: Isn’t it a fact that you, as an adjuster, went out of your way to find a way to deny this claim?Answer: No. It is quite the opposite. I was trying to reach out and help the insured.Question: Really? Tell the ladies and gentlemen of the jury, how you were doing that?

The function of this CLE report is to provide a set of fundamental principles regarding the matter of the “negative reach.” In doing so, it is necessary to sketch some fundamental principles of insurance. It is there that this “essay” will stop. There are lots of related topics, e.g., how to conduct discovery in litigation where bad faith is an issue, especially when expert witnesses are proffered, but enough is almost enough.

Insurance is insurance.

This “axiom” is intended to be a thought-generating metaphor.This is not intended to be a mere tautology.All insurance adjustment is similar and even identical in some ways.Insurers have a special relationship with their insureds. In the context of the insurer-insured relationship, this means that insurers must treat the interests of their insured as at least equal to their own.This does not mean that insurers may not enforce exclusions when they are correctly understood, reasonably interpreted, and understood in context.

The same rule applies to all sections of a contract of insurance:

Insuring AgreementConditionsDefinitionsDeclaration Section (aka “dec sheet”)

The absolutely key factor.

The fiduciary relationship is a special relationship. The duty there is much higher than that found between insurers and insureds.

Some special relations probably lower, e.g., someone who has a duty to take care of another. Insurance works this way: insurers must treat the interests of insureds as at least equal to their own. No principle is more important that this one.

In Texas, the duty of good faith and fair dealing is generated by the special relationship.

Maybe, just maybe, the duty of good faith and fair dealing is a way to talk about the duties inherent in the special relationship found in the context of insurance.

The duty of good faith and fair dealing that insurers owe their insureds has many components and dimensions.

Under Texas law, the duty of good faith and fair dealing is not a general duty to be found in all or most types of contracts and therefore contracts of insurance.

Other bodies of law are different, including the RESTATEMENT (Second) of CONTRACTS, §240.Also including the UCC.

The Restatement (Third) of Agency §7.05.

The Restatement (Third) of Torts §7.41.

Also including many states.

So much for the idea in Texas that the duty of good faith and fair dealing is restricted to insurance situations.

All adjustment must be based on investigations which are thorough, objective, rational, empirical, and other similar features regarding maximizing truth and reason. (Really an activity that does not conform to these requirements is not really an investigation at all.)

Under the special relationshipall adjustments must be reasonable at all times and in all ways with respect to every claim.

The bar for what counts as reasonable is higher under the special relationship than it is for ordinary negligence.

Still, there can be negligent conduct considered within the context of the special relationship.

It just occurs for the actor where it would not arise for the salesperson or the mechanic, or others in similar situations.

Or it might classify some activities as negligent that would not be counted as negligent in other contexts.

The requirements of sound adjustment are the same for all contracts (policies) of insurance, except in minor ways situationally generated.

Though sometimes adjustment must proceed more quickly than in others. Catastrophes are one thing; the minor damage to a small machine might be another, where there are two of them.

Still, unfairness is never permitted.

No adjustment is ever perfect. Reasonable errors do not general guilt as to principles of insurer bad faith.

Actually reasonable debate over coverage issues does not involve bad faith, even if the insurer is the looser. There is nothing making the debate just appear to look reasonable, when it is not.

Reasonableness is partly determined by the informational context. Inadequate information may make a debate unreasonable.

Insurers, and hence their adjusters, are expected to know many fundamental principles of insurance adjusting, such as, genuine ambiguities, in all relevant writings of insurers, are construed in favor of the insured and/or late notice from a policyholder is not a sound reason for denying a claim, unless the insurer was prejudiced.

Should statutes that are ambiguous be treated in the same way?

Insurers, and hence their adjusters, are expected to know that insurers bear the burden of proof as to exclusions.

What counts as an exclusion is not always clear. Everything in the “Exclusion Section” is an exclusion, but that may not be the only place they are to be found.

Exclusions may be found in the “Conditions Section,” and—conceivably—they may even be found in the “Insuring Agreement,” though the second of these two is likely to be rare.

Insurers and therefore their adjusters are expected to have reasonably extensive knowledge of the applicable insurance law.

The interests of an insured must be treated by an insurer as at least equal to its own.

A fundamental principle of all adjusting is LOOK FOR COVERAGE!

All adjusters are expected to have reasonably extensive knowledge of the applicable insurance law.

There is no law the violation of which establishes that an insured is guilty of bad faith with respect to an insurer. The same idea is contained in the common law. Thus, insureds cannot commit the “sin” of bad faith.

If there is no coverage, there can be no bad faith, or so the courts say, although Texas courts have said or implied that there may be exceptions.

Here is a significant exception: misrepresentations—relevant ones anyway. This could happen either in sale or in adjustments.

An act of waiver or estoppel could do roughly the same thing, although courts agree that these situations cannot create coverage. To be sure, this is true, but they can bar and insurer from contesting coverage issues.

The no bad faith without coverage can and usually will permit an insurer to treat an insured very badly. . . so badly, in fact, that if there were coverage, there would be bad faith.

Though under some circumstances that kind of conduct can lead to liability on other grounds.Insurers have specified obligations to perform various tasks related to claims handling, including the timing of paying claims. Failures of this sort are often classified as an instance of bad faith.

Such failures are difficult to prove in ordinary contexts, since an insurer will focus on whether the insured has dragged “his” feet, as they say.

A key bad faith concept is “prompt, fair and equitable.” This phrase is always used in bad faith cases. This marvelous, even poetically rhythmic, phrase has problems.

How does the “and” work? Does it make all three a requirement for any finding of bad faith?

What is the meaning of “fair”? Probably as between the insurer and the insured.

What does the term “equitable” mean in this context, especially since the term “fair” is present already?

The term “prompt” is vague and flexible, but is it factual? The terms “fair” and “equitable” are not. What bearing does this have on jury questions? Does it create an argument for specific definitions when no such thing is found in the current PJCs?

Other “tensions” amongst terms and concepts also involved problems, but not all have yet been recognized. “Settlement process” and other processes, like a claims adjustment process or the process of denying claims, diverge. This makes §541.060 very confusing but also opening up wonderful, heretofore unpursued ideas used as central arguments.

It is contested whether acts of bad faith can occur once actual litigation has begun.

It is easily argued that the answer is “Yes.” Consider the claim that has been denied for outrageously bad reasons. Or consider the claim that has been miserably investigated, and that situation continues during litigation.

The other side has arguments. Perhaps the principal ones are that (1) the process of litigation is different, slower, and more contested by its nature and that (2) attorneys have the obligation to defend their clients vigorously.

Of course, there’s a lot more to talk about, that’s enough for not just now but a short future at least.

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Quinn Quotes

A variation is never identical to that which is being varied upon.  This too is probably a necessary truth.  Both variances can be true at the same time. Then again sometimes they are something like contradictory, though probably not completely, given the meaning of “variation.”~Michael Sean Quinn, PhD, JD, CPCU, Etc.Tweet

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Michael Sean Quinn, PhD, JD, CPCU, Etc*., is available as an expert witness in insurance disputes and other litigation matters. Contact