INSURANCE IDEAS, CONCEPTS, GENERAL CHARACTERISTICS AND VOCABULARY

UNIVERSALS OF INSURANCE

Michael Sean Quinn

(More About Author At end)

All
red objects are red, no matter what differences there may be in shades.  All actual Xs involve the same concepts, pretty much, even if not
everyone uses them all in the same way. 
The same point is true about vocabulary. 
Some concepts and/or things are almost universal even though they aren’t
quite. This essay is about concepts, characteristics, and vocabulary at the
foundations of insurance and insurance law. It is an adaptation of a part of an
earlier essay.  

Of course, there may be some limitations on these assertions, but not many, and when there various ideas are missing from a proposed system, there has usually been a mistaken.  Then again, Ludwig Wittgenstein introduced the idea of “family resemblances” into discourses like this one–essays devoted to semantic analysis–and his ideas reign today, even if there were articulated early-ish in the last century. 

This
essay is not a systematic, scholarly, exhaustive, and/or pedantic essay of how these
terms are concepts are used in an array of case law.  All the concepts are used, and some of them are
formulated and applied utilizing the same vocabulary and the same system of ideas
as are used here.  When there is variation,
it makes almost no difference because the whole system of concept and characteristics
is uniform (or very nearly so) when there is no error.

I. Universal Concepts

The fundamental universal concepts to be found in all
insurance contracts are these:

·        
Peril,

·        
Risk,

·        
Causation,

·        
Injury,

·        
Loss,

·        
Moral Hazard, and

·        
Fortuity.

These terms and the
concepts expressed by them are used everywhere in the insurance industry.  It is not the case, that they are all used,
in the same way, by everyone, or—in fact—always defined in the same way.   For example, sometimes “risk” is
sometimes-to-often used in place of “peril,” and “loss” can be used instead of
“injury.”  These diversities are
conceptually insignificant, though conflicting uses in conversation,
discussion, argument, and the like can be confusing. What is significant is the
concepts involved here, and they are quite distinct.
                        

Since the concepts are universal, the terms may
correspondingly be very roughly defined as follows:

A  fortuity needs to be understood in
terms of an event or state of affairs, that is fortuitous and is one which is not planned, not deliberately
performed or brought about, and/or not intentional. Often it is reasonable to
think of a fortuitous event, as an accident,
when thought of from the point of view of the insured.  (It should be remembered that acts are types
of events; omissions need to be thought of as acts, and the effects or
consequences of the event, whether acts or not, may be other events or simply
states of affairs. Acts are not fortuitous; their consequences, however, may
well be.)
 

A peril is
a state of affairs that may injure an insured and cause it loss. The state of
affairs may be a complex one with many parts. The idea of a storm is like that.

 A risk is the probability that a peril
may cause, or participate in causing, an injury to an insured and thereby a
loss.[1]

Causation is the rough idea pertaining to one empirical
event—or a grouped together set of empirical events–inducing another
subsequent event, substantially more probably than not.  This idea can be more easily grasped at an
intuitive, commonsense level if one thinks about A causes B if A makes B happen[2]
(or brings it about that B happens), or is a necessary part of a group of
events which do that, or is part of a chain of events that makes B happen.  More than the last state of affairs in a
chain can be a cause.

An injury
is a state of affairs that is recognizably unacceptable to the insured.  It can easily be, and often is referred to as
harm.  Some of those in the insurance industry
associate injuries with the human body, damages with property of some sort
(often tangible), and harm with property and more abstract insurable entities
or processes, though the term “damages” is the use in that area as well.  I suggest that injuries hurt; they are setbacks; they damage a person; they make
valued things less valuable and less valued than they were, for example, less
functional, uglier, and more objectionable for some reason.  Surveying the insurance industry, the three
terms—“injury,” “damage,” and “harm”—get used in all sectors of the insurable
as meaning the same thing, which they do, except that “harm” may have a broader
sweep.  (If I were choosing a universal
system of insurance vocabulary, I would make “harm” the key general term, use
injury for human bodies, and damage to everything else.

A loss is
how much dealing with an injury is going to cost or how much that of value must
be “kissed goodbye” as a result of the injury. 
Usually this is measured by (or actually is) money. (There can be some
confusion here, since what I am calling “loss”; and I when necessary called
“damages.” After all, that is what plaintiffs see as their loss, their
“damages.” “What were your client’s damages?” Ans. “We said 1M.” Qu. “Did you
get them.” Ans. “We got more for it than its actual losses.” And so forth.)

Finally, there are the problems of moral hazards.  This is a complex concept with a number of
meanings run together, some of them over time and some of them all at once.[3][i]  Thus, the concept of moral hazards is both vague and ambiguous.  (Of course, some think that all vague terms
are ambiguous.)

(1) One of the usages is (or, was) that not all
applicants for insurance should be insured since they are of poor character,
immoral individuals.  Such people are
unreliable and financially dangerous.  It
is not good for society that such people are “awarded” with the safety to be
found in insurance.  This was a
traditional conception.

(2) That traditional concept went with another, and it
went like this: since society regarded insurance as a species of gambling, or
something close to it, and since gambling was regarded as filled with persons
of poor character, no such person should ever be provided insurance. After all,
the business of insurance should be kept far away from gambling in
society.  The insurance industry needed
to adopt this view, assuming its members didn’t believe it themselves if they
wanted to become a legal business.

(3) Another ancient view is that the term “moral” in
traditional theology, political theorizing, moral philosophizing, historically
speaking; popular ethical thinking, and long ago in ordinary conversation
referred simply to the realm of human
actions.  David Hume, the famous
empiricist philosopher of the Eighteenth Century, used the phrase “moral
science” one of his famous works;[4]
for him it meant a kind of what is today called sociology.  Economists to this day call what they do
“moral science.” Thus, the phrase “moral sciences” might refer to
considerations of immoral conduct, or it might not.  Thus, the moral hazard would be any  problems which arose out of the realm of
human actions, activities, and interactions.

(4) The contemporary and prevailing view—in fact, now
the only prevailing view, the explicit recognition and use of which has a
history going back two centuries, or so–is that owning insurance has a
tendency to encourage  a deceptive
increase in sloppiness and temptation for many insureds with respect to
whatever is insured.  This can easily be
regarded as immoral, and so there is a “moral hazard.” What is being described
here is not necessarily a temptation with respect to which a decision much be
made; instead, it is quite often a kind of slippage of commitment.

Fortunately, given the timing of the genesis of the
cyber world, only “Moral Hazard # (4)” is applicable here. “What the hell,
we’ve got insurance, so let’s not worry about expensive network security
protection.”

II. Universal Characteristics

What then are essential characteristics of all types
of insurance. The nature of insurance is revealed at least in what are commonly
called insurance policies. All insurance policies are now and always have been
contracts.[5]
As with any other bona fide contract, one or both parties to it have tried to
set forth relatively clearly the applicable terms of the contract either
explicitly or by the use of entailments. Like all other contracts the vast
majority of the duties and rights of the relationship formed by the contract
are to be “found” in the contract document, though this is occasionally subject
to disputes.[ii]   There are at least ten of them.  At least they are to be found at the
foundation of conceiving insurance.  They
are very simple and can be listed this way:

1.                 
All contracts of
insurance explicitly involve the transfer of risks, though not using these
words (One party is receiving, usually buying, risks facing the other party.
This is the nature of indemnification. 
To one degree, or another, indemnifications are future looking.)

2.                 
All insurance
contracts involve the transfer of the risk of dealing with having been beset by
one or more perils, i.e., being
beset by a particular peril that was named explicitly, something that still
often (more or less) happens today,[6]
though sometimes in the last couple of centuries, more general terms are
used.  (Indeed, “today,” unlike
“yesteryear” an insurance policy can transfer a risk of an insured to  the insurer having to deal with that
insured’s having been struck by one or more perils to be found in an abstract
category set forth in the contract, where only the abstraction is set forth in
the contract.[7])

3.                 
All insurance
contracts involve the transfer of the risk of dealing with direct and
immediate, immediately connected causes
or with causal chains, the nature of
which are sometimes specified explicitly.[8]

4.                 
All contracts of
insurance are restricted to a determinable set of insureds, sometimes an
explicit list; sometimes they are specified by name, and sometimes they are
specified by category. There is always an attempt and complete
specification.  Usually this has been
done, but sometimes not.

5.                 
All contracts of
insurance are for specified, understood, or nearly understood types of injuries.[9][iii]  Contracts of insurance do not insure against
all possible injuries. Not every injury, however results in a loss; in fact,
sometimes an injury can result in high benefits or profits.

6.                 
All contracts of
insurance exist to transfer risks of losses,
and losses are tied to asset or money damages.

7.                 
All contracts of
insurance are based upon the idea of fortuity.  The purpose of insurance is not for paying
people who deliberately perform acts that are intended to obtain compensation
under the contract of insurance. Often these kinds of acts violate terms of the
relevant insurance policy.

8.                 
All contracts of
insurance are designed to transfer risks only from persons who have a prudent
or prudence-inducing[10]
relationship with that which is insured.[11]
This might be described as an insured’s valuing positively that which is
insured.

9.                 
At the same time,
all contracts of insurance entail the existence of moral hazards. Some ways of them are usually parts of the
insurance contracts,[12] the applications for and of them, plus some
of the conditions connected to the contract. They are there, as indicated to
try to eliminate, minimize, mitigate, or control at least some of the insureds’
susceptibility to moral hazard problems. The existence and power of moral
hazards results from the nature of man in general. We are creatures of
self-interest and temptation. Getting contracts of insurance to be clear about
this point in general, i.e., in standardized and hence generalized policies, is
anything but easy.[13]

            10. Proposition #10, the Moral Hazard Problem(s), as
already indicated, arises because when a person is characterized, at least in
part, by the pursuit of self-interest, having insurance, or a relevant paid-for
source of or right to money, at least tends to diminish the wish and the will
of that person to make sure that it has no loss. It makes no difference,
whether a person is a human person or a corporate type person owned and/or run
by human persons.

 Given this
characterization of moral hazards, there is moral hazard resting upon the
shoulders of the insurer as well as those of all insureds. Insurers have
received premiums in advance of having to pay any claim.  Having already received money from its
insureds and having put the receipt of it onto its books, an insurer is tempted
(has a tendency) to keep the money to spend as little as possible paying
claims. 

Since insurers, or their hirelings, with few very
narrow exceptions, are the only, or the only final, drafting entities doing the
central features of all modern real-world insurance policies, the fact of the
moral hazards inherent in the insurers is not explicitly acknowledged.  Nor are clear rules of prevention, restraint,
or other considerations deterring insurers from succumbing to that hazard—that
peril–acknowledged, even impliedly, it insurance policies.  One wonders the situation would be different
was drafting by “bi-party commissions” invented by both of the what I have
called “families” in the insurance industry. 
(Nor are the moral hazards insureds face because they are afflictions of
insurers generally acknowledged outside the policies either.  Indeed, ads for insurers virtually deny any
such thing or suggest that only other insurers are subject to them.)

It
is important, to keep in mind that every contract of insurance has all these
characteristics, and that is true whether the contract is designed for the
everyday—old, long established–world, for the cyber-world or both. It is also
important, to keep in mind that the idea of a loss is tied inextricably to the
so-called real world. This is true because the idea of a loss is glued to the
idea of money, and not just private currency[iv]
like Bitcoin, a type of “virtual currency,”[14][v]
since its value is determined by “coins of the realm.”

III. Nearer to Being Universals

Although there are fixed, timeless, universals at the
heart of insurance—indeed, at the heart of the very idea of insurance as we
know it—not all well known characteristics are like that.  This is true, at least in part because
insurance is an idea or set of ideas—that had an ancient start and then a long
sporadic history.

One example is that there are many, many types of
policies.  Cyber insurance is just the
latest in a long and now hugely diverse set. 
It all started with bottomry, commercial transport insurance—camels
crossing deserts may have come first but soon–including ocean marine insurance
and “burial”—and maybe a bit of life insurance–for Roman soldiers.[15][vi]

Not only are there different kinds of policies
insuring many different types of entities, actions and events, there are
different types of jobs that policies perform and the way they do it.  Thus, there is primary insurance, excess
insurance, levels of excess insurance, umbrella policies, which are both excess
and primary (as umbrella policies usually are) reinsurance policies for all of
those, and then
reinsurance for reinsurance a/k/a and so forth. 
Moreover, there are different forms, e.g., so-called “cat bonds,” bonds
for various occupations, performance bonds, fidelity bonds, and there can be
many sorts of different mixtures. Imagine a package policy that is primary with respect to one thing, excess to a
different policy, excess to another excess policy, and reinsurance as to
another.

Cyber insurance is simply the latest new substantive
area, and it came into being toward the end of the most insurance-innovative
century, or century and a half, of all times. Having come into being toward the
end of the Twentieth Century, it has been multiplying in many different ways
faster and faster. 

At the same time, it must be remembered that all new
types of insurance policies are built on the terms, definitions, general
exclusions, and conditions of older policies, to one significant extent or another—though,
of course, never completely.  New types
of policies must create or use some new terms and new understandings of what is
covered, but there will be very strong continuity. A very good example of the
reuse of traditional terminology coupled together with brand new terms is found
in the history of aviation insurance. Property policies of the 21st
century are built on policies from the 20th century, which are in
turn built upon those of the 19th century, and those of the 19th
are linked to those of the 18th.[16]
Maritime and fire policies of early in the last century are easily recognizable
as connected to policies 100 years earlier. [17][vii]
This is probably true at least back to maritime policies of the Renaissance. [18][viii]

 As one might
expect, as the centuries have gone by, the policies have gotten longer and
longer, partly, because fire policies of yesterday insured the peril of fires
only and what are often called fire policies today insure perils other than
fire, as well as fire, but are developed from the original fire policies.  In addition, some of the key language found
in earlier policies, for example, “accident,” dropped out of many policies as a
defined term and therefore as a term of immediate and central focus.  But it was followed by  the word “occurrence,”; it  was more or less substituted for it, and it
was then defined, in substantial part, by the word “accident”—the very term
that has just dropped out.   The same
propositions are already true of cyber-insurance, whether it is for that realm
only or for both realms. Perhaps standardization of the policies will cut down
on this but one doubts it.

It is also worth noting, that all insurance involves
the attempted preparation by at least one party to price the product (or
service) in a rational or reasonable way. Insurers now lead the way on this,
assuming that the insureds actively participate at all. Of course, highly
regulated markets have something to do with this as well, but there are vast
efforts spend on in-advance preparation, and it spreads all over the
respectable parts of the industry.

 The reverse may
have been true early on, 25 (or so) centuries ago. At that point, insureds may
have done the original pricing, subject to negotiation, but that changed long,
long ago. As insurance policy pricing has become more and more rationalistic or
scientific or empirically based, and therefore economically and financially
sophisticated, insurers have relied more and more on statistics, for example,
actuarial methods and results. It became even more complicated the more perils
a single policy covered, in parts the value of the perils interact in some
cases. Insureds and many other participants in the various parts of the
insurance industry do not understand how these processes work either, including
many who call themselves “risk managers.” 

(Risk managers may not be particularly involved in
underwriting. They may be engineers, security specialists, or project
managers.  Even if they have some
actuarial knowledge, it must be remembered that some of them are in-house at
insurers; some are in-house with insureds—where they might manage risk in
various ways, e.g., insurance purchasing, collecting injury data, providing
internal advice, and education; some are employees of insurance brokerage
houses; and yet others have their own businesses.)

Naturally, it is more difficult for insureds to have a
good command of all these pricing techniques, nor is it easy for them to find
out. Insurers have an incentive for their pricing methods not to reach at least
many insureds.

These methods are not easy to use in cyber insurance
just yet because the relevant and relatively reliable data is still scarce.[19]  In addition, new techniques are being placed
in the underwriting tool boxes, this being especially true now that a great
deal of the economics of  insuring is now
regarded as something to be found in the toolbox of international finance.[20][ix]

IV.              
Another Universal: Policy Typology

            All contracts of insurance can be
divided into exactly three categories. 
The first type can transfer to an insurer from an insured virtually any
type of risk that can be somehow specified in (or somehow brought into) a
contract of insurance, save one.  

             The category that is the exception is one in
which the insured itself is the peril, where certain conduct of the insured is
the peril against which there is insurance, that is, where the peril to the
insured is its own liability to someone or some entity it has injured or is
said to have injured.  Another way to put
it, is that there is a distinct type of insurance that transfers the insured’s
risk resulting from it (or an entity for which it is liable) having caused
specified injuries to another.

            The
third type is an insurance contract is one that contains both the types of risk
transfers found in the other two. Of course there are other ways to
“typologize” insurance policies. For example, there is insurance for tangible
physical objects, and there is insurance for rights to performances.  There is insurance for autos; there is
insurance for airplanes; and there is insurance for sea ships. That is not the
point here, however.

            The former type of the insurance
contract is called a “First Party [Insurance] Policy” (“1PPs”), while the
second is called a “Third Party Policy” (“3PPs”) and the third type is one type
of that is called a “package policy,” or something of the sort. 1PPs are often
called “property policies,” while 3PPs are usually called “liability policies,”
though they often 3PPs contain a 1PP component, namely, the carrier’s duty to
defend its insured, if sued or compelled to arbitrate.[21]

The presence of 1PP coverage inserted into a 3PP
policy is extremely important to remember when we consider the cyber-policy—the
Travelers CyberRisk Policy to be
discussed later in Part II.  There is an
issue that will be seen to arise in a policy with both 1PP and 3PP parts, where
one of the parts is entitled “Third Party Insuring Agreements” while the other
is entitled “First Party Insuring Agreement” but where one of the latter
agreements (a 3PP) is—or appears to be–quite surprisingly incorporated, mixed,
or blended,  at least in part, into one
of the former type (1PP) agreements, or vice versa, where a 1PP is incorporated
into a 3PP, somehow.  From the point of
view of an insurance policy geek with proclivities toward cyber policies, this
is an astounding and fascinating development.)

In addition, there can be both cyber-policies and
real-world policies in the same joined together and be a sort of integrated
packet of documents that is, the same “package policy.”  (It is a good idea to remember that a package
policy can be “togethered,” if that can be a word, if that is a word, as one
might say, to various degrees.  These can
be real headaches when it comes to policy interpretation for lawyers and
adjusters. The problems can be multiplied if both 1PPs and 3PPs of both worlds
are packaged together.)

In any case, there are at least, four ways to join
different types of policies together. (i) Different policies are simply
clipped/stabled together. (ii)  Policies
can be shuffled together with substantive portions of two or more policies
overlapping with more or less true fit. 
Of course, when creating package policies from the two worlds this can
be difficult. One way to help is by stating which explicitly which exclusions
apply to which insuring agreements. 
(iii) The two or more policies can be genuinely integrated. And (iv)
Packaging can be done by using endorsements.

At the same time having “integrated” policies—one
policy with consecutively numbered pages, a Table of Contents that’s clear and
briefly descriptive, as few endorsements 
as possible, and no jumping around required—makes life easier for
handlers, whether from the insurer, the agent-broker, or the risk manager from
the insured. A policy can simply be this way right from the start without any
shuffling or endorsements. A totally integrated policy also makes it easier for
a coverage attorney to do the coverage analysis and the explanatory letter and
lay it all out clearly.  Too many different
parts, section, and paragraph numbers make reporting by lawyers harder to
follow, but it may be necessary to foster needed precisions. Lawyer prose is
often inescapably opaque.

[1]
The nature of risk and dealing with it in the 20th Century is discussed
in an interesting manner in Arwen P. Mohun, RISK: NEGOTIATING SAFETY IN
AMERICAN SOCIETY (2013). A large number of more general discussions are
referenced in her endnotes for the introductory chapter and in the discussion
of insurance in the next chapter.

[2]
From a philosophical point of view, the idea of to make happen may itself be
obscure.  But we don’t practice insurance
law at a philosophical level.

[3]
See Tom Baker, On the Genealogy of Moral
Hazard, 75 Tex. L. Rev. 237 (1996). 
Professor Baker studies the history of this idea, and discusses all of
the phases, except for #(3). Here are two forms of moral hazard–one old, one new.  For several centuries observers have been concerned about there being life insurance where the policyholder was someone other than the insured or someone close to (usually a) him. It was though that this might create the moral hazard of murder. Obviously this is correct.  More recently there is the case of “crop prevented coverage.” This is a type of crop insurance where what’s covered is the farmer’s inability to plant a specified crop because of conditions existing at relevant times.  That might be flooding, or it might be drought. The moral hazard s that the farmer will be tempted to seek coverage for a type of crop that the farmer knows will likely be “unplantable.” This has become a political controversy because of fact that some corp insurance is subsidized by the federal government.  

[4] David
Hume, ENQUIRY CONCERNING THE PRINCIPLES OF MORALS (1751).

[5] Quite
frequently, I will refer to both parties to contracts of insurance as entities.
Thus, I am treating real persons—people—as entities, which they actually are.

[6]
Here are some actual examples of “named perils”: fire, flood, hail, collision,
terrorist attack, hackery, embezzlement by an employee, trademark infringement,
breach of security, lock out of network system, and extortion as to lock out.
Here is an example of an unnamed, general peril: an accident, a disease, health
of an animal, business interruption, computer malfunction, default on a note,
specified defects in a bond, and so forth.

[7] As
a matter of semantics and logic, of course, all risks listed have some level of
generality.  This is true even if the
risk is “hail stones no larger than a dime width sphere blown into a tin roof
from the west.” Semantically speaking this risk still have elements of
generality built into it. Of course, taking recognition of this fact makes the
idea of ambiguity much broader than it is usually perceived, and that have
potentially profound implications for insurance in the cyber world, since much
of the terminality invented for it is relatively new and therefore not fixed in
stone.

[8]Here
is an example of different types of causation: insurance for direct causation,
but none for indirect.

[9]
Sometimes the term “injury” is used explicitly, e.g., with respect to the human
body (“bodily injury”). Sometimes the term “damage” is used instead of “injury”
to mean the same thing (“property damage”). That useless distinction can be
confusing and the concept of “damages” goes well with the concept of “loss.” (If
asked “What were you damages?,” most people would know the question was “How
much?”)

[10]
From what point in time the prudence is
measured, for how long it’s measured, and how much there need be, varies.

[11]
Where tangible property has been involved ownership, something related to
ownership (like a mortgage), or something like ownership, are used as one of
the ways to limit who may be an insured. The same more or less holds for
intangible property.  For example, in
trade credit insurance and its near relationships a right is covered, in
particular, the right to be paid. The same propositions are true in the cyber
realm.

[12]
Often some of these pieces of the design are built into or around the
application for insurance.  For example,
an insurer might require that the insured have and know how to use fire
extinguishers. Some of these may be for real world policies (for example,
having tires checked); others may be for cyber-world policies (having using
encryption codes of some sort or a specified sort; and yet other may pertain to
both worlds (like fire extinguishers).

[13]
See Kenneth S. Wollner, HOW TO DRAFT AND INTERPRET INSURANCE POLICIES (2nd
Ed. 2007), a mildly interesting book that actually portrays nothing an average
lawyer would not know about how to draft an insurance policy correctly.  The point to the citation being that there is
little helpful literature about how to actually to draft; this is now and
perhaps always has been and esoteric art. 

[14]
The phrase or term “virtual currency” is just another name for “private
currency” devised for the “virtual world.” One wonders whether this use of
“virtually” is like usage of “worlds” and “spaces” in talking about the
so-called “real-world” and the so-called “cyber-world.”  Historically, the latter lead to the former,
bit semantically, they are distinct.  The
world “virtually” usually means “very much alike,” “can perform the same
function though different in nature,” “almost alike,” or “near substitute.” The
term “world” has not such meaning except, maybe referring to video games. The
terminology around “virtual currency” is just another phraseology for a kind of
currency devised for the one world that there is.  There is a nice example of fog and confusion
arising out of the idea of there being plural worlds.

[15] [15]
C.G. Trenerry, THE ORIGIN AND EARLY HISTORY IN INSURANCE: INCLUDING THE
CONRRACT OF BOTTOMRY (1926) though written a while before that. (Actually,
bottomry is an obvious case of what is actually insurance, and why people have
resisted recognizing this is beyond me.)

[16]
See H.A.L. & Edwin Green, THE BRITISH INSURANCE BUSINESS 1547-1970 (1976),
Harold E. Raynes, A HISTORY OF BRITISH INSUANCE 
(Second Edition1964), and Robin Pearson, INSURING THE INSUSTRIAL
REVOLUTION: FIRE INSURANCE IN GREAT BRITAIN, 1700-1850), and a few others for
UK.

[17]
Samuel Marshall. A TREATISE ON THE LAW OF INSURANCE: IN FOUR BOOKS
(1800-1805[hard to tell). Most of the sections and pages by far are about
maritime insurance. The others are an Introduction, Life Insurance, and Fire Insurance.
The U.S. version was apparently published in 1805, though the British version
was used in the U.S. before that.  The
currently available volume is a “hugely” thick one volume paperback. It is not
recommendation that you drop it on your foot or on the head of your baby or
grand-baby in residence or elsewhere.

[18] Giuseppe
Stephani, INSURANCE IN VENICE[:] FROM THE ORIGINS TO THE END OF THE SENREISSIMA
(1958) Chapters  V entitled “The Insurance Contract” pp.
57-65, including picture  (It is
distressing to observe that there was a brisk trade in slave insurance. It is
encouraging to note that there were strict laws against at least some forms of
trading in them.  Unfortunately, the
business was too lucrative (literally in ducats) to resist. See pp. 52-54.

[19]
See Michael Sean Quinn,  “Underwriting and Cyber Insurance Coming of
Age,” Quinn’s
Commentaries on Insurance Law (June 24, 2014)[a Blog].

[20]
Eric Briys & Francois de Varenne, INSURANCE FROM UNDERWRITING TO
DERIVATIVES[:] ASSET LIABIITY MANAGEMENT
IN INSURANCE COMPANIES (2001)

[21]
For reasons of saving space, I will use 1PP to
refer to a first party insuring agreement where there are other insuring
agreements, and 3PP to refer to a liability insuring agreement where there are
other insuring agreements in the policy. 
This is done, of all things, in the interest of minimizing abbreviations
and hence clarity.

The Law Firm of Michael Sean Quinn 

et

Quinn and Quinn

                                 1300 West Lynn Street, Suite 208

                                             Austin,
Texas 78703

                                                 (512)
296-2594

                                            (512)
344-9466 – Fax

                                E-mail:  mquinn@msquinnlaw.com

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Liability Insurer and Their “Duty to Defend” Their Insureds

FUNDAMENTAL RULES OF THE DUTY TO DEFEND
OF LIABILITY INSURERS: A PRACTICAL,

INTRODUCTORY GUIDE,

 USING TEXAS LAW AS A PARADIGM

Michael Sean Quinn*

                This
is a “ how-to essay.” It is not designed to prove anything.  We are uninterested in reviewing the 100±
Texas cases that can be found at least partially on this topic.  All we want to do is to help new-comers find
their way around quickly. 

            Many liability insurance
policies—although not all of them–have a semi-automatic duty built into them
requiring the insurer to defend the policyholder (policy-owner, or close to it)
and/or at least some insureds against certain lawsuits.  In many states, if claims are asserted for
which there would be a duty to indemnify when the covered claims are proven,
then there is a duty to defend an insured in a lawsuit filed against the
insurer’s insured.  (Sometimes, this duty
can extend out to sit situations in which an uninsured person/organization is
the first named defendant, but he/she/it files a third party action (or a cross
action) against the insured.)

Usually,
the duty to defend is determined by the content of the plaintiff’s pleadings,
without reference to actual empirical facts. 
This is a widely recognized rule. 
In Texas, and some other states, 
it is often referred to as the “Eight-Corners Rule,” in accordance with
which an insurer’s duty to defend is determined by comparing the plaintiff’s
pleading with the insurance policy. 
(Page by page, it is the comparison of the four corners of the
petition/pleading and the four corners of the insurance contract, for a total
of 8 corners.)  (Conceivable the new
cyber and/or digital world(s) will change some of this, but the changes will
probably keep the same old name.  We are
all used to it, and trivial changes are pointless. Why should the phrase
“business interruption insurance” ever have been changed to “business income
insurance”?)

            In some states, the rule is not
quite as strong as it is being portrayed here. 
Some courts will depart from the rule when a plaintiff files outrageous
pleadings.  This essay is not meant to
address the more relaxed rule in other states; it’s a distinctly minority rule
anyway, and some of the states which have a different rule actually have
several different rules, and the one explored here is usually one of them or
one of the variants on what only appears to be a single guiding principle.

            Just for the record, it is worth
remembering that contracts of liability insurance are often called “third-party
insurance,” while contracts where the insurer’s obligations to pay will be
generated by damages the insured sustains are called “first-party policies.”
The duty to defend is first party coverage inserted into a third-party
policy.  It is also worth noting that
although liability policies are called “indemnity policies,” this is not
generally exactly right. As a legal term, “indemnity” traditionally and
narrowly understood means that A will pay B for what B has had to pay C.  Thus indemnity is principally a concept of
reimbursement. Most commonly used third-party policies are not reimbursement
policies; they are “pay on behalf of” policies. However, they have called
“indemnity policies” for so long that there is no going back.

            When there is a “duty to defend,”
the carrier is often contractually required to conduct the defense, and it
often has the right to do so, subject to some exceptions.  Usually, the carrier picks defense counsel,
subject to some exceptions. Usually, the carrier pays the defense lawyer on
behalf of the insured, but not in all policies. And in some liability policies,
there is no duty to defend at all. For generations, defense lawyers from around
the country—from around the U.S.A.—have worried about the fact that the insured
is clear their client, but they are taking instructions and receiving fees from
the liability carrier. This is sometimes referred to as the “triangle of
conflicting interests,” but it has many names, Sometimes, the carrier had a
duty to pay for a defense, e.g., by reimbursing the client, and often this partial-duty-to-defend
lets the insured pick its own lawyer, but from a list created by the insured.
Having mentioned all these very important topics, now is the time to remark
that this essay is about none of them.

            The topic of this essay is mainly of
sets of simple rules, directives and norms.

 Section I formulates eleven rules for
determining the insurer’s duty-to-defend. 

Section
II is a set of rules for plaintiffs’ lawyers trying to devise pleadings that
will trigger the duty to defend for the defendant/s being sued.   (Notably insurers make decisions not by
groups but by individuals.  Thus, if a
plaintiff wants each of five defendants to be defended by an existing liability
insurer, the plaintiff must make sure that the rules apply to each defendant.)         Section
III is designed for coverage lawyers trying to figure out whether there is a
duty to defend.  Coverage lawyers can
apply these twelve rules and thereby avoid mistakes in analyzing and
determining whether the duty applies.

           

I.          ELEVEN RULES GOVERNING
THE LIABILITY INSURER’S DUTY TO           DEFEND.

            Almost all of what is said here
should be understood in the context of the Eight-Corners Rule.  The application of this rule and thus
determinations of an insured’s right to a defense, do not depend upon truths
about the external world.  Instead one
depends upon truths about the complaint/petition filed against the
defendant-insured and upon truths about the liability insurance policy between
the defendant-insured and the insurer. 
These truths should not generally be regarded as complex, subtle, hidden
or mysterious. 

These
rules should be applied in a common-sense and straightforward way.  This is a hard lesson for legal academics,
resourceful and clever coverage lawyers and insurance executives that may be
tempted by economics.  Nevertheless, they
are almost always fundamental, except when the plaintiff’s complaint/petition
in the underlying case is outrageous.  Even
then, liability insurers usually have a duty to defend which courts recognize.  See
Lee R. Russ and Thomas F. Segalia, Couch
on Insurance 3D § 200:20 at p. 200-51 (2005+Supplements).  Chapters on the duty to defend for liability
insurers can be found in Chapters 200-202.

            These rules apply to every court
(state or federal) so long as “Eight-Corners Duty”-type law applies.  However, not all liability policies contain a
duty to defend, such as D&O policies.

1.         Whether
an insurer to a liability policy/contract is obligated to defend the insured is
a question of law to be decided by
the court.

                        Comment:   This implies that
virtually all questions as to whether the liability insurer has a duty to
defend, at least under the Eight-Corners Rule, should be decided by summary
judgment.  Even if this issue were not a
question of law, it should be decided on summary judgment since the only
relevant evidence is the plaintiff’s pleading in the underlying case and the
insurance policy.

2.         To
determine an insurer’s duty to defend compare the relevant factual allegations or assertions in the four corners of the
plaintiff’s live petition or complaint with the language of the insurance
policy. 

Comment:  What is most important about this rule is
that it is factual assertions which
are to be examined.  Assertions as to law
are irrelevant.  The closest case one ever
finds to issues of law influencing the duty has to do with whether someone is
an insured.  Sometimes, plaintiffs try to
plead a policy into existence by pleading facts in a way that might evidence
that the defendant is an insured under a certain insurance policy.  Usually, courts refuse to treat this sort of
tactic as a relevant factual assertion. 
In general, factual assertions are relevant when they pertain to
empirical matters that tend to prove that a defendant is liable for injuring
one or more plaintiffs.

3.         The
focus is on the factual allegations that show the origin or alleged cause of
the compensable damages.  It is not on
the legal theories alleged.

Comment:  Some words used by lawyers encompass factual
assertions and legal assertions.  The term
“negligence” is one such example.  Thus,
asserting that someone has acted in a negligent way is an assertion of
fact.  The term is also the name of a
cause of action.  In general, when there
is an assertion that a defendant has been negligent, that should be treated as
a fact assertion.

4.         Courts
are to give a liberal interpretation to the factual allegations in the petition
when applying the Eight-Corners Rule.

Comment:  The word “liberal” here is not clear.  It likely means “expansive” or “flexible”. It
should be thought of in terms of a judicial tendency to try to find
coverage.  After all, the purpose of
insurance is to protect its insured, and if the insured has been sued, the
insured probably needs a defense.

5.         In case
of doubt as to whether allegations in the complaint/petition against the
insured state a cause of action covered by a liability policy that are
sufficient to compel the defense, all such doubt will be resolved insured’s
favor.

Comment:  In general liability policies, including many
homeowners policies, there are two separate approaches to liability.  One of them, often called Coverage A pertains
to physical injuries caused by accidents. 
The other coverage, often called Coverage B, pertains to economic and
psychological injuries caused by named causes of action, such as defamation and
false arrest.  It is much easier to be
expansive and flexible in the case of Coverage A than it is in the case of
Coverage B.

6.         If a
petition/complaint does not allege any facts falling within the scope of
coverage, an insurer is not required to defend a suit against its insured.

Comment:  The fact pleadings on the basis of which a
duty to defend is decided need not be specific, narrow or colorful.  For example, the following proposition would
probably trigger a duty to defend in most jurisdictions:  “The defendant acted negligently when he
mistakenly performed some act at issue in this case that proximately caused a
series of unexpected consequences in the empirical world causing the plaintiff
bodily injury (or property damage).” 

7.         The
insurer does not have a duty to defend if the facts pleaded falling within the
insuring agreement also fall within an exception or exclusion.

Comment:  If the plaintiff pleads two separate
propositions, one of which is within the insuring agreement only, while the
other is within both the insuring agreement and an exclusion, then there is a
duty to defend.  (See Rule 10.)

8.         The
court may not read facts into the
pleadings, look outside the
pleadings, or imagine unpleaded factual
scenarios that might trigger coverage when they are not there or genuinely
suggested.

Comment:  This rule does have some vagueness in
it.  How does one distinguish between
something that is genuinely suggested, something that is only suggested and something
that is subtly hinted at?  The
problem:  The prohibition on the use of
imagination is common.  It is to be found
in a variety of cases, and its opposite is to be found nowhere. Suppose a judge
is trying to figure out whether a duty to defend is to be provided given vague
language in the pleadings.  Entertaining
and reflecting upon images of conduct in the imagination to determine whether
they would fit into both general terms of the pleading and the terms of the
policy, and so thereby conform to the Eight-Corners Rule is appropriate and
sensible.  Hypotheticals invariably
involve the use of the imagination to some degree.  What the imagination should not be utilized
to do is to alter the language of or the ideas in the pleadings. 

9.         An
insurer’s duty to defend arises if the factual allegations against the insured,
when reasonably construed, state at least one cause of action potentially
covered by the policy.

Comment:  A potentially non-covered suit creates
problems for the insurer that abides by its contractual duty to defend but also
intends to disavow any duty to indemnify. 
Should the insurer choose to assume the defense, it must clearly and explicitly
reserve its right to disclaim coverage early on.

10.       A duty
to defend any one of the claims against an insured requires the insurer to
defend the entire suit.

Comment:  The court will not allocate the defense to
only those claims in the petition that are covered under the policy.  The whole suit gets defended, if any part of
it does.  This rule does not apply in all
states.  It does not apply in certain
states restricting coverage away from causes of action that could not possibly
be covered, for example, battery or fraud.

11.       Courts
are required to resolve all doubts regarding the duty to defend in a favor of
the duty.

Comment:  Many courts subscribe to this rule quite
explicitly.  The word “all” should be
changed to the word “most” in some states. 
When a trial court indicates that there is a duty to defend, courts of
appeal seldom reverse them. 

II.        PLAINTIFF’S PLEADINGS:
HOW TO PLEAD IN ACCORDANCE WITH THE RULES.

1.                 
Some allegation of accident, negligence, inadvertence,
mistake or error must be pleaded (subject to a few exceptions).

Comment:  A fundamental principle of insurance is the
Principle of Fortuity.  Generally,
insurance is the transfer of risk for losses that are fortuitous.  This is not to suggest that only accidental
human behavior is insurable.  Intentional
conduct may be insurable (for example, when it accidentally leads to
consequences that cause unintended injuries). 
Nevertheless, insurance does not cover deliberate conduct that
intentionally causes contemplated injuries. 
Plaintiffs’ are advised not to be obscure on this point.  There should be a clear allegation of
fortuity.

2.                 
Address the time of occurrence in a general and broad
manner when you are unsure about when there was coverage—this may trigger more
than one policy.

Comment:  Avoiding dates may diminish over time, if
summary judgment is sought, for example, on the basis of limitations.  Frequently, however, the plaintiff and
defense counsel will defer any such motions until late in the game, in order to
make sure that the duty to defend is not destroyed.

3.                 
If it is reasonable to believe that some sort of bodily
injury may exist, plead that there is “probably” bodily injury.

Comment: Pleading
only mental anguish and/or financial loss, as a general rule, will not trigger
coverage.  In addition, it is not
permissible to lie and claim there was bodily injury when there was not any.

If
the plaintiff’s claim is defamation, the bodily injury is not central. Make
sure that injury and damages independent of bodily injury are pleaded.

Comment:  There usually is no coverage for bodily
injury when recovery is being sought under Coverage B.  It need not be pleaded, and certainly should
not be emphasized–unless there is also an injury-causing accident involved.

4.                 
Remember the phrase “personal injury” is used quite
differently in tort-talk and the language of insurance policies.

Comment:  In many general liability insurance policies,
the phrase “personal injury” simply refers to the kinds of injuries that arise
in torts for which Coverage B applies. 
Under general tort law, the phrase “personal injury” refers to any kind
of injury (whether bodily, mental or financial) suffered by a person as a
result of the tort.

5.                 
Obtain all the possibly relevant liability insurance
policies at issue as soon as possible.

Comment:  If there are a variety of liability insurance
policies, there may be various ways to plead the complaint/petition.  Various policies may also influence how
insurance policies are triggered.  Study
them.  If policies are not available, but
one possibly exists, use standard forms as a guide until the policy/policies
are produced.

6.                 
Once you have a policy that may possibly provide
coverage, amend your petition/complaint as necessary to trigger a duty to
defend.

Comment:  Often, defense lawyers will not attempt to
file special exceptions to pleadings if it is not in the interest of their
client, the insured.

7.                 
Plead facts both in particular and in general
ways.  Fact-pleadings that trigger duty
to defend coverage need not be specific, unless you are court ordered to do so.

8.                 
Conflicting fact patterns involving unintentional
conduct about which there is uncertainty should be explicitly pleaded in the
alternative. 

Comment:  This does not require that there be separate
repetitive paragraphs.

9.                 
Never plead a factual proposition that you know
to be false.

Comment:  A lawyer asserting a clear factual
proposition which s/he knows to be false in a pleading is unethical.  This sort of conduct is prohibitive by the
Rules of Professional Conduct governing lawyer behavior and by Rules of
Procedure, such as Rule 11 of the Federal Rules of Civil Procedure, by Rule 13
of the Texas Rules of Civil Procedure and by those of most other
jurisdictions. 

10.             
Avoid pleading factual propositions that your client
will likely reject. 

Comment:  This is especially true if the client is
rejecting the proposition on the grounds of contrary evidence.  There should be less concern when the client
is rejecting the proposition on the grounds of embarrassment.

11.             
It is not necessary to plead the legally organized
elements of causes of action in orderly detail to trigger a duty to defend.

Comment:  Recall section I, Rule 3, courts are not
looking for legal theories alleged.

13.       If the
defendant probably has liability insurance but no such insurer has provided a
defense, counsel for the plaintiff should consider doing one of the following:

a.         Ask the defendant’s
lawyer why not;

b.         Ask the
defense lawyer what you can do to help obtain insurer involvement (e.g.,
replead if petition was inappropriately pleaded).

c.         Report
the claim yourself to the defendant’s insurer, indicating who you are.

12.             
When in doubt use an experienced coverage lawyer to
draft the petition.

III.       COVERAGE COUNSEL:  ANALYZING THE EIGHT CORNERS.

1.         Carefully
study and take notes in your analysis of the petition and insurance policy,
including endorsements.

2.         Rarely
are insurers (or their lawyers) permitted to go outside the pleading to decide
a duty to defend even when the factual allegations in the live pleading are
extremely vague.  The use of extrinsic
evidence is not favored in most states, including the federal courts.  Most courts tend to strictly apply the
“Eight-Corners Rule.”  In the absence of
clear contrary authority, do not use extrinsic evidence.

Comment: Although Texas has no bright-line
rule against the use of extrinsic evidence, recently the courts have moved in
that direction.  California and Arizona are states that do not subscribe to
the rule against use of extrinsic evidence.

3.         Factual
matters that are not in any way connected to the underlying tort claims are not
to be included in duty-to-defend coverage analysis.

4.         Focus
on factual allegations not the causes of action, when analyzing
petitions for duty-to-defend determinations.

Comment:  This proposition applies to Coverage A in
general liability insurance policies.  It
applies whenever what is insured against are accidents.  Even in the case of Coverage B, it is
unlikely that an insurer would have to find a duty to defend if the only
relevant allegation in the petition is this: 
“The defendant committed the tort of defamation against the
Plaintiff.”  Factual allegations can be
quite general, even vague, but there must be some factual allegations.  Arguably, the mere assertion that someone has
committed a tort does not by itself imply factual allegations triggering a duty
to defend.  The preceding assertion may
be controversial in some states.  On the
other hand, the following assertion probably triggers coverage:  “The Defendant committed the tort of
defamation with respect to the Plaintiff, although the Defendant did not
realize that his assertions were false.” 
This allegation contains a factual assertion, whereas the former does
not.

5.         Use of
the graphic tool below will assist in the analysis. 

I    (1)  
(3)

II    (2)  
(3)

III    (1)  
(4)

IV    (2)  
(4)

Specific Factual

Allegations of

Unintentional

Behavior

General Factual

Allegations of

Unintentional

Behavior

Specific Factual

Allegations of

Intentional

Actions

General Factual

Allegations of

Intentional

Actions

            a.         Ignore columns III and IV.

            b.         Ignore the presence of any
contradictions or inconsistencies across the various columns.  Analyze each separate component of any
contradiction or inconsistency.

c.         If
there are sufficient specific factual
allegations to constitute negligence, gross negligence or products liability
cause of action, then there is a duty to defend.

d.         If
there are sufficient factual allegations to constitute a cause of action named
in the insuring agreement, then there is a duty to defend. 

            e.         If (i) there are sufficient general factual allegations to
constitute a cause of action and if (ii) a reasonable person can coherently
find a cause of action, then, there probably is a duty to defend.

            f.          Generally, facts alleging intentional conduct will be excluded and will
not trigger the duty to defend (so long as there is no other facts fall within
the scope of coverage).

6.         Resolve
ambiguities in favor of there being a duty to defend.

Comment:  Looking for, recognizing, discarding and even
thinking about ambiguities is sometimes a complicated process.  It is true in reviewing coverage.  The following are five sub-rules in thinking
about ambiguities.

            a.         If the ambiguity is obvious, infer a
duty to defend.

b.         If an
ambiguity is obscure, and research reveals no unreversed cases asserting
ambiguity, ignore the ambiguity at least at first and treat the language as
unambiguous, without danger of insurer bad faith.

c.         If
ambiguity exists, is obscure and there is mixed law, let the insurer client
decide whether to defend after proper consultation.

d.         Remember:
The term “accident” is ambiguous, but few courts have said so.

e.         Ambiguity
comes in many forms:  vague terms can be
ambiguous; word orders can render apparent clarity ambiguous, and conflicts
between two terms can produce ambiguity.

7.         All
doubts and genuine uncertainties are to be resolved by courts in favor of the
duty to defend.  This is the way coverage
counsel should approach them.

8.         Coverage
determinations should be researched and written out.

IV.            
CONCLUSION

As indicated in the beginning, this essay consists
of three separate sets of rules, introductions thereto and comments
thereon.  It is a formulation of basic
rules that can be utilized in analyzing the “Eight Corner’s Rule” and
determining whether the insurer owes its insured the duty to defend a
lawsuit.  Hopefully, with this essay as a
guide, the analysis can be tackled with some ease.

*Michael Sean Quinn, Ph.D., J.D., c.p.c.u. . . .

The Law Firm of Michael Sean Quinn et

Quinn and Quinn

                                 1300 West Lynn Street, Suite 208

                                             Austin,
Texas 78703

                                                 (512)
296-2594

                                            (512)
344-9466 – Fax

                               E-mail:  mquinn@msquinnlaw.com

Olga
Seelig was substantially involved in writing an earlier draft that was presented
at a State Bar CLE in Texas some time ago. 
The rules have not changed, though wordings sometimes have.

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Lusitania Sunk, Causes of Action, and Insurance — Part I

THE SINKING OF THE R.M.S. LUSITANIA AND IMMEDIATE LITIGATION–MOST ESPECIALLY INCLUDING INSURANCE, Part I

Michael Sean Quinn (See below*)

May 7, 2015 will be the 100th birthday of the sinking of the cruise liner The Lusitania.  It was one hell of a big boat, and it was a good deal more elegant both on its inside and outside than are the many storied cruise boats of our current age. Even a columnist as distinguished as George Will (Washington Post) wrote about it. See Austin American-Statesman, May 3, 2015. Mr. Will wrote that the sinking of the Lusitania was a tragedy, but not the cause of others; in other words, not the cause of significant events. Maybe so. That has been contested now for nearly a century. One thing is certain however. It plaid a significant role in the reparations controversies between Germany and the United States after the conclusion of the war, and it general several significant litigated cases, e.g., with respect to war risk exclusions in life insurance policies, among others. Life insurers even made a claim to the commission adjudicating reparations. 

In any case, the ship was on a voyage from New York to Liverpool.  The ship sailed more or less directly NE; when it got a little past Ireland, it was to turn left; get to the ocean near Liverpool, and turn right.  The ship was not zigging and not zagging.  The sinking happened 12 or so miles off the southern, coast of Ireland, more or less.  There were a large number of fatal casualties, of which 125+ were Americans. The ship sank approximately 300± feet of water, where it has resided for the last century.  

It was torpedoed by a German U-Boat, as the result of a change in German maritime war policy. The one torpedo coming from the U-Boat may have triggered a second explosion, and especially as a result of that second explosion, the ship sank very quickly—18± minutes or so. (The second explosion happened, no doubt; the only question about it is what caused it.)

There is a substantial literature on the disaster—a few books, some articles, many newspaper stories, and now bunches of stuff on the Internet. As one might expect some of the literature is excellent; some is respectable; some is ok; while some is shit, especially the ones deploying the rhetoric of conspiracy theories and nothing or not much else. Like respectable evidence, for example. (Here’s an example: Did Winston Churchill arrange the sinking of the boat—him and his Mason and Jewish buddies?)

 Just as one would expect, the literature is creeping up, now that the 100th birthday is approaching. Erik Larson’s DEAD WAKE: THE LAST CROSSING OF THE LUSITANIA   (Crown Publishers, 2015) has been well reviewed by both NYT, Book Review, Sunday March 8 and WSJ on the previous day. The book has been a best-seller for more than several weeks, and had the #1 spot in Sunday NYTs at least twice. (On May 17, 2015, I was still there, ranked #5 On June 21, 2015, it was listed as #8 on the NonFiction Best Seller List, and by July 12, 2015 it had gone back up to #5. Or was it #4?  On September 6, 2015, it was #7.) In the Review section of the Saturday-Sunday WSJ, available on August 29, 2015, the book was #4 on the “Nonfiction E-Book” Best Seller List for the period ending on August 23. Of course, most interesting things get old and “peter out” eventually, but this one is hanging on for a long time, as these things go. It was still listed on September 6th.) Perhaps it is worth knowing that the phrase “dead wake” means the stage of a wake from a ship where the existing of the wake is almost over.) According to the January 3, 2016 NYT Book Review DEAD WAKE was still on the best seller list: 14th after 31 weeks on the list. It had dropped off the WSJ’s list long before. 

A second book was also published recently, though not with the same “buzz”; for example it was not reviewed in the Sunday NYT, and it has not been a best seller. Greg King and Penny Wilson, LUSITANIA: TRIUMPH, TRAGEDY AND THE END OF THE EDWARDIAN AGE (2015). Neither book has anything significant to say about insurance and the King-Wilson book says nothing at all on the subject.

A bit more about insurance is to be found in the Jules Witcover, SABOTAGE AT BLACK TOM: IMPERIAL GERMANY’S SECRET WAR IN AMERICA – 1914-1917 (1989). See p. 284. Of particular interest in this book the way insurers played a role in the case before the Mixed Claims Commission–the one that lasted from 1914 until 1939 at the earliest–that arose in part out of the explosion at Black Tom Island in New York harbor.  That is an interesting tale, but it is not one to be retold in

One of the most interesting speculations was that the ship was carrying a good deal of ammunition for the British. That mystery was resolved some years ago—it was carrying a lot of it–and I will tell a bit of that part of the story later. A related speculation has been what did the Germans know about this and when did they come to know it. Finally, there is the more legalistic controversy about the international law of Germany’s justification for doing what it did, given what the British were doing about Atlantic shipping. (That speculation is purely abstract and hyper-academic, since Germany threw in—or was forced to throw in–the towel on this matter by the Treaty of Versailles.

There has not been a good deal of discussion of insurance—indeed, hardly any, except for several discussions in the texts of the Mixed Claim Commission, and they will be discussed later.  For example, the ship itself, was worth more than $10m in the dollars of that day, and I have not been able to locate or obtain the war risk insurance policy issued by the Liverpool and London [or “London and Liverpool”] War Risk Insurance Association. [Footnote #1] covering it covering Cunard and at least some of the ships it owned. Not much is known now about form maritime policies at that time about special war risk policies then,* nor have I found the actual policy covering the Lusitania. Nor has much of anyone else;  in fact, one court observed that it was not provided with a copy of the policy. (Or, maybe it would be better to say that the court expressed surprise at not receiving it.) (*The truth is, of course, that war risk insurance has been around especially for ships of the sea, for centuries, though is is now even more so for aviation disasters.  (It was apparently one of the important issues in the so-called  “The Alabama Cases” which was a dispute between the U.S. and England arising out of the latter’ activities on behalf of the South in the American Civil War. Sometimes parts of very old policies can be found. Today, war risk insurance often includes terrorism coverage.  Centuries ago they often covered a predecessor of terrorism, to wit: piracy. Contemporary terrorism can now be covered, or not.) 

I cannot even find “knock offs” of the policy on any of the many historical antique auction houses findable on the Net. In contrast, there is at least one good fragment of an insurance story to be found on the Internet, and I will share it, as we go along.

I intend to tell the story, to the extent that it is a story, in short little essays.  Given the character of the tale, I don’t think there are many who would want it read it all at once. And I will be telling a couple of stories related to insurance that are not really insurance or not really an insurance matter closely related to this stunning beautiful ship.

Not all of the essays will be about insurance cases directly arising out of the Lusitania disaster.  One will involve an insurance case arising out of the attack on Pearl Harbor years later. One will involve a workers compensation case, which is an insurance sort of case, though it may or may not have involved an actual insurance company. In addition, (1) there is related law pertaining to probate matters, and there will be brief mention of it, since the problems arose out of the Lusitania, and (2) there is a related case  pertaining to recovery for wages. 

There is also a story involving what we would now call wrongful death cases and how they were handled by an international commission.  That is too big a story (or whole set of stories) to tell, though there is one specific piece of it that involves issues raised by life insurers.  That story will very be mentioned much later, and–interestingly–it involves the awarding of legal fees. [Footnote #2]

There is an amount of material available on amounts paid to survivors and to the relatives of those killed that have inheritance rights.  There is also a good story—although the evidence is thin—regarding some things one of the passengers had in his possession that was most assuredly insured, but with respect to which there is almost no available discussion.

This introductory blog, is now long enough, so I will not tell even one of the insurance stories.  I will start in  Part II. It will be about the Wreck Commission. and its Report–really its decision. It will be followed by Part III which will concern a decision by an American court as to Cunard’s liability in what is called a “Limitation Case,” under the law of admiralty and an 1851 statute.. 

Part IV.A is a simple case in which coverage is sought under a life insurance policy. Part IV.B is another life insurance case that years later cited the case discussed in IV.B but had a very different result. Part IV.A may say more about the times than it does about the role of insurance in the “small picture” of the disaster, and it certainly reveals something about the changing bases of legal argument in American courts. Part V is a combination insurance probate case, while Part VI is a pure insurance case, though one resulting from the Lusitania tragedy. 

The contract of insurance in question in Part IV.A was a life insurance  policy on Alfred G. Vanderbilt who was drowned as a result of the sinking of the ship. I will discuss the case first, and then say a couple of words about the insured.
Some of these “Parts” will concern the litigation regarding whether the ship owner or some of its employees were negligent and if so whether they caused the disaster.  Other parts will discuss some of the litigation consequences that followed the disaster. Some of them will pertain to insurance matters. They and some of the others will be found both in the series of blogs Quinn’s Commentaries on Insurance Law and in the blog Quinn’s Commentaries on Lawyers and Lawyering. 

[Footnote #1] I have obtained a document entitled “THE LIVERPOOL AND LONDON WAR RISKS INSURANCE ASSOCIATION LIMITED.” The edition I obtained bears Reference Code: C/WRA, Acc. No.: MM.2009.5, and it is identified as having been “Listed by John Moore, Assistant Curator and Sarah Starkey, Curator of Maritime Archives. There is a very brief description of the “club,” and an indication that the “state” was carrying some of the reinsurance at some points of time, though it looks like that started after the sinking being discussed here. So for s the Lusitania policy is concerned, there is a section entitled “Registers of Membership Policies”; it covered the relevant coverage periods, e.g., 1914-1916. There is another sub-section entitled “Time Policy Books, and this too appears to include the relevant years, though not the subsection “Voyage Policy Books.” (Unfortunately, “voyage books” are described as giving “brief details of the routes of voyages made by insured vessel[.]  I have not gotten further than this, however, at least not yet.

[Footnote #2] What will not be discussed is the Montana case in which its supreme court affirmed a citizens conviction under a state Sedition Act for giving at least one speech in which he denounced WWI and stated that the German sinking of the ship was defensible. State v. Kahn, 182 P. 107 (1919) or the Idaho case in which the supreme court of that state refused to disbar a lawyer for negative attitude toward that war and for and fee charging the government had asked be forgone. In re Clifton, 196 P. 670 (Idaho 1921). Nor will there by discussion of the several reported cases concerning citizenship-termination, except to say that the United States does not perform well when it passes “Sedition Acts.” See Rhuberg v. U.S., 255 F. 865 (9th Cir. 865, 869-70 (9th Cir. 1919), Sandberg v. U.S., 257 F. 643 (9th Cir. 1019)(correct and well-reasoned), Schurmann v. U.S. 264 F. 917 (9th Cir. 1920)(perhaps one of the most poorly reasoned judicial opinions in American history), and U.S. v. Herberger, 272 F. 278 (W.D. Wash., 1921)(wrong, thorough, well-reasoned, and even philosophical)

****************

It might be worth mentioning in passing–though perhaps not–that Canard was no complete stranger when it came to litigation involving passengers.  In 1909 the Municipal Court of the City of New York, Borough of Manhattan, First District, the court issued an opinion involving the Lusitania, vaguely. It seems that Cyrille Eggermont was booked as a passenger on the Lusitania. Cunard, however, lost his luggage, refused to let him board–(one wonders why)–but booked him on another line, and arrangement Cyrille accepted.  Cyrille sued Canard anyway, even though there was a $25.00 limit on lost bag damages. Eggermont v. Cunard S.S. Co. Limited, 119 N.Y.S. 1110 (December 1909)(Prince, J.)

Cyrille lost, but not until after the court made a good deal of fun of his counsel, Cornelius O’Connor. Here is some of what it said: 

“The learned counsel for the plaintiff, in a brief which is verily a literary production, ingeniously, and yet by the invocation of what are undoubtedly elementary principles of law, argues that plaintiff is not bound by the contract of carriage by him entered into with the defendant, that the defendant may not urge the limited liability therein fixed, and the plaintiff is entitled to the full value of the lost trunk. He contends that, when when the defendant refused the plaintiff passage on the Lusitania, it committed a breach of contract, that the plaintiff then had a right to rescind the contract and hold the defendant as bailee, under the common law, for the full value of the trunk and its contents; and that the defendant may not urge the contract which is breached as establishing the limited liability.”

The trouble is, said the judge, that though the principles are unassailable, they do not fit the facts. If Cyrille was going to rescind the contract he had to actually do so.  He could not accept a voyage on a different ship, provided as the defendant’s expense, and then rescind.  

And the court continued: “In eloquent language counsel pictures the hardship which plaintiff, a man of small means, must suffer by limiting the recovery to $25. To this argument can be made only the now trite answer, that there was the contract of the parties, that it is the duty of courts to determine the rights of the parties under the contracts of the parties; that is the duty of the courts to determine the rights of the parties under the contracts which they make, not to make new contracts for them, and to declare the law as they fine it,not to change or strain the law to make it fit a particular hard case.”

Sound familiar? Certainly because of the case itself.  According to WestLawNext, no other case has ever cited it for anything.

Maybe but there is a piece of this case which is not so clear. Cyrille is awarded his $25.00, but from it is deducted $15.00, “the amount of the defendant’s counterclaim.” The counterclaim is $15.00 in costs recovered by Cunard against the plaintiff in a previous action. What’s going on there? Was there some secret reason why Cunard wouldn’t let him on the Lusitania? Hummm.

As a result of this anomaly I find myself wondering why Cunard was being represented by such a “white show” “blue stocking” firm as Lord, Day, and Lord.  

                                                                             

*Michael Sean Quinn, Ph.D., J.D., c.p.c.u. . . .

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Crime Against Lawyer: Murdered for Reasons with Passage Through CyberLand

Young Lawyer Murdered: A Twisted Tale With a Twist

Part I

Michael Sean Quinn(See below)

David Misserschmitt* (“L”) was a lawyer at DLA Piper, a very large, global law firm,  when he was murdered on February 9th, or so, earlier this year at the Donovan Hotel (“DH”) in Washington D.C. L was in DLA’s technology department of technology. (For a lengthy description of DLA’s tech department and its diverse subdivisions, seed their website.)(*Yes, as in the German fighter plane from WWII.)

 So, one might ask, was was L doing in the DH in Washington when he worked in that city and lived in the area? Apparently though he thought he had arranged a paid tryst by taking out an ad with another man, who makes himself available on Craig’s List to render such services. According to the NATIONAL LAW JOURNAL, the responding email was chrissanchez0906, or something like that.)

However, according to the local constabulary there was a woman, Jamyra Gallmon (W#1), 21 years old, who passed herself off as an available male prostitute, but who would show up not for those purposes but in order to rob the would-be customer.  Obviously, this was not a “big-firm” or “hi-tech” encounter, though the press is silent as to whether W#1 was using this as employment to avoid crushing student loans.  

Somehow a dispute arose between L and W#1, and L got stabbed 7-9 times and died somewhere during that process (or at the end of it).  On her behalf her lawyer for W#1 denied that the charges are true, but also says that if they are to some extent true, he would plead “imperfect-self-defense.”  

According to the same source, when the policy arrested W#1, “they recovered. . . [among other things] “a bag of zip ties similar to ones found attached to [L]is fingers and fashioned into makeshift handcuffs.”

 On his fingers? I’m out of my league.  So, perhaps, may have been L’s wife and then widow, a woman of what used to be called “oriental extraction.” I have strong feeling of empathy for what must be one of her many difficult feelings: bewilderment. 

Later, according to “Above the Law,” the policy arrested W#2’s “girlfriend” one “Dominique Johnson,” 19 years old.  There as to whether W#2 was involved in a conspiracy to murder L or merely to rob him. 

So what does this show about cyber lawyering? There are all sorts of internet frauds? The work “hack” has multiple meanings? As does the phrase “taking a stab at.” Be careful about giving unknown people the finger? Internet dating can be dangerous. Cyber- solutionism can be a very bad idea in all sorts of situations. See Evgeny Morozov, TO SAVE EVERYTHING, CLICK HERE: THE FOLLY OF TECHNOLOGICAL SOLUTIONISM (2014). Under the circumstances of this case, his THE NET DELUSION: THE DARK SIDE OF INTERNET FREEDOM (2012) may be even more interesting. 

Attachment of April 28, 2015

There is more to this story. See Part II.

Attachment of August 24, 2015
The young woman (W#1) who stabbed the young lawyer from DLA Piper pleaded guilty on Friday, August 21, 2015 and was sentenced to 24 years in prison. The even younger woman (W#2) got an even lighter sentence, 12 months, 6 months suspended, + 3 years probation.

             What’s wrong with this picture?

*Law Office of Michael Sean Quinn

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Quinn and Quinn

1300 West Lynn #208

Austin, Texas 78703

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Legal Ethics: “Patrick’s Case”: A Long Short Story or Short Novella

On the Careers and Lives of Four Lawyers

Michael Sean Quinn*

This is a work of fiction describing the lives of several lawyers: two are excellent, one is less so, and one is affected deeply by problems and disorders. I wrote is 20 years ago, or so and it was published in a law review in Texas.

Maybe this is Hollywood/AMC stuff, maybe not. Achievement, booze, sex, psychology, diminished careers, irrational anger and lying, plus more. 

Click here for the piece itself:

http://www.michaelseanquinn.com/Articles/Patrick-s-Case.pdf

*Law Office of Michael Sean Quinn
+

Quinn and Quinn

1300 West Lynn #208

Austin, Texas 78703

mquinn@msqlaw.com

(Resumes: www.michaelseanquinn.com)

(o) 512-296-2594

(c) 512-656-0503

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