Tag Archives: insureds

5 Takeaways From First Cyber Case

On May 11, 2015, in a case that is being widely celebrated as one of the first coverage rulings involving a “cyber” insurance policy, a federal court ruled that Travelers has no duty to defend its insured in Travelers Property Casualty Company of America, et al. v. Federal Recovery Services, Inc., et al.

Although the Travelers case does not involve cyber-specific coverage issues, the case nonetheless carries some important takeaways for insureds, insurers and many other interested spectators.

Here is a brief summary of the ruling and five key takeaways:

The Facts

The insured, Federal Recovery, was in the business of providing processing, storage, transmission and other handling of electronic data for its customers, including Global Fitness. In particular, Federal Recovery agreed to process Global Fitness’s gym members’ payments under a servicing retail installment agreement.

Global Fitness sued Federal Recovery, alleging that Federal Recovery wrongfully refused to return member account data to Global Fitness, including member credit card and bank account information. Global Fitness asserted claims for tortious interference, promissory estoppel, conversion, breach of contract and breach of the implied covenant of good faith and fair dealing.

The Cyber Policy

The policy at issue was a “CyberFirst” policy issued by Travelers. The policy included a technology errors and omissions liability form, which stated that Travelers “will pay those sums that [Federal Recovery] must pay as ‘damages’ because of loss … caused by an ‘errors and omissions wrongful act’….” The key term “errors and omissions wrongful act” was defined to include “any error, omission or negligent act.” In addition to covering potential damages, the Travelers policy provided defense coverage, stating that Travelers “will have the right and duty to defend [Federal Recovery] against any claim or ‘suit’ seeking damages for loss to which the insurance provided under one or more of ‘your cyber liability forms’ applies.”

Federal Recovery tendered the defense of the underlying Global action to Travelers, which initiated litigation seeking a declaration that it wasn’t required to provide coverage. Travelers argued that it did “not have a duty to defend [Federal Recovery] against the original or amended complaints in the Global action because Global [Fitness] does not allege damages from an ‘error, omission or negligent act.’”

The Coverage Disputes: Scope of Coverage and Duty to Defend

Although Travelers involves underlying cyber-related facts and a “cyber” insurance policy, the coverage issues arising out of the facts and policy certainly are not cyber-specific. Travelers’ declaratory judgment action raises two coverage disputes concerning: (1) the scope of coverage afforded by the technology errors and omissions policy at issue, as shaped by its key “wrongful act” definition; and (2) the scope of an insurer’s duty to defend under Utah law. While arising in the context of “cyber”-related facts surrounding electronic account and payment data, and under a “cyber” insurance policy, the coverage disputes at issue in the Travelers case are precisely the types of disputes that we routinely see in the context of errors and omissions and other claims-made liability coverages.

(1) The Scope of Coverage

As to the scope of coverage, errors and omissions, D&O, professional liability and other claims-made policies, like the policy at issue in the Travelers case, typically cover “wrongful acts,” a term that typically in turn is defined as “any negligent act, error or omission,” or similar language. There are scores of cases addressing whether intentional and non-negligent acts fall within or outside the purview of a covered “wrongful act.”

Unfortunately, and in contrast to other decisions, the U.S. District Court for the District of Utah in the Travelers case took a narrow view of the key language, ruling that “[t]o trigger Travelers’ duty to defend, there must be allegations in the [underlying] action that sound in negligence.” The court further found that there were “no such allegations.”

In contrast, other courts have appropriately upheld coverage for various types of intentional and non-negligent conduct under errors and omissions and other claims-made policies. As one commentator has summarized: Claims-made policies typically afford coverage for claims by reason of any “negligent act, error or omission.” What if an insured is held liable for a non-negligent act? Most courts have held that the insured is still entitled to coverage. The strongest argument in favor of that conclusion is that (i) an “error” or “omission” encompasses more than negligent conduct, and (ii) if only negligent errors and negligent omissions were covered, the “error or omission” language would be rendered redundant.

To the extent some may wish to reference other cases addressing cyber-related fact patterns, those cases exist. For example, in 1995, the Supreme Judicial Court of Massachusetts in USM Corp. v. First State Ins. Co.10 upheld coverage under an errors and omissions policy for a breach of express warranty claim involving the insured’s failure to develop and deliver a turnkey computer system that would perform certain functional specifications. The errors and omissions policy at issue in the USM case, similar to the policy at issue in the Travelers case, covered claims against the insured “by reason of any negligent act, error or omission.” Also, the insurers in USM, like the insurers in Travelers, argued that the policy only covered the insured for negligent acts. The USM court rejected the insurers’ arguments, noting that courts have not limited coverage under errors and omissions policies to circumstances involving negligence:

Other courts have not limited liability under “errors and omissions” policies to circumstances involving negligence but have recognized certain non-negligent errors as being within the coverage afforded. Cases involving the words such as “negligent act, error or omission” (the crucial language of the policies before us) have not consistently determined that an error must be a negligent one if coverage is to be available.

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Because some, but not all, judicial opinions have rejected the interpretation of errors and omissions policies for which the insurers contend, if it was the insurers’ intention, the crucial words of the policy should have been amended to eliminate the ambiguity and to make clear that coverage extended only to negligent errors. Potential policyholders could then have more accurately determined whether such coverage met their needs.
Because of the uncertainty about the scope of the word “error,” the insurers as authors of the policies must suffer the consequences of the ambiguity.

The New York Appellate Division’s decision in Volney Residence, Inc. v. Atlantic Mut. Ins. Co. is likewise instructive. In that case, the Appellate Division held that the insurer had a duty to defend a federal RICO action in which the insured defendants “were alleged intentionally to have committed acts of self-dealing and fraud.” Applying well-established rules of contract interpretation, the court ruled that there was a duty to defend:

The policy provision in question covers claims arising from “a negligent act, error or omission,” which term is defined as “any negligent act, error or omission or breach of duty of [the] directors or officers while acting in their capacity as such.” The definition is susceptible of more than one meaning and can be understood to cover any breach of duty of the directors or officers, not exclusively negligent breaches of duty. Ambiguities in an insurance policy are to be resolved against the insurer.

Other cases are to the same effect.

(2) Scope of the Duty to Defend

Turning to the separate issue of the duty to defend, it is well established that the duty to defend is very broad—broader than the duty to indemnify. The duty to defend is typically triggered if there is some potential for coverage, and, in many jurisdictions, it is appropriate to look outside the facts pled in the underlying complaint to determine whether there is a duty to defend. Again, unfortunately, the court in the Travelers case took a narrow view of the insurer’s duty to defend. Even assuming for the sake of argument that the policy covered only negligence, the underlying complaint alleged, among other things, that Federal Recovery “retained possession of member accounts data, including the billing data, which was the property of Global Fitness ….” Allegations surrounding improper retention of data, even if that retention ultimately was wrongful or not legally justifiable, clearly may arise out of negligence as opposed to intentional conduct.

Travelers Takeaways

Putting aside the ultimate merits of the court’s ruling, and whether this case addresses any coverage issues that are appropriately characterized as “cyber” issues, Travelers offers at least five key takeaways:

First, Travelers illustrates that decisions involving cyber insurance policies are coming and, considering all of the attention and buzz surrounding an otherwise seemingly mundane errors and omissions case, insureds and insurers alike are anxiously awaiting and anticipating the guidance those decisions may provide.

Second, Travelers underscores that the types of coverage disputes that we will see arise out of cyber-related facts and, under cyber insurance policies, often will involve, or at least will intertwine with, the types of disputes that routinely arise in connection with traditional insurance coverages, including errors and omissions coverage and general liability coverage. This is useful for insureds to appreciate toward the goal of being prepared for future potential coverage disputes under cyber policies.

Third, Travelers underscores the importance of securing a favorable choice of forum and choice of law in insurance coverage disputes. Until the governing law applicable to an insurance contract—cyber or otherwise—is established, the policy can be, in a figurative and yet a very real sense, a blank piece of paper.

Fourth, although its label as a first cyber case is debatable, Travelers at a minimum has spotlighted the approaching disputes under cyber liability policies, which should remind insureds of the need to be prepared for, in addition to the traditional types of coverage issues and disputes that can arise under those policies, the potential cyber-specific coverage issues and disputes that may arise, such as the scope of coverage for “cloud”- related exposures.

Fifth, Travelers illustrates the importance of obtaining the best possible policy cyber language at the initial coverage placement and renewal stage. Unlike some types of traditional insurance policies, cyber policies are extremely negotiable, and the insurer’s off-the-shelf language can often be significantly negotiated and improved—often for no increase in premium. It is important for the insured to understand its unique potential risk profile and exposure— and what to ask for from the insurer.

Often in coverage disputes, the issue of coverage comes down to a few words, the sequence of a few words or even the position of a comma or other punctuation. It is important to get the policy language right before a dispute. And while the Travelers case addresses coverage issues that are not cyber-specific, the fundamentals of successfully pursuing coverage under traditional insurance coverage are important to keep in mind as we enter a time and space in which coverage disputes based on underlying cyber-related factual scenarios, and under specialized cyber insurance coverages, are poised to become commonplace.

Do Accountants Face Risk as Fiduciaries?

Outside accountants – including auditors, those providing other attestation and compilation services, tax preparers and even mere advisers – are increasingly facing allegations that they served their clients in a fiduciary capacity. These are not simply idle observations: In general, they are made by clients and third parties seeking to obtain monetary damages from the accountants as a result of, inter alia, errors in financial reporting, tax positions that are subsequently rejected by the IRS or other authorities and losses incurred by clients or third parties following advice presented by the accountants. The reason adverse parties seek to impute fiduciary obligations to the accountants is that this offers them the opportunity to seek larger settlements or court-imposed awards, if the defending accountants are found liable. Fiduciary duties pose major risk for accountants and for those writing insurance coverage for them.

Traditionally, accountants were not considered to be fiduciaries, and in some instances still cannot be held to be such, either because of the nature of the services being rendered or the character of the client organization. However, over time the threshold for finding (or, at least, being permitted to argue in litigation) that the accountants were de facto fiduciaries has been lowered by court rulings. The implications for the accountants are serious – and they warrant taking steps to mitigate, by use of appropriate engagement letter language, and by exercising greater caution in taking on clients and in performing services for them. Those underwriting accountants’ malpractice insurance should be equally concerned with how well, if at all, their insureds have dealt with this risk factor.

What makes a party a fiduciary?

Fiduciary status is not well defined under the law, and this lack of precision has led, over time, to a creeping extension that now sometimes even reaches to outside accountants. A fiduciary relationship gives rise to fiduciary duties, the primary one of which is that of loyalty. As expressed more expansively in a number of key court decisions, “[a] fiduciary relationship carries with it the duty of candor, rectitude, care, loyalty and good faith.”[1]

Fiduciaries are required to hold their beneficiaries’ (i.e., clients) interests uppermost. Generally, fiduciary relationships are characterized as involving two parties, with the one (the fiduciary) acting on behalf of another (the beneficiary). The acting party exerts control over a critical resource that belongs to the other party – for example, the fiduciary invests funds belonging to the beneficiary, or controls the official filings (e.g., financial reports or tax returns) that are the obligation of the other party. The other party must have a relevant vulnerability (lack of investing expertise, technical knowledge, etc.) that places the beneficiary in what amounts to a subservient position vis-à-vis the fiduciary regarding the object of that relationship.

A fiduciary duty arises by either of two means: by operation of law or by application of legal factors. The first of these connotes a formal relationship between the parties, whereas the latter arises from informal relationships. Furthermore, in matters that have been elevated to the domain of litigation, there have been various ad hoc determinations that fiduciary obligations have attached, beyond those set forth in established law.

Examples of formal relationships to which fiduciary obligations will be ascribed include trusts, guardianships, agency arrangements, partnerships and joint ventures, corporations (regarding the duties of directors and officers) and counseling relationships (this being the most controversial). Counseling relationships may be those of attorneys and accountants and their respective clients, medical doctors and psychiatrists and their respective patients and even clergy and their parishioners. More generally, counseling relationships may include any others where the giving of advice in confidential settings is a central defining condition.

Informal relationships may also be interpreted as requiring the duty of loyalty. To rise to this status, there must be “trust” or “confidence” reposed by one person (or entity) in another, and there must be a resulting “domination,” “superiority” or “undue influence” of or over the other party (the putative beneficiary of the fiduciary relationship). It is important to stress that neither trust nor vulnerability alone suffice – it is widely held that both must be present to successfully assert that such an informal relationship creates fiduciary obligations.

More generally, if any person solicits another to trust her in matters in which she represents herself to be expert as well as trustworthy, and the other party is not expert and accepts the offer and reposes complete trust in that person, a fiduciary relation is likely established.

However, sharing expertise with another party is not, per se, enough: It is clear that not every expert is or can be held to be a fiduciary.[2]  There is a wide range of informal relationships, not all of which will connote fiduciary obligations. As the Restatement of Trusts notes, “Although the relationship between two persons is not a fiduciary relationship, it may nevertheless be a confidential relationship. Conversely, a fiduciary relationship may exist even though the parties do not enjoy a confidential relationship.” Thus, this is a grey area in the law, and this very ambiguity is what creates risk for the unwary.

For example, a financial reporting expert may advise a client on the various ways a particular transaction or event might be reported, or even opine that only a single approach would meet professional standards, but the ultimate decision remains that of the client, who may reject such advice or seek other opinions. The accountant does not dictate how the transaction or event has to be reported in the client’s financial report (although, if serving as independent auditor, the accountant may elect to render a less-than-unqualified opinion if the client elects an improper method of accounting having material impact on those financial statements).

As already noted, determinations establishing fiduciary obligations have been sometimes made on an ad hoc basis by the courts. Of greatest relevance to the present discussion, this tendency has increasingly brought accountants under the fiduciary duty umbrella, sometimes to the accountants’ great surprise and dismay. Most commonly, in the author’s experience as a practicing accountant, this has involved tax preparers who may rather casually offer investing advice to their clients. For example, upon noting a particular client’s high tax bracket, some tax preparers will make offhand comments about the virtues of, say, municipal bonds or real estate as investment options, or wax enthusiastic about a specific bond issue or mutual fund, which is more of a concern. More recently, this logic – applying fiduciary obligations to accountants offering investment counseling – has been extended to those offering a range of non-tax services, even if tradition and professional standards clearly prohibit the accountants performing those services from also serving in a fiduciary role.

What are the duties of a fiduciary?

Being defined as a fiduciary (whether or not a formal fiduciary relationship has been documented) brings with it a range of obligations. As noted, the most significant of these is the duty of loyalty. The interest of the principal (the beneficiary, or the client) must come first – even to the exclusion of the interests of the fiduciary. For example, if our hypothetical tax preparer suggests a certain class of investment to his client, it must be believed that this is an optimal investment strategy for the client, unrelated to the accountant’s own investment interests. Touting an investment in the hopes that, e.g., an increased demand will lift prices and thus benefit the accountant’s own holding of the same asset would clearly be a breach of this obligation.

In addition to making (or seeking to make) a hidden profit from advice given to the beneficiary, competing against the beneficiary (e.g., putting in a bid for property sought by the beneficiary, or “front running” an investment in securities), or simultaneously acting on behalf of another party whose interests are adverse to the beneficiary, would constitute breaches of the loyalty obligation. Because accountants typically have a large number of clients, there is a real risk that this prohibition could inadvertently be contravened.

A fiduciary also has a duty to disclose all relevant facts to its beneficiary. Again harking to the tax preparer/adviser situation, if the accountant is positioned to benefit if the client follows this investment advice (e.g., will obtain a referral fee or commission), this must be clearly communicated to the putative beneficiary. If an accountant is placed in the role of a fiduciary, the duties to exercise reasonable care and to maintain client confidences, found in the professional technical and ethical standards, must still be observed. Additionally, the fiduciary has a duty to maintain client confidences, which might carelessly be disobeyed even in the course of casual conversations with the accountants’ other clients.

Why is being held to be a fiduciary a risk for accountants?

Being held accountable as a fiduciary has one very crucial implication. Whereas assertions of failure to exercise due care (the normal standard to which outside accountants are held) lie within the domain of tort law, assertions of failure to meet the requirements of loyalty are found within fiduciary obligations. In the instance of allegations of breach of fiduciary duty, the burden of proof shifts to the respondent accountant, who must show, inter alia, that all material facts had been provided to the beneficiary and that all other fiduciary obligations have been satisfied.

In the event of a finding of failure to exercise ordinary due care, as defined in the professional standards with which the accountant is obligated to comply, damages are limited, typically, to actual damages suffered by the plaintiff, assuming that the tripartite required demonstrations of liability, reliance and damages have been achieved by the complaining party. In contrast, a failure to meet fiduciary obligations may result in punitive damages as well as the awarding of plaintiff’s legal fees, and thus presents a significantly greater financial risk for the accountants and for their insurers. The burden of proof, coupled with the potentially greater monetary damages, makes defending against well-founded accusations of having been a fiduciary and having breached associated duties to the beneficiary a much more serious concern.

The evolution toward fiduciary obligations for accountants has accelerated over the past few decades. During the 1970s and 1980s, claims against CPAs were commonly based on fraudulent misrepresentation and negligence (i.e., professional malpractice), as well as on contractual breaches (in the case of suits by clients against their accountants, who had purportedly failed to perform the assignment for which they had contracted). The 1990s witnessed an increase in claims made against CPAs that argued that they had served as financial advisers. This led to allegations of breach of fiduciary duty and a range of other assertions, such as functioning as an unlicensed investment adviser.

In the early 2000s, courts readdressed fiduciary duty claims, as they might pertain to CPA liability matters. In a seminal case, Miller v. Harris, decided in 2013,[3] a state appellate court reversed and remanded the trial court’s dismissal of a complainant’s breach of fiduciary duty claim against the respondent accountants. It found that contracts (such as that between the accountant and his client) between litigating parties do not control a claim for breach of fiduciary duty, because the latter are not based on contract law. This distinction is a vital one, establishing an important principle. Further, the court stated that a claim for breach of fiduciary duty must allege the existence of a fiduciary relationship and a breach of duties imposed as matter of law as a result of that relationship. The net effect of the Miller v. Harris appellate decision was to set a new, lower bar for fiduciary status by operation of law (i.e., for an informal relationship).

Given this decision and others, there is an enhanced likelihood that future actions against accountants will attempt to assert as fiduciary those relationships that, in the past, were not deemed to be such. Accountants, and their insurers, thus would be wise to give increased attention to this risk, and take steps to mitigate it, where possible.

What steps should be taken in actual practice to guard against this risk?

Although the record has been mixed, there has been some expansion of fiduciary duties over past decades to include accountants. Traditionally, of course, accountants generally had not been deemed fiduciaries. Indeed, their obligations to third parties and requirement for independence historically confirmed non-fiduciary status on accountants, inasmuch as duties to third parties could not coexist with loyalty to the client entity’s management.

Whereas at one time any attempt to attribute fiduciary status to accountants, for the purpose of alleging breach of fiduciary duty by them, would have been almost automatically dispensed with, today accountant defendants are very unlikely to obtain summary dismissal of breach of fiduciary duty claims. Instead, courts are holding this matter to be a fact issue to be resolved at trial. For the accountants, one important implication is that, even if the defense ultimately prevails, they will be forced to incur costs to defend against such claims. In litigation, even when you win, you often lose.

The existence of a fiduciary relationship is now defined to be a question of fact. If the facts support the assertion that an accountant acted as a fiduciary for the client, that accountant will be exposed to liability for breach of fiduciary duty, which may result in economic harm greater than in the situation of a garden-variety failure to exercise due care in a professional negligence suit, including the possibility of punitive damages and attorney’s fees being levied. The burden of proof is essentially placed on the defending party once the existence of a fiduciary relationship has been established by the complainant. Summary dismissals of fiduciary obligation claims against accountants are now unlikely to be obtained, meaning costs of defense must be borne even when ultimate exoneration is achieved.

Engagement letter limitation of damages language will often not be effective in precluding punitive damages, so this risk element cannot easily be protected against, if a fiduciary relationship can be established by the complaining party.

Contractual language defining the assignment as not implying fiduciary duties may not be sufficient to defend the suit. Nevertheless, having a well-crafted engagement agreement with clients remains an important defensive strategy – and such letters are mandated under professional standards for most ordinary accounting and auditing services. In the author’s opinion, the role of “adviser” should be avoided or severely constrained, if later allegations of breach of a fiduciary relationship-based obligation are to be averted.[4]

If advice is provided in circumstances in which the client can later plausibly claim to have been in a subservient role – thus, where the accountant was effectively making decisions for the client – there will be risk. Obtaining “informed consent” for recommendations made to the client would be one procedure providing some reduction in such risk. All recommendations should be couched in language that requires the client to consider and then independently conclude upon the matter, by either accepting and acting upon it, or rejecting it.

Finally, for both insureds and insurers, it would be wise to consult with a qualified attorney regarding the language used or proposed for accountants’ engagement letters for the various services being offered. Only in this way will risks, including that of being held accountable for breach of fiduciary duties, be most effectively addressed and, to the extent possible under evolving legal standards, contained.



[1]  See, e.g., Miller v. Harris, 2013 IL App (2d) 120512, ¶21; In re the Estate of Abernethy, 2012 Tex. App. LEXIS 4272; and Gracey v. Eaker, 2002 Fla. LEXIS 2662.

[2]  Burdett v. Miller, 957 F. 2nd 1375, 1381 (7th Circuit, 1992).

[3]  Miller v. Harris, Appellate Court of IL, Second District, 2013

[4]  Somewhat ironically, the trade association of public accountants, the AICPA, long promoted the catch-phrase “trusted (business) adviser” as a marketing tactic for CPAs to employ. It no longer does this, but a review of recent on-line articles and firm web sites reveals that this proclamation, or a close variant, continues in wide usage. Knowingly or not, many accountants are playing a dangerous game, wanting to tout their roles as adviser while rejecting status as fiduciaries.

9 Things to Know Before Buying Life Insurance

Life is unpredictable. So, even when doing very well in life, you are never sure what the future holds for you or your beloved family. Perhaps nothing  provides more peace of mind than securing your family’s financial future for the day “when you are not there.” The question is: How?

It takes more than just saving

  • You will have a hard time securing your family’s future just by saving and cutting expenses.
  • A life insurance policy can fulfill your family’s immediate cash flow requirements.
  • Your family can face no, or minimum, disruption financially if something happens to you.
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Getting the best of an insurance policy

  • You need a well-thought-out insurance plan and must pay attention to various aspects of a policy.
  • Remember: Insurance is a long-term investment, and it’s difficult to make changes in a policy’s terms later.

Here are 9 things to bear in mind before buying or upgrading an insurance policy:

1. Figure out your insurance needs

  • Your insurance needs depend on whether you are single, married with children, married without children, a single parent, an empty nester or a retiree.
  • The first thing you need to figure out is who and what needs to be covered under your life insurance policy — mortgage, utilities, healthcare, education of any children, etc.
  • Ideally, your family, home and the status of your career should be reflected in your insurance policy.

2. What type of insurance do you need?

Term insurance

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  • It has no investment component.
  • It provides coverage for a specific period at fixed premiums.
  • Compared with cash-value insurance, term insurance has lower premiums
  • You need to decide the amount and period of coverage – 10, 15, 25 or 30 years.
  • In the event of the insured’s death, beneficiaries get the face value of the policy tax free.

Cash-value or permanent life insurance

  • It covers the lifetime of the insured.
  • Permanent life insurance is of many types: whole life, universal life and variable life.
  • Such policies have a cash value – you are paid back a portion of your premium.
  • Tax is not charged on such policies until you withdraw the cash value or surrender your policy before your death.

3. Make sure premiums are affordable:

  • Keep your financial limits in mind.
  • Go for a policy whose initial, as well as future, premiums are within your range.3

4. Read policy terms carefully

  • It’s imperative to carefully review the terms, coverage premiums, benefits, renewals and termination clauses of the policy before buying it.
  • Understand the time period for providing the insurance benefits to beneficiaries in case of untimely death.
  • Your beneficiaries should also have information about your insurance policy and its terms and conditions.

5. Study before dropping or replacing a policy

  • Weigh the pros and cons before dropping your current policy in favor of a new one.
  • Insurance companies charge to drop or replace your current policy with a new one.

6. Keep track of renewal policies

  • Even if your health status changes, most term insurance policies can be renewed for a term or more.
  • The premiums for renewed term policies are higher.
  • Ask about the amount of premiums to be paid if renewal is sought after a certain age.
  • Ask for the age up to which you can renew your term insurance policy.

7. Review your policy every few years

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  • You can upgrade your existing policy if your requirements change.
  • Take inflation, current economic status, changing family size and future plans into count while reviewing your insurance policy.

8. Be accurate on your application

  • Hiding personal health information or filing wrong information to get lower premiums can later lead to the loss of coverage and benefits.
  • Insurance companies can deny full benefits to beneficiaries if you die of an illness you had before signing the policy and did not reveal.

9. Avoid solely depending on your employer’s insurance

  • Life insurance should be 10 to 12 times of your salary, but your employer may not offer that amount.
  • You’ll lose your coverage if you change your job or your health declines.
  • Employer-provided life insurance tends to get more expensive as you age.

Outlook For The Private Directors & Officers Marketplace

Private Directors and Officers Liability (D&O) policies are generally combined policies including D&O and Employment Practices Liability (EPL). Although they are typically marketed as Directors & Officers policies, and there are definitely D&O claims, claims frequently come from the Employment Practices Liability side of the form. Private Directors & Officers carriers find it challenging to cope with the high frequency of Employment Practices Liability claims that come with this line of business.

The premiums associated with these policies have been creeping up over the past few years, and now is an appropriate time to investigate and report on the causes. Rather than give you generalities that claims are frequent, here is some of the data that supports what the insurers are telling us.

2012 EEOC Complaints
Top Five States Total Complaints Percent Change Since 2010 2010 Total Complaints Total Population 2010*
Texas 8,929 -4.1% 9,310 25.1 million
Florida 7,940 2.1% 7,779 18.8 million
California 7,399 3.3% 7,161 37.3 million
Georgia 5,903 2.3% 5,771 9.7 million
Illinois 5,490 3.8% 5,288 12.8 million
Year Total Total Complaints – All 50 States
2012 99,412
2011 99,947
2010 99,992
2009 93,277
2008 95,402

* The population totals are included to show that the highest volume of claims generally come from the largest states.

The Equal Employment Opportunity Commission (EEOC) isn't the only regulatory body bringing employment actions against employers — state agencies like the California Department of Fair Employment and Housing (DFEH) are filing cases as well. In its 2010 annual report, the California DFEH notes that they filed between 17,500 and 20,000 cases each year between 2007 and 2010 (2011 and 2012 numbers are not yet available). The department also estimates that the average post-accusation case settled for more than $40,000.

Let's put this into perspective. The Betterley Report: Employment Practices Liability Insurance Market Survey 2012 (December 2012) estimates the total Employment Practices Liability market at around $1.6 billion in premium. Just for discussion purposes, let's assume that the Department of Fair Employment and Housing estimate is applied to all claims. At $1.6 billion in total premiums collected, the insurance marketplace could handle 40,000 claims and break even (40,000 claims X $40,000 average settlements = $1.6 billion). Considering we know there are more than two times that many EEOC complaints, plus tens of thousands of other state agency claims, we know that the volume of insured claims exceeds 40,000 per year.

Since we know that there are more than 40,000 claims a year, the second half of the debate is what these claims cost. The Department of Fair Employment and Housing has their estimate for out of court settlements at over $40,000. Jury Verdict Research, a publication that puts out jury trial settlement trend data, indicated in its 2011 report titled, “Employment Practices Liability: Jury Award Trends and Statistics,” that the average awards range from $600,000 for discrimination claims to as much as $790,000 for wrongful termination claims. Their median award range is from $200,000 to $260,000 based upon their research. This data implies that the average claims are going to be far greater than $40,000 to settle on a nationwide basis. These reports only show us awards, which do not include the defense costs paid to get to the award stage.

If we take this one step further and assume that the average claim will cost approximately $120,000 — though the Jury Verdict data tells us it's higher — then the amount of claims the insurers could handle in a year, and possibly break even, is more like 13,333 claims per year ($1.6 billion total annual premium divided by $120,000). If we factor in underwriting expenses and other transactional costs, then even less money is available for defense costs and settlements.

So, what's the bottom line? The insurers have been struggling to make a profit on this line of business for many years. While competition for market share has continually lowered the premiums they could charge and still write business, we've gotten to a crossroads and blown right through the stop sign. The pricing has been creeping up over the past three to four years, and we are still far from a corrected market. The dilemma for insurers has been how to adjust their pricing and terms in a way that still provides a valuable policy for insureds. The responses have varied from insurers pulling out of a specific region (like southern California), gradual elevation of retentions, increasing premiums, reducing limits available and declining risks with specific employee count ranges.

Bertrand Spunberg, Senior Vice President, Hiscox USA: “We have strived to maintain 'sustainable underwriting' since we opened up in 2009, even when the market was still very soft. That discipline is now starting to pay off as other insurers are adjusting their rates and retentions up to a point that's more comparable to what we have been all along. We are seeing some insurers revising their appetites or pulling out of jurisdictions and segments altogether. Other carriers are taking a portfolio view of the business, making them more prone to declining rather than underwriting around account-specific exposures. This creates an environment that is increasingly difficult to navigate for both insureds and brokers. EPL claims have been leading the way, but we are also seeing D&O claims arising from financial issues, such as bankruptcy. In response to that, we have seen insurers indicate that they would be looking to limit or even remove entity coverage.”

Mr. Spunberg's comments should serve as a warning to all brokers. While pricing and retention changes are typically obvious changes to renewal terms, you need to pay extra attention to any other changes in coverage terms. On some policy forms, the inclusion of entity coverage may only be signified by an “X” in a box on a declarations page or quote letter. It could be easy to miss the removal of this subtle notation. Also watch out for changes in endorsement numbers and titles. You may find an insurer substituting an endorsement with the same title as previous years but adding a new clause that removes or restricts coverage from what you've come to expect.

Steven Dyson, Executive Vice President, ERisk Services, LLC: “We track a lot of data on our insureds and claim performance. Rather than penalize all insureds in every state, we have evaluated where our claims are coming from and adjusted our rates in a targeted fashion. Difficult venues like southern California, Illinois, southern Florida and metro New York, are getting more rate adjustments than less litigious parts of the country. We drill down to the county level when evaluating the performance of our book and adjust accordingly.”

As brokers, we appreciate ERisk's targeted approach. As insurance professionals, it can be a difficult message to give to insureds that an underwriter is penalizing them for the poor performance of another risk, or that the underwriters may have misunderstood the risks of the businesses they underwrite.

No insured likes to see their premiums rising. It helps when underwriters are doing their best to stabilize the marketplace and articulate the logic behind rate changes.

Joseph Casey, President, ACE Westchester: “At Westchester, we have seen a significant increase in the number of Private Company D&O submissions, apparently based in part by some markets reacting to an increase in Employment Practice Liability claims. The increase in EPL litigation and the corresponding rise in defense costs require, more than ever, greater underwriting discipline. However, the right carrier, with an expertise in EPL and a flexible approach, has the ability to look at the type of company, the jurisdictions in play and other factors unique to the insured, and provide suitable coverage.”

Our wholesale-dedicated markets like ACE Westchester and ERisk are less prone to some of the broad brush underwriting approaches taken by many of the standard markets. The wholesale markets are always looking for a way to differentiate and uncover risks that are neglected or underserved by the standard markets. When the retail-focused markets head out the door, our markets are usually running in; that appears to be what we are currently experiencing. We've had a sustained period of underpricing in the private D&O/EPL area as insurers compete for market share. With the loss frequency where it is and expenses rising, it is indeed time to reevaluate. While the wholesale markets are noticeably more competitive in a challenging market, they also do a great job when things are going smoothly.