Insurance Coverage Exclusions for Known Loss, Prior Knowledge, and Prior Notice: Evolving Judicial Standards
Advocating Scope of the Exclusions From the Policyholder and Insurer Perspectives

Course Details
- smart_display Format
On-Demand
- signal_cellular_alt Difficulty Level
Intermediate
- work Practice Area
Insurance
- event Date
Tuesday, April 9, 2024
- schedule Time
1:00 p.m. ET./10:00 a.m. PT
- timer Program Length
90 minutes
-
This 90-minute webinar is eligible in most states for 1.5 CLE credits.
The CLE course will address property and liability policy exclusions designed to preclude coverage for known loss, loss in progress, prior knowledge, and prior notice at the time coverage is applied for. The panel will provide insights into the evolving standards for how courts construe such provisions and how and when such exclusions apply.
Faculty

Ms. Moore represents policyholders in insurance coverage and bad faith litigation in state and federal courts. Ms. Moore has handled numerous complex cases and tried insurance coverage, negligence and bad faith cases to policyholder verdicts. She is a frequent speaker on insurance law issues.

Mr. Hamawi has extensive expertise in insurance coverage, business negotiations, and commercial litigation. He focuses his practice on representing businessowners, homeowners, property owners, and other insurance policyholders in fire, property damage, and insurance-coverage disputes with insurance companies and in errors-and-omissions cases against insurance agents. Mr. Hamawi has successfully litigated hundreds of cases against insurance companies and insurance agents, and recovered millions of dollars for his clients. He has also litigated cases against residential and commercial builders, restoration companies, and fire repair contractors. He has also litigated cases against towing and storage companies for charging consumers unreasonable and excessive towing and storage costs, and for wrongfully determining vehicles to be abandoned. Mr. Hamawi has also litigated cases involving breach of commercial lease agreements, commercial real estate transactions, commercial purchase agreements, and sales commissions agreements. He has represented insurance agents, financial advisors, stockbrokers, and public insurance adjusters in regulatory or other disciplinary actions initiated by governmental agencies.

Mr. Wester focuses his practice on representing insurers in the investigation and litigation of complex insurance matters arising out of commercial disputes, construction accidents and defects, trucking and transportation accidents, marine casualty, environmental and long-tail claims, premises liability, and property damage. He has served as special coverage counsel to major insurers in connection with catastrophic weather, and has particular experience defending first-party property claims. Mr. Wester has substantial experience representing clients in all aspects of litigation in New York, New Jersey, and Pennsylvania state and federal courts. He regularly counsels and provides written opinions to primary and excess level insurers concerning a full spectrum of coverage issues involving multiple lines of insurance to help achieve cost-effective resolutions. Drawing from his extensive first-hand experience, Mr. Wester has lectured to peers and industry representatives on the topic of defending first-party property claims and has written about states’ expansion of private causes of action for bad faith.
Description
Insurance coverage is premised on the concept of fortuity--a loss that occurs by chance or accident, not one that has occurred, is in progress, or is substantially certain to occur.
While insurers can avoid these problems by either excluding coverage for known losses, losses in progress, losses of which there is prior knowledge or prior notice in the insuring agreement or requesting information about known losses or those in progress during the application process, it is not always practicable to seek this information across all business lines.
Many courts interpreting exclusions for prior loss, losses in progress, or losses as to which the insured had prior notice or knowledge, have found them to be clear, unambiguous, and adequate to support summary judgment. On the other hand, some courts have found that these exclusions do not apply or that issues of material fact exist that prevent the court from granting summary judgment for an insurer.
Listen as our panel of veteran coverage counsel discusses these exclusions and highlights their benefits and shortcomings as useful tools for both the insured and insurer to identify and manage specific categories of risk that will--or will not--be included in the underlying policy.
Outline
- Introduction to prior knowledge exclusions
- Known loss
- Loss in progress
- Prior knowledge
- Prior notice
- Analysis of recent case law
- Best practices for limiting client exposure
Benefits
The panel will review these and other contentious questions:
- What is the elusive key to determining the difference between known and unknown losses?
- What is considered to be a claim that is "reasonably foreseeable"?
- When does the insured’s subjective knowledge, impressions, and opinions play a dispositive role?
- When do judges find that the prior knowledge exclusion does not apply or that issues of material fact exist that prevent the court from granting an insurer summary judgment?
- What are the most recent case law developments on the scope and applicability of these exclusions?
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