“whether it was reasonable in terms of the amount paid compared with the true extent of the claimants’ recoverable loss”
“whether the settlement was reasonable in the sense of fairly reflecting the overall merits of the action”
“NOTICE THE COMPANY DOES NOT HAVE ANY DUTY TO DEFEND. DEFENSE COSTS COVERED BY THIS POLICY ARE INCLUDED WITHIN AND ARE NOT IN ADDITION TO THE LIMITS OF LIABILITY OF THIS POLICY. INSURING AGREEMENTS INSURING AGREEMENTS 15. I COVERAGE Zeneca Insurance Company (the "Company") shall, subject to the limitations, terms, conditions and exclusions below, indemnify the Insured for Ultimate Net Loss the Insured pays by reason of liability: (a) imposed by law, or (b) of a person or party who is not an Insured assumed by the Insured under contract or agreement, for Damages on account of: (i) Personal Injury (ii) Property Damage (iii) Advertising Liability encompassed by an Occurrence, provided: COVERAGE A: notice of the Occurrence shall have been first given by the Insured in an Annual Period during the Policy Period in accordance with Article V of this Policy, or COVERAGEB: notice of the Occurrence shall have been first given during the Discovery Period in accordance with Article V of this Policy, but only if the Discovery Period option has been elected in accordance with the provisions of this Policy. for Damages on account of: (ii) Property Damage (iii) Advertising Liability encompassed by an Occurrence, provided: COVERAGE A: notice of the Occurrence shall have been first given by the Insured in an Annual Period during the Policy Period in accordance with Article V of this Policy, or COVERAGEB: notice of the Occurrence shall have been first given during the Discovery Period in accordance with Article V of this Policy, but only if the Discovery Period option has been elected in accordance with the provisions of this Policy. 16. III DEFINITIONS A. "Advertising Liability" means liability for Damages on account of: (1) libel, slander or defamation, (2) any infringement of copyright or of title or of slogan, (3) piracy or misappropriation of ideas under an implied contract, or (4) any invasion of right of privacy, committed or alleged to have been committed in any advertisement, publicity article, broadcast or telecast and arising out of the Insured's advertising activities. G. "Damages" means all forms of compensatory damages, monetary damages and statutory damages, punitive or exemplary damages and costs of compliance with equitable relief, other than governmental (civil or criminal) fines or penalties, which the Insured shall be obligated to pay by reason of judgment or settlement for liability on account of Personal Injury, Property Damage and/or Advertising Liability covered by this Policy, and shall include Defense Costs. H. "Defense Costs" means reasonable legal costs and other expenses incurred by or on behalf of the Insured in connection with the defense of any actual or anticipated Claim, including attorneys' fees and disbursements, law costs, premiums on attachment or appeal bonds, pre-judgment and post-judgment interest, expenses for experts and for investigation, adjustment, appraisal and settlement, excluding the salaries, wages and benefits of the Insured's employees and the Insured's administrative expenses. R. "Integrated Occurrence" means an Occurrence encompassing actual or alleged Personal Injury, Property Damage and/or Advertising Liability totwo or more persons or properties which commences over a period longer than thirty (30) consecutive days which is attributable directly, indirectly or allegedly to the same actual or alleged event, condition, cause, defect, hazard and/or failure to warn of such; provided, however, that such Occurrence must be identified in a notice pursuant to Section C of Article V as an "Integrated Occurrence" and is subject to all provisions of paragraphs (1) and (2) of Definition V. V. (1) An "Occurrence" exists if, and only if: (a) except with respect to actual or alleged Personal Injury or Property Damage arising from the Insured's Products, there is an event or continuous, intermittent or repeated exposure to conditions which event or conditions commence on or subsequent to the Inception Date, or the Retroactive Coverage Date, if applicable, and before the Termination Date of Coverage A, and which cause actual or alleged Personal Injury, Property Damage or Advertising Liability; (b) actual or alleged Personal Injury to any individual person, or actual or alleged Property Damage to any specific property, arising from the Insured's Products takes place on or subsequent to the Inception Date, or the Retroactive Coverage Date, if applicable, and before the Termination Date of Coverage A. (2) Except as provided in paragraph (3) below, where an Occurrence exists and a series of and/or several actual or alleged Personal Injuries, Property Damages and/or Advertising Liabilities occur which are attributable directly, indirectly or allegedly to the same actual or alleged event, condition, cause, defect, hazard and/or failure to warn of such, all such actual or alleged Personal Injuries, Property Damages and/or Advertising Liabilities shall be added together and treated as encompassed by one Occurrence irrespective of the period (but without limiting the effect of Exclusion IV.A) or area over which the actual or alleged Personal Injuries, Property Damages and/or Advertising Liabilities occur or the number of such actual or alleged Personal Injuries, Property Damages and/or Advertising Liabilities;provided, however, that any actual or alleged Personal Injury, Property Damage or Advertising Liability which is Expected or Intended by any Insured shall not be included in any Occurrence. So far as Personal Injuries, Property Damages and/or Advertising Liabilities resulting or alleged to result from the design, formulation, manufacture, distribution, use, operation, maintenance and/or repair of an Insured's Product, and/or the failure to warn as to the use, operation, maintenance and/or repair of an Insured's Product, the term "the same actual or alleged event, condition, cause, defect, hazard and/or failure to warn of such" means any such design, formulation, manufacture, distribution, use, operation, maintenance, repair and/or failure to warn, as the case may be, as to which such losses, injuries or damages are directly, indirectly or allegedly attributable. As respects Advertising Liability,multiple or repeated broadcasts or publications of the same or similar materials shall constitute "the same actual or alleged event, condition, cause or defect." (3) Notwithstanding paragraphs (1) and (2) above, if an Occurrence is not identified in the notice thereof as an "Integrated Occurrence," then actual or alleged Personal Injury to each person, Property Damage to each piece of property and/or Advertising Liability which commences at any time shall be deemed to be encompassed within a separate Occurrence from which Personal Injury to any other person, Property Damage to any other piece of property and/or Advertising Liability which commences more than thirty (30) days prior or later thereto is encompassed. W. "Personal Injury" means Bodily Injury, mental injury, mental anguish, shock, sickness, disease, disability, false arrest, false imprisonment, wrongful eviction, detention, malicious prosecution, discrimination, humiliation, and libel, slander or defamation of character or invasion of rights of privacy. Z. “Product Pollution Liability" means liability or alleged liability for Personal Injuryor Property Damage arising out of the end-use of the Insured’s Products, ifsuch use occurs after possession of such goods or products has been relinquished to others by the Insured or by others trading under its name and if such use occurs away from premises owned, rented or controlled by the Insured; such goods or products shall be deemed to include any container thereof other than an Automobile, Watercraft or Aircraft. AA. “Property Damage” means: (1) physical damage to or destruction of tangible property, including the loss of use thereof at any time resulting therefrom; (2) loss of use of tangible property which has not been physically damaged or destroyed arising from physical damage to or destruction of other tangible property; or (3) losses consequent upon evacuation arising from actual or threatened BodilyInjury or destruction of tangible property. AD. "Ultimate Net Loss" means the total sum which the Insured shall become obligated to pay for Damages on account of Personal Injury, Property Damage and/or Advertising Liability whichis, and/or but for the amount thereof would be, covered under this Policy less any salvages or recoveries. A. "Advertising Liability" means liability for Damages on account of: V. (1) An "Occurrence" exists if, and only if: AA. “Property Damage” means: 17. IV EXCLUSIONS This policy does not apply to actual or alleged: A. PRIOR TO INCEPTION OR RETROACTIVE COVERAGE DATE Personal Injury to any individual person, Property Damage to any specific property or Advertising Liability which takes place prior to the Inception Date or, if applicable, the Retroactive Coverage Date. F. ADVERTISING Advertising Liability arising out of: (1) breach of contract, but this paragraph (1) shall not exclude liability for unauthorized misappropriation of advertising ideas based upon breach or alleged breach of an implied contract; (2) infringement of registered trademarks, service marks or trade name by use thereof, but this paragraph (2) shall not apply to titles or slogans; (3) the failure of goods, products or services to conform with advertised quality or performance; (4) the wrong description of the price of goods, products or services; or (5) advertising activities on behalf of a party other than an Insured by an Insured engaged in the business of advertising. I. AIRCRAFT Liability arising out of the design, manufacture, construction, maintenance, service, use or operation of any Aircraft or any component part of or equipment thereof or any other Aircraft navigational or related equipment or service, including, without limitation, liability arising from a crash or hijacking; provided, however, that this Exclusion I shall not apply to any liability or alleged liability in respect of: (1) Aircraft fueling and related operations with respect to Personal Injury or PropertyDamage occurring at the time of such operations, i.e., while the Aircraft involved is on the ground and motionless; …… K. POLLUTION (1) (a) liability for Personal Injury, Property Damage or Advertising Liability arising out of the Discharge of Pollutants into or upon land or real estate, the atmosphere, or any watercourse or body of water whether above or below ground or otherwise into the environment; or (b) liability, loss, cost or expense of any Insured or others arising out of any direction or request, whether governmental or otherwise, that any Insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize Pollutants. This Exclusion K applies whether or not such Discharge of such Pollutants: (i) results from the Insured's activities or the activities of any other person or entity; (ii) is sudden, gradual, accidental, unexpected or unintended; or (iii) arises out of or relates to industrial operations or the Waste or by-products thereof. (2) Paragraph (1) of this Exclusion K does not apply to: (a) Product Pollution Liability; or (b) (i) liability of the Insured for Personal Injury or Property Damage caused by an intentional Discharge of Pollutants solely for the purpose of mitigating or avoiding Personal Injury or Property Damage which would be covered by this Policy; or (ii) liability of the Insured for Personal Injury or Property Damage caused by a Discharge of Pollutants which is not Expected or Intended, but only if the Insured becomes aware of the commencement of such Discharge within seven (7) days of such commencement; provided that the Insured gives the Company written notice in accordance with Section D of Article V of this Policy of such commencement of the Discharge under subparagraphs (2)(b)(i) or (ii) of this Exclusion K within forty (40) days of such commencement. Such notice must be provided irrespective of whether notice as soon as practicable otherwise would be required pursuant to Section A of Article V of this Policy. This policy does not apply to actual or alleged: A. PRIOR TO INCEPTION OR RETROACTIVE COVERAGE DATE F. ADVERTISING Advertising Liability arising out of: I. AIRCRAFT K. POLLUTION This Exclusion K applies whether or not such Discharge of such Pollutants: 18. V NOTICE OF OCCURRENCE A. NOTICE AS SOON AS PRACTICABLE If any Executive Officer shall become aware of an Occurrence likely to involve this Policy, the Named Insured shall, as a condition precedent to the rights of any Insured under this Policy, give written notice thereof to the Company in the manner provided in Section D of this Article V. Such notice shall be given as soon as practicable and, in any event, during the Policy Period or the Discovery Period, if applicable, and in accordance with Paragraph 2(b) of Exclusion K, if applicable. Failure to provide written notice as prescribed above shall result in a forfeiture of any rights to coverage hereunder in respect of such Occurrence. B. PERMISSIVE NOTICE Any Insured may at any time during the Policy Period or Discovery Period give notice of an Occurrence to the Company in the manner provided in Section D of this Article V. C. PERMISSIVE NOTICE OF INTEGRATED OCCURRENCE The Insured may at its option give written notice to the Company of any Occurrence as an "Integrated Occurrence" by designating it as such and giving such notice in the manner provided in Section D of this Article V. Once the Insured gives Notice of Integrated Occurrence, all Personal Injury or Property Damage that falls within the Integrated Occurrence (as provided in the terms, conditions and exclusions of this Policy) shall be treated as such for all purposes under this Policy irrespective of whether this Policy has been terminated after the Insured has given Notice of Integrated Occurrence. The limit of liability applicable to such Integrated Occurrence shall be the limit described in Article II of this Policy. 19. VI CONDITIONS C. CROSS LIABILITY In the event of a Claim being made by reason of Personal Injury suffered by an employee of one Insured hereunder for which another Insured hereunder is or may be liable, this Policy shall cover such Insured against whom such a Claim is made or may be made in the same manner as if separate policies had been issued to each Insured hereunder. Nothing contained herein shall operate to increase the Company's limits of liability as set forth in Item 2 of the Declarations. D. ASSISTANCE AND COOPERATION (1) The Company shall not be called upon to assume charge of the settlement or defense of any Claim made or suit brought or proceeding instituted against an Insured, but the Company shall have the right and shall be given the opportunity to associate with the Insured or the Insured’s underlying insurers or both in the defense and control of any Claim, suit or proceeding relative to any Occurrence where the Claim or suit involves, or appears reasonably likely to involve, the Company, in which event the Insured and the Company shall cooperate in all things in the defense of such Claim. (2) The Insured shall furnish promptly all information reasonably requested by the Company with respect to any Occurrence, both with respect to any Claim against the Insured and pertaining to coverage under this Policy. (3) If liabilities, losses, costs and/or expenses are in part covered by this Policy and in part not covered by this Policy, the Insured and Company shall use their best efforts to agree upon a fair and proper allocation thereof between covered and uncovered amounts, and the Insured shall cooperate with such efforts by providing all pertinent information with respect thereto. (4) Those expenses incurred by the Company on its own behalf in connection with claims representation pursuant to this Condition D shall be at its own expense and shall not be part of Ultimate Net Loss. E. APPEALS In the event the Insured or the Insured’s underlying insurers elect not to appeal a judgment in excess of the retention or the underlying limits, as the case may be, the Company may elect to make such appeal at its own cost and expense and shall be liable for the taxable costs and disbursements of such appeal and post-judgment interest on the judgment appealed from accruing during such an appeal. In no event, however, shall liability of the Company for UltimateNetLoss exceed the applicable limit of liability plus the costs and expenses of such appeal. F. LOSS PAYABLE Liability under this Policy with respect to any Occurrence shall not attach unless and until: (1) the Insured's underlying insurer(s) or the Insured shall have paid the greater of the amount of any applicable underlying limits or the applicable retention set forth in Item 2(a) of the Declarations; and (2) the Insured's liability covered hereunder shall have been fixed and rendered certain either by final judgment against the Insured after actual trial or by settlement approved in writing by the Company, and the Insured shall have paid such liability. Any consideration paid by the Insured or the Insured's underlying insurers other than in legal currency shall be valued at the lower of cost or market, and any element of the Insured's profit or other benefit to the Insured shall be deducted in determining the value of such consideration. TheCompany may examine the underlying facts giving rise to a judgment against or settlement by the Insured to determine if, and to what extent, the basis for the Insured's liability under such judgment or settlement is covered by this Policy. The Insured shall make a definite demand for payment for any amount of the Ultimate Net Loss for which the Company may be liable under this Policy within twelve (12) months after the Insured shall have paid such amount. If any subsequent payments shall be made by the Insured on account of the same Occurrence or Claim, additional demands for payment shall be made similarly from time to time. Such losses shall be due and payable by the Company thirty (30) days after they are respectively paid by the Insured, demanded and proven in conformity with this Policy. AMENDMENT OF ARTICLE VI. CONDITION O. ENDORSEMENT [14] It is hereby agreed that Article VI. Condition O. is deleted and replaced by the following: O. LAW OF CONSTRUCTION AND INTERPRETATION This Policy, and any dispute, controversy or claim arising out of or relating to this Policy, shall be governed by and construed in accordance with the internal laws of England and Wales, except insofar as: (1) such laws may prohibit payment in respect of punitive damages hereunder; (2) the law of another jurisdiction must apply pursuant to any directive of the Council of the European Community relating to non-life insurance (3) such laws are inconsistent with any provision of this Policy; provided, however, that the provisions, stipulations, exclusions and conditions of this Policy are to be construed in an evenhanded fashion as between the Insured and the Company; without limitation, where the language of this Policy is deemed to be ambiguous or otherwise unclear, the issue shall be resolved in the manner most consistent with the relevant provisions, stipulations, exclusions and conditions (without regard to authorship of the language, without any presumption or arbitrary interpretation or construction in favor of either the Insured or the Company or reference to the "reasonable expectations" of either thereof or to contra proferentem and without reference to parole or other extrinsic evidence).”
“I feel bound to read the words of the condition in the light of existing English decisions. It would take a very strong case to induce me to give to the words a meaning different from that given to them by an English decision unquestioned for fifty years. I am not impressed by the fact that a different view has been taken by American Courts on American policies. Those Courts frequently differ from ours on the construction of mercantile documents. English Courts construe documents by the light of English decisions. ”
“then the indemnitor is conclusively bound by any reasonable good faith settlement the indemnitee may make or any litigated judgment that may be rendered against him”
“When an insurer declines coverage, as here, an insured may settle rather than proceed to trial to determine its legal liability…In order to recover the amount of the settlement from the insurer, the insured need not establish actual liability to the party with whom it has settled ‘so long as a potential liability on the facts known to the [insured is] shown to exist, culminating in a settlement in an amount reasonable in view of the size of possible recovery and degree of probability of claimant’s success against the [insured].’ Damanti v. A/S Inger, 314 F.2d 395, 397 (1963) [an earlier decision of the Court of Appeals of the Second Circuit].”
“The general principle is that liability insurance provides an indemnity against actual established liability, as opposed to mere allegations …”
“The essence of the main indemnity clause — as indeed of any indemnity clause — is that the assured must prove a loss. The assured cannot recover anything under the main indemnity clause or make any claim against the underwriters until they have been found liable and so sustained a loss. If judgment were given against them for the sum claimed, they would undoubtedly have sustained a loss and the question would then arise what was the cause of the loss. If the proximate cause (this seems to be the test; Goddard and Smith v Frew[1939] 4 All ER 358 ) of the loss was the dishonesty of their servant, they could not recover under the policy; if on the other hand it was their own neglect, they could recover. If the action between the claimants and the assured did not settle the question of causation, it would in all probability settle the facts in the light of which the question could be answered. But all this would involve publicity which, where charges of professional negligence are made, might do considerable harm to an assured over and above the amount of any judgment obtained against him. For this reason professional men may prefer paying a bad claim to fighting it. Obviously one of the main objects of a QC clause is to give the assured additional cover, not only against the costs of litigation but also as a protection against unwelcome publicity.”
“I turn now to an analysis of the Q.C. clause. It comprises three promises by the underwriters, and while this combination of promises produces a clause which is sui generis in contracts of insurance, each of the promises looked at individually is, I think, based on a conception which is not a novelty in insurance law. The three promises, each contingent upon the happening of certain events, are: (1) that the underwriters will pay the costs of legal proceedings; (2) that they will pay a claim against the assured without proof of actual loss, if it is more likely than not that there will be a loss, the question of likelihood being determined by Queen's Counsel; (3) that they will pay a claim without proof of loss, and even if it is unlikely that it would cause a loss, if the assured reasonably objects to fighting it.”
“If the action against the assured succeeds, a loss will be proved; but it would still be open to underwriters to assert that the loss is not within the policy. For example, a claim which appeared on presentation to be in respect of negligence might turn out in reality, when all the facts were known In MDIS v Swinbrook [1999] Lloyd’s Rep IR 516 at 524, Clarke LJ rejected an argument by the assured that by “when all the facts are known”
“The third promise involves underwriters in the obligation of paying the claim, whether or not it can be successfully contested, if the assured has reasonable grounds for refusing to contest it. This is not, I think, an indemnity insurance at all. The underwriters undertake to pay on the happening of an event, namely, the making of a claim within the categories defined in the policy, even though it may be beyond question a bad claim and therefore one which cannot legally involve the assured in any loss; the assured need prove neither that the loss has occurred nor that there is any likelihood of a loss occurring. It is, in short, what is called contingency insurance.”
“2. Operative Clause The underwriters will indemnify the Assured to the extent and in the manner detailed herein against any claim for which the Assured may become legally liable, first made against the Assured and notified to the Underwriters during the period of this Certificate arising out of the professional conduct of the Assured's business as stated in the Schedule alleging: (a) Neglect Error or Omission any neglect or omission including breach of contract occasioned by same. (b) Dishonesty of Employees any dishonest, fraudulent, criminal, malicious act(s) or omission(s) of any person employed at any time by the Assured. The Assured will not be indemnified against any claim or loss, resulting from the dishonest, fraudulent, criminal or malicious act(s) or omission(s) perpetrated after the assured could reasonably have discovered or suspected the improper conduct of the employee(s).
“both the decision and the dicta in that case can in my judgment properly be treated as relevant to the construction of this clause since they have been well known amongst insurance lawyers and indeed brokers for many years and would be likely to have been in the back of the minds of those negotiating this contract.”
“The certificate wording is no model of precise draughtsmanship. Clause 2 deals in a rolled up way with different times and concepts. Its reference to ‘any claim for which the Assured may become legally liable, first made …’ refers first to the need for a third party claim to be made and notified during the period of the certificate and secondly to the idea of legal liability (which either exists or does not from the time of the original act, error or omission, etc.) or possibly, the establishment of legal liability for a third party claim by judgment, award or agreement. The use of the word ‘alleging’ in relation to sub-clause (a) and (b) is understandable in so far as clause 2 is concerned with a third party claim, and, in location and grammar, ‘alleging’ appears to qualify ‘first made’ or possibly ‘any claim’”
“It is important…to note that, in the context of the main indemnity clause which Devlin J was considering, he said that once the loss had been ascertained (or as he put it sustained) it remained for the insured to prove that that loss was proximately caused by neglect.”
“In my judgment the operative clause is concerned with the reality and not the epithet chosen by the third party to apply to the claim against the assured. The claim, or the allegation, triggers the process which may ultimately demonstrate the assured's right to indemnity and the underwriter's corresponding obligation to indemnify. If the result of this process demonstrates that the “loss” against which the assured is seeking indemnity in fact arises from improper conduct by employees within clause 2(b), in my judgment the underwriters are entitled to avoid liability where such conduct could reasonably have been discovered or suspected by the assured.”
“It is unnecessary to decide upon the correctness or otherwise of the Court of Appeal’s obiter observations on the effect under reinsurance of a judgment against the insurer. I note only that there was no suggestion in the Scor case[1985] 1 Lloyd’s Rep 312 , where there was such a judgment, that this judgment could be binding in the absence of a follow the settlements clause; and that the basis for such a contractual implication has been questioned by a powerfully constituted Bermudian arbitration panel in an interim award dated12 December 2000 in Gold Medal Insurance Co v Hopewell International Insurance Ltd, as well as by specialist writers: O’Neill & Woloniecki, The Law of Reinsurance in England and Bermuda, 2nd ed (2004), pp 191—193.”
“Without it [i.e. a judgment that the insurers were liable], if the plaintiffs wished to claim from NRG as reinsurers, there was an independent necessity to demonstrate legal liability which the affidavit of Mr Reasoner did not attempt to achieve other than by a prediction directed to other considerations than those of legal merit.”
“…if the claim were settled rather than being fought to judgment it was necessary to show that the insured was in fact liable on a correct view of the law. It follows that in the present case the plaintiffs must show that one or other of them, or for that matter the two of them together, were actually liable in an amount not less than that paid under the Settlement Agreement.”
“In my judgment this argument proceeds on a false basis. Since the plaintiffs must show that they were liable to the claimants in order to bring themselves within the policy at all, no question arises as to whether the settlement was reasonable in the sense of fairly reflecting the overall merits of the action, only whether it was reasonable in terms of the amount paid compared with the true extent of the claimants' recoverable loss.”
“provided [the insured] can show that they were liable to [the third party] in an amount at least equal to the total sum paid under the Settlement Agreement, the amount of the settlement cannot be regarded as unreasonable”
“Now we the Underwriters to the extent and in the manner hereinafter provided hereby agree: To indemnify the Assured against any claim or claims first made against the Assured during the period of insurance as shown in the Schedule in respect of any Civil Liability whatsoever or whensoever arising (including liability for claimants' costs) incurred in connection with the conduct of any Professional Business carried on by or on behalf of the Assured.”
“Fundamental to this construction is that it is not relevant to investigate whether the claim was well-founded. What matters is whether the claim falls within the scope of the description to be found in [the insuring clause].”
“it is important to bear in mind that in liability policies such as this an insurance clause has to define the eventuality insured against by reference both to its intrinsic character and to the period of cover provided by the policy. That against which the insured is to be indemnified is loss caused by the eventuality as defined.”
“In the present case Insuring Clause 1 defines the intrinsic character of the eventuality insured against by reference to ‘any civil liability whatsoever and whensoever arising (including liability for claimants' costs) incurred in connection with the conduct of any Professional Business carried on by or on behalf of the Assured’ (emphasis added). These words make it very clear that the eventuality is the actual liability of the insured, as distinct from the alleged liability, of the Assured. If the latter meaning had been intended the clause would hardly have referred to ‘Liability … incurred’. Nor would it have expressly provided for liability for the claimants' costs. When this wording refers to ‘liability’ it is thus referring to actual liability. When the underwriters are expressed to ‘indemnify the Assured against any claim or claims first made … during the period of insurance’ the wording is directed to defining the eventuality by reference to the period of cover. The scope of cover is thus defined as being against loss caused to the assured by their actual liability incurred in connection with the conduct of any professional business, including their actual liability for claimants' costs in respect of which liability a claim or claims are first made during the period of insurance.”
“It is true that in none of these cases was it argued that the relevant insuring clause engaged the insurers' liability upon the making of a claim as distinct from the ascertainment of the assured's liability. However, the approval of Devlin J's analysis in these two subsequent cases, in my judgment, leaves no room for such an argument unless the insuring clause is drafted to show in clear terms that this basic principle of liability insurance is intended to be excluded. This could not be said of the wording in the present case: as I have already indicated, it points very strongly towards the application of the usual principle.”
“For all sums which the Insured [i.e. Enterprise] may be obligated to pay by reason of liability imposed on the Insured by law or assumed under Contract or Agreement (written or oral) or otherwise, on account of personal injury and/or bodily injury and/or loss of life and/or loss of and/or damage to tangible property, (including loss of use following physical loss of or damage to property or persons) arising out of an occurrence occurring during the period of this Policy, all in connection with the Offshore/Marine and/or waterborne and/or airborne operations of the Insured wheresoever occurring. The term “personal injury” or “personal injuries”, wherever used herein, shall include, but not by way of limitation, bodily injury (including death at any time resulting therefrom), mental injury, mental anguish, shock, sickness, disease, disability, false arrest, false imprisonment, wrongful eviction, detention, malicious prosecution, discrimination whether on the grounds of sex or sexual orientation, race, ethnic origin, nationality or skin colour, creed, religious or political convictions, disability or appearance or otherwise, humiliation, invasion of rights of privacy, libel, slander, defamation of character, piracy and/or infringement of copyright or of property or contract rights committed or alleged to have been committed in the conduct of the Insured's operations.”
“In the event of any conflict of interpretation between the various clauses and conditions contained in this Policy, the broadest and least restrictive wording to the benefit of the Insured shall always prevail”
“Generally speaking when an insured makes a claim under a liability policy it has to demonstrate that it has suffered a loss by virtue of a legal liability which has been ascertained, whether by a judgment being entered against it by a third party, or an arbitration award or a settlement of the third party's claims. Moreover, if the loss is to be recovered under the policy, the insured must prove that its loss was caused by an insured peril under the policy. Again, generally speaking, in order to claim under a liability policy where the insured has settledthe claim of the third party, the insured still has to demonstrate that it was or would have been liable to the third party. It cannot simply rely on the fact of the settlement to demonstrate either liability or that the amount of the settlement was reasonable. In order to show the settlement was reasonable, the insured must show that the amount of damage for which it would have been liable is at least as much as the amount paid under the settlement.”
“that the combination of the words ‘liability assumed under contract or agreement’ and ‘committed or alleged to have been committed’ mean that to recover an indemnity under the policy, it only has to prove that: (a) the sum paid under the Settlement Agreement was a reasonable sum; (b) it was paid under an honest and business-like settlement of an arguable liabilityfor a peril that is insured under the policy; (c) in this case, the arguable liability was in respect of the tortious interference with the Service Agreement—loss resulting from liability for tortious interference with contract being an insured peril under the policy.”
“64….First, in my view the arguments of Mr Beazley [counsel for Enterprise] do not recognise sufficiently the importance of the words ‘on account of personal injury’ in clause 1(a) of Section iv (a). By clause 1 the insurer agrees to indemnify the insured for all sums that the insured may be obligated to pay ‘on account of personal injury’, as that is subsequently defined. So the insured's obligation to pay must be referable to ‘personal injury’, not alleged personal injury.”
“65 Secondly, it must be noted that the right to indemnity arises in two circumstances that are defined in the clause. The first of these is if the insured is obligated to pay sums by law “on account of personal injury”
“72 The importance of the decision of Mance J and the Court of Appeal in the MDIS case lies in the approach they took to the nature of the liability policy. All, including Peter Gibson LJ, started from the proposition that, in the absence of express wording to the contrary, an insured under a liability policy can only recover against his insurer if it was actually under a liability to a third party, upon a proper analysis of the law and the facts. In this case it is clear from the wording of the opening of clause 1(a) of Section iv (a) of the Policy, that the same rule applies. In my view, the words ‘alleged to have been committed’ at the end of the wording that defines ‘personal injury’ refer to the time the acts which come within ‘personal injury’ were committed ‘or alleged to have been committed’.”
“(i) when an English court has to consider whether one party is liable to another under a contract and that matter has been decided by a foreign court, then the English court should accept the decision of a foreign court as to relevant liability (which in this case would be that of Enterprise to Rowan), subject to exceptions which are not relevant to this case; (ii) in cases where the foreign court has not actually determined the matter, then the English court has to decide what the foreign court's decision would have been, following the applicable law and any relevant rules of construction; (iii) it is for the English court to determine, by evidence, the applicable law; (iv) the presumption of the English court should be that a foreign court would arrive at a decision according to law, whether the decision is by a judge's ruling or a jury's verdict; (v) extraneous reasons for saying that a jury would arrive at a particular verdict are irrelevant, at least when such a verdict would be contrary to the applicable law.”
“The most important, if obvious, point is that an insurer always has the right to challenge whether the insured's right to indemnity under the policy has been established. Therefore it has the right to challenge whether the insured was, in fact and law, liable to the third party. It has the right to challenge the quantum of the liability. And it must also have the right to challenge whether, on the facts of the case, the insured's liability to the third party is a loss within the scope of the liability policy, whatever is stated in a judgment, award or settlement. Apart from anything else, the insurer will not be a party to the judgment, award or settlement, unless specifically involved. I accept that in the case of judgments and awards, the conclusion of a competent tribunal on the merits as to liability and quantum is unlikely to be upset in an action on the liability policy. But I cannot see why, in principle, it should not be challenged. In the case of settlements, Colman J himself specifically accepted that an insurer is not bound by a settlement agreement between the insured and the third party as to liability, or quantum.”
“As it seems to me in liability insurance such as this the position, generally speaking, lies thus: 1. The insured must establish that it has suffered a loss which is covered by one of the perils insured against: West Wake; Post Office v Norwich Union[1967] 2 QB 363 ; Bradley v Eagle Star Insurance Co Ltd[1989] AC 957 ; Horbury Building Systems Ltd v Hampden Insurance NV [2004] 2 CLC 453 , 464; 2. That may be done by showing a judgment or an arbitration award against the insured or an agreement to pay; 3. The loss must be within the scope of the cover provided by the policy; 4. As a matter of practicality, the judgment, award, or agreement may settle the question as to whether the loss is covered by the policy because the insurers will accept it as showing a basis of liability which is within the scope of the cover; 5. But neither the judgment nor the agreement are determinative of whether or not the loss is covered by the policy (assuming that the insurer is not a party to either and that there is no agreement by the insurer to be bound). 6. It is, therefore, open to the insurers to dispute that the insured was in fact liable, or that it was liable on the basis specified in the judgment; or to show that the true basis of his liability fell within an exception; 7. Thus, an insured against whom a claim is made in negligence, which is the subject of a judgment, may find that his insurer seeks to show that in reality the claim was for fraud or for something else which was not covered, or excluded by, the policy: MDIS Ltd v Swinbank; 8. Similarly, an insured who is held liable in fraud (which the policy does not cover) may be able to establish, in a dispute with his insurers, that, whatever the judge found, he was not in fact fraudulent, but only negligent and that he was entitled to cover under the policy on that account.”
“If A successfully sues B to judgment the basis upon which he succeeds will be apparent from the judgment. It will not be open to C to say that A succeeded on another basis. To do so would be to rewrite history. But if A succeeds in suing B and B then claims against C, it is open to C to claim that in truth B was not liable to A (either at all or to the same extent), or that, if liable, it was not on the basis decided by the judge or not only on that basis. Unless B and C have by contract agreed something different, a judgment given in proceedings between A and B is neither binding on, nor enforceable by, C in subsequent proceedings between B and C. The authorities to this effect were recently reviewed and applied by the Court of Appeal in Sun Life Assurance Co of Canada v Lincoln National Life Insurance[2005] 1 Lloyd’s Rep 606 .”
“This [the reasoning in Redbridge] …assumes that what the insurer has agreed to cover is only such liability as is found by another court in proceedings against the insured, whether those findings were correct or not, and whether or not the insured could also have been found liable on another basis as well. That is not, however, the nature of the cover which, in the present case is against ‘all sums which the Insured becomes legally liable to pay’. Whether in truth there is such a liability begs the question as to who shall determine that question. As to that, in circumstances where no cause of action or issue estoppel arises the insured (and the insurer) are both, absent some special agreement, entitled, in my judgment, to have the matter determined by the judge who hears the suit to which they are both party.”
“As Mr Beazley accepts, an insured can only be obligated to pay sums by law if there is an actual liability to do so. One cannot be obligated by law to pay sums if there is only an alleged liability.”
“Liability under this Policy…shall not attach unless and until…the Insured’s liability covered hereunder shall have been fixed and rendered certain either by final judgment against the Insured after actual trial or by settlement approved in writing by the Company.”
“TheCompany may examine the underlying facts giving rise to a judgment against or settlement by the Insured to determine if, and to what extent, the basis for the Insured's liability under such judgment or settlement is covered by this Policy.”
“In my judgment the fallacy of Mr. Griffiths' argument is that it seeks to elevate the ‘event’ or ‘occurrence’ into the peril insured against, whereas the peril insured against is in fact: ‘legal liability for damages in respect of accidental loss or damage to material property’ (Sun Alliance). ‘all sums which insured shall become legally liable to pay as damages and compensation in respect of … loss or damage to property’ (Prudential). It involves reading in between the words ‘against’ and ‘legal liability’ (Sun Alliance) some such words as ‘against all such costs and expenses incurred in respect of an event which may give rise to legal liability’. Such a major re-writing of the bargain is not in my view justified.”
“such cancellation or non-extension …shall not limit whatever rights the Insured otherwise would have under this Policy as respects actual or alleged Personal Injury…included in such Occurrence or Integrated Occurrence taking place subsequent to such cancellation or non-extension”
“This Policy does not apply to actual or alleged”