Insurance Coverage Opinions & Litigation

Brown & Bullock represents insurance companies, businesses and individuals in claims investigations, coverage disputes, claim settlement negotiations and litigation. When a claim arises, whether involving a commercial loss, liability exposure, or an emerging risk, understanding the scope and applicability of coverage early is critical. Here at Brown & Bullock, LLC, our litigation experience allows us to seamlessly pursue or defend coverage at the carrier level and before administrative tribunals as well as state and federal trial courts.  Contact the Maryland insurance lawyers at Brown & Bullock today to learn about our services and how we can help.

Insurance Coverage Opinion Letters

Insurance coverage opinion letters are often the starting point when a claim presents uncertainty, risk, or potential exposure beyond what can be resolved through routine claim handling. These letters are used to analyze whether coverage exists under a particular policy, how courts have interpreted similar provisions, and what obligations may be triggered.

A coverage opinion is a legal analysis that considers the specific claim, the precise policy language at issue, and applicable statutes and case law. These opinions are commonly requested when claims involve gray areas, novel issues, or conflicting policy provisions. Coverage opinion letters typically address the following issues:

• Whether an insuring agreement is triggered by the alleged loss or claim
• How exclusions, limitations, or endorsements may apply
• Whether conditions precedent, such as notice or cooperation requirements, have been satisfied
• How courts have ruled on similar policy language in the past
• Potential exposure if coverage is ultimately found to exist

Coverage opinions help insurers make decisions about defense obligations, indemnity exposure, and reservation of rights. Additionally, they also play an important role in regulatory compliance and internal documentation. Coverage opinions also help policyholders who are looking to clarify available benefits, identify potential arguments for coverage, and challenge denials.

Denial of Coverage / Unfair Claim Settlement Practices

Denials of coverage, by their nature, are often the flashpoint that marks the beginning of a dispute between an insurer and an insured.  When coverage is denied, insurers are generally required to provide a clear, written explanation identifying the policy provisions relied upon and explaining how those provisions apply to the facts of the claim. A denial that lacks adequate support can lead to additional disputes, and, in some cases, allegations of unfair claim settlement practices.

Unfair claim settlement practices are governed by statute and can involve both administrative and judicial processes, depending on the type of policy and coverage limits.  Selecting the correct forum, whether before an administrative tribunal or before a trial court, is critical, as an unfair claim settlement practices action brought in the incorrect venue can create grounds for an early, and potentially dispositive, dismissal.  Depending on the policy at issue, insureds may need to first pursue relief through the Maryland Insurance Administration before seeking certain damages in court. Common grounds for coverage denials may include:

• Policy exclusions that apply to the loss
• Failure to comply with notice or reporting requirements
• Claims falling outside the policy period or coverage territory
• A loss that does not trigger a coverage grant or endorsement under the policy
• Misrepresentation of a risk or material non-disclosure during underwriting

Declaratory Judgment Actions

Declaratory judgment actions, used correctly, can be a common and effective way to resolve insurance coverage disputes before uncertain terms or issues lead to unnecessary expense. These actions ask a court to determine the rights and obligations of the parties under an insurance policy, often before the underlying liability case is resolved. Declaratory judgment actions are frequently used to address a wide range of questions, such as:

• Whether an insurer has a duty to defend an insured
• Whether indemnity obligations apply to a particular claim or loss
• Whether an alleged loss triggers coverage obligations under the specific policy language at issue
• How exclusions or endorsements should be interpreted
• How coverage should be allocated among insurers

Declaratory judgment actions are not limited to disputes between insurers and policyholders, nor are they limited to insurance.  These actions may also involve disputes between insurers, questions of contribution or priority, disagreements over excess and umbrella coverage, or parties rights under an agreement, contract or other instrument.

Contact Our Firm for Assistance With Insurance Coverage Opinions & Litigation

If you have questions or need a team of experienced Maryland insurance lawyers who can effectively represent your interests, contact Brown & Bullock today.