New Appleman Ohio Insurance Law

New Appleman Ohio Insurance Law is the only Ohio-specific litigation practice guide that covers the broad sweep of insurance law. This valuable resource is updated by Ohio attorneys with decades of practical experience in insurance law.

This product includes extensive cross-references to related, authoritative New Appleman Insurance Law coverage and numerous examples, practice pointers, strategic advice, warnings, checklists, and references to countless statutes, regulations, and cases, as well as cross-references to other LexisNexis treatises.
Publisher: Matthew Bender

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New Appleman Ohio Insurance Law is the only Ohio-specific litigation practice guide that covers the broad sweep of insurance law.

This valuable resource is updated by Ohio attorneys with decades of practical experience in insurance law and includes extensive cross-references to related, authoritative New Appleman Insurance Law coverage and numerous examples, practice pointers, strategic advice, warnings, checklists, and references to countless statutes, regulations, and cases, as well as cross-references to other LexisNexis treatises.

In addition, it includes discussion of not only one line of insurance, but also health, homeowners, life, CGL, D&O, EPL, and many others. This one-volume title provides invaluable information written by experts so that you can find what you need and read advice on how to apply it.

The 2023 edition ISBN is 9781663350398.

eBooks, CDs, downloadable content, and software purchases are noncancelable, nonrefundable and nonreturnable. Click here for more information about LexisNexis eBooks. The eBook versions of this title may feature links to Lexis+® for further legal research options. A valid subscription to Lexis+® is required to access this content.

 

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Table of contents

CHAPTER 1 UNDERSTANDING INSURANCE
PART I: CHAPTER OVERVIEW
§ 1.01 Scope
PART II: INSURANCE EXPLAINED
§ 1.02 Understanding Insurance as a Contract
§ 1.03 Understanding Insurance as Regulated Industry
§ 1.04 Understanding How Insurance Works
§ 1.05 Understanding the Insurance Industry
§ 1.06 Understanding parties to Insurance
§ 1.07 Understanding Common Insurance Terms
§ 1.08 ISO Forms
PART III: TYPES (LINES) OF INSURANCE
§ 1.09 Personal Lines Coverages
§ 1.10 Commercial Lines Coverage
§ 1.11 Professional Liability Coverage
§ 1.12 Life Coverage
§ 1.13 Health Coverage
§ 1.14 Disability Coverage
CHAPTER 2 PERSONAL LINES INSURANCE (AUTO, HOMEOWNERS, TITLE & FLOOD)
PART I: CHAPTER OVERVIEW
§ 2.01 Scope
PART II: KEY CONCEPTS IN AUTOMOBILE INSURANCE
§ 2.02 Auto Liability Insurance
§ 2.03 Uninsured/Underinsured Motorist Insurance
§ 2.04 Other Automobile Insurance Coverages
PART III: KEY CONCEPTS IN RESIDENTIAL HOMEOWNERS INSURANCE
§ 2.05 Property Insurance: Homeowners & Renters Policies
PART IV: KEY CONCEPTS IN TITLE INSURANCE FOR RESIDENTIAL PROPERTIES
§ 2.06 Title Insurance
PART V: KEY CONCEPTS IN FLOOD INSURANCE FOR RESIDENTIAL PROPERTIES
§ 2.07 Flood Insurance
APPENDIX 2A HOMEOWNER’S POLICY OF TITLE INSURANCE
APPENDIX 2B OHIO TITLE STANDARDS
APPENDIX 2C TITLE 44: EMERGENCY MANAGEMENT AND ASSISTANCE
CHAPTER 3 COMMERCIAL GENERAL LIABILITY POLICIES
PART I: CHAPTER OVERVIEW
§ 3.01 Scope
§ 3.02 Overview
PART II: COMMERCIAL GENERAL LIABILITY POLICIES
§ 3.03 Structure and Organization of a Commercial General Liability Policy
§ 3.04 “Coverage A”: Bodily Injury and Property Damage
§ 3.05 Who Is Insured: Policy II
§ 3.06 Standard Exclusions of Coverage for Bodily Injury and Property Damage Liability
§ 3.07 “Coverage B” Pertaining to Personal and Advertising Injury
§ 3.08 “Coverage C” Pertaining to Medical Payments
§ 3.09 Supplementary Payments
§ 3.10 Pre-Tender Defense Costs
§ 3.11 Determining Limits of Insurance: Policy § III
§ 3.12 Understanding CGL Conditions: Policy § IV
CHAPTER 4 COMMERCIAL LINES
PART I: CHAPTER OVERVIEW
§ 4.01 Scope
PART II: ENVIRONMENTAL COVERAGE
§ 4.02 Environmental Coverage Overview
§ 4.03 Understanding Environmental Coverage Under CGL Policies
§ 4.04 Understanding Types of Policies Available for Environmental Liability
§ 4.05 Understanding Coverage for Cleanup Costs
§ 4.06 Understanding When Coverage Is Triggered
§ 4.07 Understanding Conditions
§ 4.08 Considerations When Multiple Policies Are Triggered
PART III: EMPLOYMENT PRACTICES LIABILITY INSURANCE
§ 4.09 Understanding EPL Coverage for Employment-Related Claims
§ 4.10 Understanding Who Is Covered Under EPL Policies
§ 4.11 Understanding Common Exclusions for Employment-Related Liability
§ 4.12 Understanding the Duty To Defend Under the EPL Coverage
§ 4.13 Understanding Conditions of the EPL Coverage
PART IV: FIDELITY AND EMPLOYEE DISHONESTY BONDS
§ 4.14 Understanding Fidelity Bonds
§ 4.15 Complying with Conditions Under Fidelity Bonds
CHAPTER 5 PROFESSIONAL LINES
PART I: CHAPTER OVERVIEW
§ 5.01 Scope
§ 5.02 Professional Lines Overview
PART II: PROFESSIONAL LINES
§ 5.03 Understanding Claims-Made Policy Forms
§ 5.04 Consent To Settle or Hammer Clauses
§ 5.05 Enforcing Arbitration Clauses
§ 5.06 Professional Liability Insurance/Errors and Omissions Insurance
§ 5.07 Directors and Officers Coverage
PART III: FORMS AND CHECKLISTS
§ 5.08 E&O Fundamental Policy Review Checklist
§ 5.09 D&O Fundamental Policy Review Checklist
CHAPTER 6 LIFE, HEALTH, AND DISABILITY INSURANCE
PART I: CHAPTER OVERVIEW
§ 6.01 Scope
§ 6.02 Overview of Life, Health, and Disability Insurance
PART II: COVERAGE ISSUES UNDER PRIVATE LIFE INSURANCE POLICIES
§ 6.03 Identifying Event that Implicates Coverage Under Private Life Insurance Policy
§ 6.04 Identifying Private Life Insurance Policy and Applicable Terms To Determine Coverage
§ 6.05 Determining Effect of Ohio Law on Private Life Insurance Policy Terms and Coverage
§ 6.06 Determining Whether Private Life Insurance Policy and Coverage Are Affected by Law of Another State or Foreign Jurisdiction, or Federal Law
§ 6.07 Resolving Private Life Insurance Coverage Issues
PART III: COVERAGE ISSUES UNDER PRIVATE HEALTH INSURANCE POLICIES
§ 6.08 Identifying Events Implicating Health Insurance
§ 6.09 Identifying Applicable Health Insurance Policy
§ 6.10 Reading a Health Insurance Policy and Determining Compliance with Mandatory Requirements
§ 6.11 Recognizing Impact of PPACA, COBRA, ERISA, and Supreme Court Decisions Legalizing Same-Sex Marriage and Striking down Defense of Marriage Act on Health Insurance
§ 6.12 Considering Limits of Preexisting Condition Exclusion
§ 6.13 Establishing a Basis for Health Insurance Coverage
§ 6.14 Resolving Issues Involving Other Applicable Insurance
§ 6.15 Resolving Health Insurance Benefits Disputes
PART IV: COVERAGE ISSUES UNDER PRIVATE DISABILITY INCOME PLANS
§ 6.16 Identifying the Applicable Disability Income Insurance Policy
§ 6.17 Determining Compliance with Policy Provisions
§ 6.18 Determining Time of Commencement of Disability
§ 6.19 Determining Presence of Total Disability
§ 6.20 Identifying Setoffs from Amounts Payable Under Disability Income Insurance Policy
§ 6.21 Establishing Claim for Disability Benefits
PART V: DETERMINING APPLICABILITY OF ERISA
§ 6.22 Recognizing Purpose of ERISA
§ 6.23 Recognizing Mechanisms of Uniformity
§ 6.24 Determining Whether Plan Is Covered by ERISA
§ 6.25 Determining Whether ERISA Preempts State Law
§ 6.26 Identifying Remedies Under ERISA
PART VI: CHECKLISTS
§ 6.27 Resolving Coverage Issues Under Private Life Insurance Policies
§ 6.28 Resolving Coverage Issues Under Private Health Insurance Policies
§ 6.29 Resolving Coverage Issues Under Private Disability Income Plans
§ 6.30 Determining Applicability of ERISA
CHAPTER 7 FORMATION, MODIFICATION, RENEWAL, AND CANCELLATION OF INSURANCE POLICIES
PART I: CHAPTER OVERVIEW
§ 7.01 Scope
§ 7.02 Overview
PART II: FORMATION, MODIFICATION, RENEWAL, AND CANCELLATION OF INSURANCE POLICIES
§ 7.03 Key Issues in Contract Formation
§ 7.04 Rules Governing Modification of the Insurance Policy
§ 7.05 Rules Governing Mid-Term Cancellation
§ 7.06 Rules Governing Renewal, Non-Renewal, and Reinstatement
PART III: FORMS AND CHECKLISTS
§ 7.07 Policy Checklist
§ 7.08 Litigation Checklist
§ 7.09 Key Ohio Statutes Related to Formation, Modification, Renewal, and/or Cancellation of Insurance Policies
CHAPTER 8 RESCISSION AND REFORMATION OF INSURANCE POLICIES
PART I: CHAPTER OVERVIEW
§ 8.01 Scope
§ 8.02 Rescission and Reformation of Insurance Policies: Overview
PART II: RESCISSION AND REFORMATION OF INSURANCE POLICIES
§ 8.03 Understanding Rescission
§ 8.04 Understanding Reformation
§ 8.05 Understanding Jury Trial Rights in Rescission and Reformation
CHAPTER 9 EVALUATING THE LIABILITY INSURER'S DUTY TO DEFEND, SETTLE, AND INDEMNIFY
PART I: CHAPTER OVERVIEW
§ 9.01 Scope
§ 9.02 Overview of the Duty To Defend
PART II: EVALUATING THE LIABILITY INSURER'S DUTY TO DEFEND, SETTLE, AND INDEMNIFY
§ 9.03 When the Duty Begins
§ 9.04 When the Duty Exists
§ 9.05 Duration of the Duty To Defend
§ 9.06 Defenses and limitations on the Duty To Defend
§ 9.07 Duty To Settle
§ 9.08 Duty To Indemnify
§ 9.09 Duty To Appeal
§ 9.10 Rights and Obligations of Insurers Vis-à-Vis Each Other
CHAPTER 10 RESPONDING TO TENDER
PART I: CHAPTER OVERVIEW
§ 10.01 Scope
PART II: DETERMINING THE PROPER RESPONSE TO A TENDER
§ 10.02 Introduction
§ 10.03 Standards for Responding to a Tender
§ 10.04 Bad Faith for Failure To Accept Tender
§ 10.05 Consequences and Damages for Bad Faith
§ 10.06 Defending Claim Under Reservation of Rights
§ 10.07 Declaratory Judgment Actions
§ 10.08 When the Insured Is Entitled to Independent Counsel
CHAPTER 11 THE INSURED’S DUTIES
PART I: CHAPTER OVERVIEW
§ 11.01 Scope
§ 11.02 Understanding the Insured’s Duties
PART II: INSURED’S OBLIGATIONS
§ 11.03 Understanding the Insured’s Duties in the Application Process
PART III: UNDERSTANDING INSURED’S DUTIES WITH RESPECT TO POLICY CONDITIONS
§ 11.04 Understanding the Insured’s Duties in Reviewing the Policy
§ 11.05 Understanding an Insured’s Duty in Presenting a Claim
§ 11.06 Duty To Notify
§ 11.07 Duty To Cooperate
CHAPTER 12 EXCESS, UMBRELLA, AND SURPLUS POLICIES
PART I: CHAPTER OVERVIEW
§ 12.01 Understanding the Differences Between Umbrella and Excess Coverage
§ 12.02 Understanding the Distinction Between Admitted Carriers and Surplus Lines
§ 12.03 Triggering Umbrella or Excess Coverage
§ 12.04 The Umbrella or Excess Duty To Defend
§ 12.05 Duty To Settle
§ 12.06 Umbrella or Excess Carrier Rights Against Primary or Peer Coverage
§ 12.07 Umbrella or Excess Coverage Sitting Above a Self-Insured Retention
§ 12.08 Settlement Credits for Underlying Coverage
CHAPTER 13 CLAIMS IMPLICATING MULTIPLE INSURERS
PART I: CHAPTER OVERVIEW
§ 13.01 Scope
§ 13.02 Overview
PART II: CLAIMS IMPLICATING MULTIPLE INSURERS
§ 13.03 Identifying Primary, Excess, and Umbrella Policies
§ 13.04 “Other Insurance” Clauses and “Additional Insured” Endorsements
§ 13.05 Subrogation Claims Among Insurers
§ 13.06 Contribution Claims Among Insurers
§ 13.07 Indemnity Claims Among Insurers
§ 13.08 Distinguishing Contribution, Subrogation, and Indemnity
§ 13.09 Settlement as a Bar to Claims by Settling Insurers Against Non-Settling Insurers
PART III: FORMS AND CHECKLISTS
§ 13.10 Checklist for Claims Among Multiple Insurers
CHAPTER 14 EXTRACONTRACTUAL LIABILITY OF INSURERS
PART I: CHAPTER OVERVIEW
§ 14.01 Scope
PART II: COMMON THEORIES OF EXTRACONTRACTUAL LIABILITY
§ 14.02 Ohio Common Law
§ 14.03 Statutory and Regulatory Influences
PART III: INSURANCE BAD FAITH
§ 14.04 Historical Development
§ 14.05 Current Standard for Establishing Bad Faith
§ 14.06 Elements of the Bad Faith Cause of Action
§ 14.07 Common Defenses to and Limitations on Bad Faith Claims
CHAPTER 15 INSURANCE-SPECIFIC ISSUES IN COVERAGE AND BAD-FAITH LITIGATION
PART I: CHAPTER OVERVIEW
§ 15.01 Overview
PART II: INSURANCE COVERAGE-RELATED LITIGATION
§ 15.02 Common Types of Coverage and Bad-Faith Litigation
§ 15.03 Common Issues Arising in Coverage and Bad-Faith Litigation
CHAPTER 16 REGULATION OF INSURERS
PART I: CHAPTER OVERVIEW
§ 16.01 Scope
§ 16.02 Overview of Regulation of Insurers
PART II: REQUIREMENTS FOR INSURERS TO CONDUCT BUSINESS IN OHIO
§ 16.03 Considering Insurance as Regulated Contract
§ 16.04 Considering Basics of How Insurance Pricing Works
§ 16.05 Recognizing that Insurance Constitutes Interstate Commerce Subject to Federal Preemption
§ 16.06 Determining Whether Coverage Issue Encompasses Regulation Delegated to State
§ 16.07 Determining What State Regulation Is Implicated
§ 16.08 Recognizing Special Consideration for Risk Retention Groups
§ 16.09 Recognizing Special Consideration for Plans Governed by ERISA
PART III: REQUIREMENTS FOR FILING AND APPROVAL OF POLICY FORMS
§ 16.10 Recognizing that Policy Forms Must Be Filed by Insurers and Approved by Superintendent of Insurance
§ 16.11 Recognizing General Form Filing Rules
PART IV: CHECKLISTS
§ 16.12 Fulfilling Requirements for Insurers to Conduct Business in Ohio
§ 16.13 Fulfilling Requirements for Filing and Approval of Policy Forms
CHAPTER 17 OHIO INSURANCE GUARANTY ASSOCIATION ACT
PART I: CHAPTER OVERVIEW
§ 17.01 Scope
§ 17.02 Overview of Ohio Insurance Guaranty Association Act
PART II: OHIO INSURANCE GUARANTY ASSOCIATION ACT
§ 17.03 Considering Nature of Ohio Insurance Guaranty Association
§ 17.04 Considering Role of OIGA
§ 17.05 Determining What Is a “Covered Claim” for Purposes of OIGA
§ 17.06 Recognizing that OIGA’s Rights Are Generally Coextensive with Rights of Insolvent Insurer
§ 17.07 Recognizing Statutory Six-Month Stay
§ 17.08 Considering Limitations on Recovery from OIGA
§ 17.09 Recognizing OIGA’s Subrogation Rights
§ 17.10 Asserting Bad Faith and Extra-Contractual Claims Against OIGA
§ 17.11 Making Claims to Estate of Insolvent Insurer
§ 17.12 Contacting OIGA
PART III: CHECKLIST
§ 17.13 Seeking Recovery Under the Ohio Insurance Guaranty Association Act