LexisNexis Practice Guide: New Appleman Pennsylvania Insurance Law

With checklists, tips and analysis, this single-volume practice guide is designed to help Pennsylvania practitioners manage insurance matters with confidence
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2019 Edition
ISBN: 9781522139799
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LexisNexis® Practice Guide: New Appleman Pennsylvania Insurance Law is a single-volume practical guide designed specifically for Pennsylvania attorneys and professionals in the insurance field. Complete with checklists, practice tips and references to relevant caselaw, statutes and regulations, this handy resource provides rich, in-depth discussions and analysis on a variety of insurance topics, including:

•  How and where insurance is regulated
•  Types of insurance policies and coverages
•  Policy formation and sale
•  Extra-contractual liability
•  Exclusions and policy conditions
•  Litigating insurance matters

Brought to you by LexisNexis, a worldwide leader in primary and secondary legal publications, and Professor Christopher C. French, an accomplished author and former partner and commercial litigator at K&L Gates LLP, this practice guide is a must-have for Pennsylvania insurance practitioners and professionals.

LexisNexis eBooks feature links to the Lexis Advance® service for further legal research options.

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Table of Contents

CHAPTER 1   INTRODUCTION TO INSURANCE 

PART I:   CHAPTER OVERVIEW

1.01  Scope
1.02   Objective

PART II:   UNDERSTANDING INSURANCE
1.03   Insurance as a Regulated Contract
1.04   How Insurance Works
1.05   Structure of the Insurance Industry
1.06   Parties to the Insurance Contract
1.07   Insurance Terminology
1.08   The Structure of Particular Insurance Companies

PART III:   HOW AND WHERE INSURANCE IS REGULATED
1.09   Insurance Affects Interstate Commerce and Therefore Is Subject to Federal
  Preemption
1.10   When Coverage Issue Is Within State
1.11   Determining When State Regulation Is Implicated
1.12   Recognizing Special Consideration for Risk Retention Groups
1.13   Special Considerations for Insurance Plans Governed by ERISA

PART IV:   TYPES OF INSURANCE POLICIES AND COVERAGES
1.14   Two Basic Types of Coverage: Third-Party Direct Benefits
1.15   Personal Lines Insurance: Homeowners and Automobile
1.16   Commercial Lines Insurance: CGL, Workers' Compensation, First Party
1.17   Professional Lines Insurance
1.18   Life Insurance: Term, Whole, Fixed or Variable Rate Annuity
1.19   Health Insurance: PPO, POS, HMO, Long-Term Care
1.20   Disability Insurance
1.21   Shipping Insurance
1.22   Maritime Insurance

PART V:   DOCUMENTS IMPORTANT TO COVERAGE AND POLICY STRUCTURE
1.23   Formal Filing Requirements of Insurance Documents
1.24   Policy Application
1.25   Insurance Binder
1.26   Certificate of Insurance
1.27   The Declarations Page
1.28   Basic Insurance Policy
1.29   Endorsements
1.30   Policy Notices; Cancellation and Nonrenewal
1.31   Checklist

CHAPTER 2   POLICY FORMATION AND SALE
2.01   Scope
2.02   Objective
2.03   Insurance Policies as Contracts
2.04   Application for Insurance
2.05   Misrepresentations or Concealment by Applicant
2.06   Waiver and Estoppel
2.07   Insurable Interest
2.08   Payment of Premium
2.09   Temporary Insurance
2.10   Delivery of Policy
2.11   Duty of Insured to Read Policy
2.12   Policy Interpretation
2.13   Renewal Policies
2.14   Insurance Producers
2.15   Checklist

CHAPTER 3   POLICYHOLDER OBLIGATIONS
3.01   Scope
3.02   Objective
3.03   Introduction
3.04   Notice of Loss or Claim
3.05   Proof of Loss
3.06   Miscellaneous Obligations of Insureds
3.07   Notice-Prejudice Rule
3.08   Cooperation
3.09   Examination Under Oath
3.10   Subrogation
3.11   Checklist

CHAPTER 4   POLICYHOLDER/INSURER RELATIONS
4.01   Scope
4.02   Objective
4.03   Responding to a Claim
4.04   Proof of Loss
4.05   The Adjustment Process
4.06   Investigation of Claim
4.07   Declining Coverage
4.08   Duty to Settle an Insured’s Claim for Loss
4.09   Declaratory Judgments
4.10   Appraisal
4.11   Insurer's Defense of its Insured Under a Liability Policy
4.12   Checklist

CHAPTER 5   EXTRA-CONTRACTUAL LIABILITY
5.01   Scope
5.02   Objective
5.03   Common Law Bad Faith
5.04   The Statutory Bad Faith Cause of Action
5.05   Proper Parties to a Statutory Bad Faith Claim
5.06   Bad Faith Defined
5.07   Elements of a Statutory Bad Faith Claim
5.08   Proving Bad Faith
5.09   Right to a Jury Trial
5.10   Attorney's Fees
5.11   Defenses to the Statutory Bad Faith Action
5.12   Checklist
5.13   Pennsylvania Unfair Insurance Practices Act
5.14   Checklist
5.15   Pennsylvania Unfair Trade Practices and Consumer Protection Law
5.16   Checklist

CHAPTER 6   PERSONAL LINES
6.01   Scope
6.02   Objective
6.03   Life Insurance
6.04   Health Insurance
6.05   Disability Insurance
6.06   Flood Insurance
6.07   Overview of Homeowner's Insurance
6.08   Homeowner's Insurance—Property Coverage
6.09   Homeowner's Insurance—Liability Coverage
6.10   Personal Automobile Policies
6.11   Title Insurance
6.12   Checklist

CHAPTER 7   COMMERCIAL LIABILITY COVERAGES

PART I:   CHAPTER OVERVIEW

7.01   Scope
7.02   Objective
7.03   Purpose of CGL Insurance; The Insurer's Duty; The Risks it Covers

PART II:   THE COMMERCIAL GENERAL LIABILITY POLICY
7.04   Insured Parties
7.05   Coverages

PART III:   SCOPE OF COVERAGE
7.06   Scope of "Bodily Injury"
7.07   Scope of "Property Damage"
7.08   Scope of Personal or Adverting Injury
7.09   Scope of "Occurrence"
7.10   Duty to Defend
7.11   Meaning of "Suit"
7.12   Known Loss Doctrine
7.13   Limits of Coverage

PART IV:   EXCLUSIONS
7.14   Bodily Injury and Property Damage Exclusions
7.15   Personal or Adverting Injury Exclusions

PART V:   POLICY CONDITIONS
7.16   Duties of Insured
7.17   Legal Action Against the Insurer
7.18   Other Insurance
7.19   Checklist

PART IV:   GAP-FILLER LIABILITY COVERAGES
7.20   Environmental Liability Insurance
7.21   Employment Practices Liability Insurance
7.22   Cyber Insurance Liability Coverage
7.23   Workers' Compensation Insurance
7.24   Checklist

CHAPTER 8   COMMERCIAL PROPERTY COVERAGES
8.01   Scope
8.02   Objective
8.03   Commercial Property Insurance
8.04   Boiler and Machinery or Equipment Breakdown Insurance
8.05   Flood Insurance
8.06   Crime/Fidelity Insurance
8.07   First-Party Cyber Insurance
8.08   Checklist

CHAPTER 9   PROFESSIONAL LINES
9.01   Scope
9.02   Objective
9.03   Overview of Professional Liability Insurance
9.04   Directors & Officers Insurance
9.05   Errors and Omissions Insurance
9.06   Checklist

CHAPTER 10   EXCESS, UMBRELLA, AND SURPLUS LINES INSURANCE

PART I:   CHAPTER OVERVIEW

10.01   Scope
10.02   Objective

PART II:   EXCESS AND UMBRELLA INSURANCE
10.03   Excess Insurance
10.04   Umbrella Insurance
10.05   Pennsylvania Motor Vehicle Financial Responsibility Law

PART III:   SURPLUS LINES INSURANCE
10.06   Surplus Lines Law
10.07   Checklist

CHAPTER 11   GUARANTY ASSOCIATIONS
11.01   Scope
11.02   Objective
11.03   Introduction
11.04   Legal Basis for Guaranty Associations
11.05   Administration and Governance of Guaranty Associations
11.06   Assessments
11.07   Purpose of Guaranty Associations
11.08   Workers' Compensation Security Fund
11.09   Warrentech Consumer Prods. Servs. v. Reliance Ins. Co In Liquidation, 96 A.3d
  346 (Pa. 2014)
11.10   Pennsylvania Life and Health Insurance Guaranty Association
11.11   Checklist

CHAPTER 12   LITIGATING INSURANCE MATTERS
12.01   Scope
12.02   Objective
12.03   Pre-Litigation Considerations
12.04   Causes of Action
12.05   Choice of Law
12.06   Interpleader
12.07   Declaratory Judgments
12.08   Discovery
12.09   Checklist