'Late Notice' under Liability Policies: California Law

Liability insurance policies typically contain provisions requiring that an insured notify the insurance carrier “as soon as practicable” of a claim or loss that potentially might be covered by the policy. If there is any delay in providing notice, an insurance carrier may deny coverage, or at least reserve its right to deny coverage. However, there are many situations in which a delay in notice, even if not excusable, will not result in a loss of coverage.

California courts long have held that “[a]n insurer may assert defenses based upon a breach by the insured of a condition of the policy such as a cooperation clause, but the breach cannot be a valid defense unless the insurer was substantially prejudiced thereby.” Campbell v. Allstate Ins. Co., 60 Cal. 2d 303, 305-06, 32 Cal. Rptr. 827 (1963). The Campbell court so held even though the insured had failed to cooperate with its carrier. It did so because the carrier had failed to show that it was prejudiced by the insured's failure to cooperate.

California courts have reached similar conclusions with respect to other policy conditions. For example, in Shell Oil Co. v. Winterthur Swiss Insurance Co., 12 Cal. App. 4th 715, 15 Cal. Rptr. 2d 815 (1993), the court of appeal recognized that “California law is settled that a defense based on an insured's failure to give timely notice requires the insurer to prove that it suffered substantial prejudice.” Id. at 760. See Clemmer v. Hartford Ins. Co., 22 Cal. 3d 865, 881-83, 151 Cal. Rptr. 285 (1978) (same). No matter what breach the insured allegedly has committed, prejudice will not be presumed. See Campbell, 60 Cal. 2d at 307 (“a judicially created presumption of prejudice, whether conclusive or rebuttable, is unwarranted”); Moe v. Transamerica Title Ins. Co., 21 Cal. App. 3d 289, 302, 98 Cal. Rptr. 547 (1971) (prejudice is not presumed from the fact of untimely notice). Instead, the insurance carrier has the burden of proving that a breach of a condition in the policy actually and substantially prejudiced it. Campbell, 60 Cal. 2d at 306; Shell, 12 Cal. App. 4th at 760. “The insurer must show actual prejudice, not the mere possibility of prejudice.” Id. at 761. See Billington v. Interins. Exch., 71 Cal. 2d 728, 737, 79 Cal. Rptr. 326 (1969) (same). As the California Supreme Court has explained, “prejudice is not shown simply by displaying end results; the probability that such results could or would have been avoided absent the claimed default or error must also be explored.” Clemmer, 22 Cal. 3d at 883 n.12. See also Insurance Co. of the State of Pa. v. Associated Internat'l Ins. Co., 922 F.2d 516, 523 (9th Cir. 1991) (The purpose of a condition in an insurance policy is “not to provide a technical escape-hatch by which to deny coverage in the absence of prejudice nor to evade the fundamental protective purpose of the insurance contract to assure the insured and the general public that liability claims will be paid.”).

Rejected'Prejudice' Arguments

California courts have rejected a number of arguments raised by carriers to establish prejudice. For example, in Campbell, the California Supreme Court ruled that testimony by an insurance carrier's claim manager that a report by the insured is required to guard against false claims, to verify that there has been an accident, and to determine liability was an insufficient showing of prejudice when the carrier had a sufficient opportunity to verify that there had been an accident, the insured was negligent, and the carrier would have been liable on its policy even if its insured had cooperated with it. 60 Cal. 2d at 306.

The court of appeal reached a similar conclusion in Northwestern Title Security Co. v. Flack, 6 Cal. App. 3d 134, 85 Cal. Rptr. 693 (1970). There, the carrier contended that a delay in notice cost it the opportunity to settle the claim against the insured for a small sum early in the proceedings. The court rejected this argument, noting that “prejudice does not arise merely because a delayed or late notice has denied the insurance company the ability to contemporaneously investigate the claim or interview witnesses,” Id. at 142-43, or because the carrier has been denied “the opportunity to make an early settlement of the claim.” It ruled that the carrier had to prove that:

but for the delay in making a prompt investigation and in hiring [its] own attorney at the early stages, there was a substantial likelihood that [it] could have prevailed in a negligence action brought against [its] assured or that [it] could have settled the case for a small sum or a smaller sum than that for which [the] insured ultimately settled the claim. Id.

The Shell court rejected another argument made by carriers to establish prejudice. In Shell, the insured was seeking coverage for environmental cleanup costs. The carriers argued that the insured had delayed in notice and that the carriers had proven substantial actual prejudice by showing that the cleanup costs increased dramatically over a 10-year period. They also asserted that the passage of time made defending against the claims more difficult, and that the insured had denied them the right to investigate and had deprived them of the right to defend or settle the claims. By way of example, the carriers provided a list of 18 persons who they could not interview because they were now dead or unavailable. The carriers also noted that the cleanup costs had escalated drastically over the years before they were notified. The court of appeal rejected these arguments, finding that “the record does not support an inference that earlier notice would have changed anything.” 12 Cal. App. 4th at 762. It stated:

In order to demonstrate actual, substantial prejudice from lack of timely notice, an insurer must show it lost something that would have changed the handling of the underlying claim. If the insurer asserts that the underlying claim is not a covered occurrence or is excluded from basic coverage, then earlier notice would only result in earlier denial of coverage. To establish actual prejudice, the insurer must show a substantial likelihood that, with timely notice, and notwithstanding a denial of coverage or reservation of rights, it would have settled the claim for less or taken steps that would have reduced or eliminated the insured's
liability. 12 Cal. App. 4th at 763.

The court also held that when “an insurance company denies liability under a policy which it has issued, it waives any claim that the notice provisions of the policy have not been complied with.” Id. at 762. In other words, the court specifically concluded that because the carriers had denied coverage on grounds in addition to breach of the notice condition, there could not have been any prejudice. Simply put, earlier notice would have resulted in nothing but an earlier denial.

Indeed, as another court of appeal has explained:

[A]n insurer is not allowed to rely on an insured's failure to perform a condition of a policy when the insurer has denied coverage because the insurer has, by denying coverage, demonstrated performance of the condition would not have altered its response to the claim. Select Ins. Co. v. Superior Court, 226 Cal. App. 3d 631, 637, 276 Cal. Rptr. 598 (1990).

Carriers Argue Inapplicability Of 'Notice-Prejudice' Rule

Notwithstanding the above principles, insurance carriers often argue that the notice-prejudice rule is not applicable to all types of liability policies. For example, carriers typically claim that the rule does not apply to “claims made” or “claims made and reported” policies. A “claims made” policy typically is a policy in which coverage depends not on when an underlying event took place, but rather on whether a claim was made within that policy period. Under such a policy, coverage is triggered when a claim is made during the policy period. A “claims made and reported” policy adds an additional requirement to trigger coverage ' a requirement that the claim not only be made against the insured during the policy period, but also that the claim be reported to the carrier within the policy period or a specified time thereafter.

Many courts have held that the notice-prejudice rule does not apply to the “claims reported” provision of a “claims made and reported” policy. As one court explained, under a “claims made and reported” policy, the policy:

unambiguously provides [the insured's] ability to report claims ' would terminate at the end of the ' period. The extension clause gave [the insured] [a specific period within which] to report claims ', a benefit for which [the carrier] received a specific “end date” of coverage in exchange.

Industrial Indem. v. Superior Court, 224 Cal. App. 3d 828, 831, 275 Cal. Rptr. 218 (1990). See also Diluglio v. New England Ins. Co., 959 F.2d 355, 359 (1st Cir. 1992) (“Since the reporting period prescribed in a 'claims-made' insurance policy defines the scope of coverage ', [we] conclude that prejudice may be presumed where notice is not provided within the policy period ' “).

However, the claims reporting requirement should be distinguished from the notice requirement also typically found in “claims made and reported” policies. Most “claims made and reported” policies have a separate condition that the insured provide “notice as soon as practicable” after a claim is made. In other words, as noted above, “claims made and reported” policies have two requirements applicable to notice ' a condition that requires that notice be given as soon as practicable after a claim is made, and the reporting requirement, which requires that the claim be reported to the carrier before the policy or reporting period expires. It is this latter requirement that courts have strictly enforced. Indeed, the Ninth Circuit has emphasized the importance of distinguishing between a “claims made” notice condition and a “claims made and reported” reporting requirement:

It is reasonable to conclude that a claims-made-and-reported policy differs from a general claims-made policy containing no requirement that the claim be reported within the policy period. We hold that this is a reasonable interpretation of California law. The reporting requirement serves two different purposes in the two policies. The notice provision on a general claims made policy, as in an occurrence policy, often requires notice “as soon as practicable.” This serves to “facilitate the timely investigation of claims by bringing an event to the attention of the insurer and allows an inquiry 'before the scent of factual investigation grows cold.'” In contrast, in a claims-made-and-reported policy, notice is the event that actually triggers coverage. Pension Trust Fund for Operating Engineers v. Federal Ins. Co., 307 F.3d 944, 956-57 (9th Cir. 2002).

Based on this distinction, the Ninth Circuit concluded that the notice-prejudice rule would apply to the notice provision of a “claims made” policy. Id.

The Ninth Circuit's holding is in accord with established California precedent. One of the leading California cases is Northwestern Title Security Co. v. Flack, 6 Cal. App. 3d 134 (1970). In Northwestern, the insured delayed approximately one year in notifying the carrier of a claim and more than four months in notifying the carrier of the filing of a lawsuit against it. The carrier contended that notice under its claims-made policy was barred because of the insured's delay in giving notice. The court of appeal rejected this argument, citing to the California Supreme Court's decision in Campbell:

Campbell stands for these propositions: (1) that breach by an insured of a cooperation or notice clause may not be asserted by an insurer unless the insurer was substantially prejudiced thereby; (2) that prejudice is not presumed as a matter of law from such breach; [and] (3) that the burden of proving prejudicial breach is on the insurer '

6 Cal. App. 3d at 141.

The court noted that the insurance carrier's burden of establishing substantial prejudice “is not carried by a showing of possibility of prejudice to the insurer. Rather, actual prejudice must be shown.” Id. The court then stated:

[The carrier] makes the policy argument that we should enunciate a strict rule of construction as regards the fulfillment of conditions precedent to indemnity found in claims-type policies. He argues that the cases which hold that an insurer may assert defenses based upon a breach by the insured of a policy condition only where the insurer was substantially prejudiced thereby, have been enunciated in “occurrence-type” policies where the obligation of the insurer is fixed in time by reference to the happening of an occurrence occasioning loss, such as an automobile accident ' In considering this argument we observe that, notwithstanding the generic differences between the two types of policies, there is not indication in Campbell or the other cases ' that a different rule can apply in “claims-type” policies. The cases make it clear that the subject rule applies to all cases in which the insurer asserts a defense based upon a breach by the insured of a cooperation or notice clause. Id. at 143-44.

Claims Made Near the End Of the Reporting Period

Furthermore, courts have not strictly enforced claims reporting requirements, at least with respect to claims made near the end of the reporting period. For example, in Root v. American Equity Specialty Insurance Co., 130 Cal. App. 4th 926, 30 Cal. Rptr. 3d 631 (2005), the court addressed a malpractice policy that covered claims first made against the insured and reported in writing to the company while the policy is in force. The insured was named in a lawsuit just days before the policy expired and reported the suit after the policy expiration when he read that it had been filed. The court noted that the case involves “one of the worst nightmares faced by most every attorney, doctor, accountant or other professional covered by a malpractice insurance policy: the possibility of no malpractice coverage under a 'claims made and reported' policy where a claim is made very late in the policy period and the insured learns of the claim under highly ambiguous circumstances, so the claim is not reported until there is confirmation of that claim, which is shortly after the policy has expired.” Id. at 929.

The court then observed that “[t]he definition of 'claim' in the policy is ambiguously open-ended. The policy doesn't say that the mere filing of a suit is not a claim. It merely says that a claim is a demand for money ' [T]here could be a situation in which an insured might have two 'claims' against him or her based on just one malpractice suit.” Id. at 933. The court concluded that “the insured could be whipsawed ' into having no coverage under policies on either side of a policy period expiration divide. Ambiguities in insurance contracts aren't supposed to work that way.” Id. at 933-34.

Conclusion

The notice-prejudice rule should apply, as a minimum, to notice requirements in liability policies, even if they are claims made policies. As for the reporting requirements in claims made and reported policies, an insured should seek to comply with reporting requirements, but, depending upon the circumstances, still may be entitled to coverage even if there is a delay in reporting.

Kirk Pasich, a member of this newsletter's Board of Editors, is a partner in the Los Angeles office of Dickstein Shapiro LLP. He is the chair of the firm's Insurance Coverage Practice and represents insureds in complex coverage matters.

Liability insurance policies typically contain provisions requiring that an insured notify the insurance carrier “as soon as practicable” of a claim or loss that potentially might be covered by the policy. If there is any delay in providing notice, an insurance carrier may deny coverage, or at least reserve its right to deny coverage. However, there are many situations in which a delay in notice, even if not excusable, will not result in a loss of coverage.

California courts long have held that “[a]n insurer may assert defenses based upon a breach by the insured of a condition of the policy such as a cooperation clause, but the breach cannot be a valid defense unless the insurer was substantially prejudiced thereby.” Campbell v. Allstate Ins. Co. , 60 Cal. 2d 303, 305-06, 32 Cal. Rptr. 827 (1963). The Campbell court so held even though the insured had failed to cooperate with its carrier. It did so because the carrier had failed to show that it was prejudiced by the insured's failure to cooperate.

California courts have reached similar conclusions with respect to other policy conditions. For example, in Shell Oil Co. v. Winterthur Swiss Insurance Co., 12 Cal. App. 4th 715, 15 Cal. Rptr. 2d 815 (1993), the court of appeal recognized that “California law is settled that a defense based on an insured's failure to give timely notice requires the insurer to prove that it suffered substantial prejudice.” Id. at 760. See Clemmer v. Hartford Ins. Co., 22 Cal. 3d 865, 881-83, 151 Cal. Rptr. 285 (1978) (same). No matter what breach the insured allegedly has committed, prejudice will not be presumed. See Campbell, 60 Cal. 2d at 307 (“a judicially created presumption of prejudice, whether conclusive or rebuttable, is unwarranted”); Moe v. Transamerica Title Ins. Co., 21 Cal. App. 3d 289, 302, 98 Cal. Rptr. 547 (1971) (prejudice is not presumed from the fact of untimely notice). Instead, the insurance carrier has the burden of proving that a breach of a condition in the policy actually and substantially prejudiced it. Campbell, 60 Cal. 2d at 306; Shell, 12 Cal. App. 4th at 760. “The insurer must show actual prejudice, not the mere possibility of prejudice.” Id. at 761. See Billington v. Interins. Exch. , 71 Cal. 2d 728, 737, 79 Cal. Rptr. 326 (1969) (same). As the California Supreme Court has explained, “prejudice is not shown simply by displaying end results; the probability that such results could or would have been avoided absent the claimed default or error must also be explored.” Clemmer, 22 Cal. 3d at 883 n.12. See also Insurance Co. of the State of Pa. v. Associated Internat'l Ins. Co., 922 F.2d 516, 523 (9th Cir. 1991) (The purpose of a condition in an insurance policy is “not to provide a technical escape-hatch by which to deny coverage in the absence of prejudice nor to evade the fundamental protective purpose of the insurance contract to assure the insured and the general public that liability claims will be paid.”).

Rejected'Prejudice' Arguments

California courts have rejected a number of arguments raised by carriers to establish prejudice. For example, in Campbell, the California Supreme Court ruled that testimony by an insurance carrier's claim manager that a report by the insured is required to guard against false claims, to verify that there has been an accident, and to determine liability was an insufficient showing of prejudice when the carrier had a sufficient opportunity to verify that there had been an accident, the insured was negligent, and the carrier would have been liable on its policy even if its insured had cooperated with it. 60 Cal. 2d at 306.

The court of appeal reached a similar conclusion in Northwestern Title Security Co. v. Flack, 6 Cal. App. 3d 134, 85 Cal. Rptr. 693 (1970). There, the carrier contended that a delay in notice cost it the opportunity to settle the claim against the insured for a small sum early in the proceedings. The court rejected this argument, noting that “prejudice does not arise merely because a delayed or late notice has denied the insurance company the ability to contemporaneously investigate the claim or interview witnesses,” Id. at 142-43, or because the carrier has been denied “the opportunity to make an early settlement of the claim.” It ruled that the carrier had to prove that:

but for the delay in making a prompt investigation and in hiring [its] own attorney at the early stages, there was a substantial likelihood that [it] could have prevailed in a negligence action brought against [its] assured or that [it] could have settled the case for a small sum or a smaller sum than that for which [the] insured ultimately settled the claim. Id.

The Shell court rejected another argument made by carriers to establish prejudice. In Shell, the insured was seeking coverage for environmental cleanup costs. The carriers argued that the insured had delayed in notice and that the carriers had proven substantial actual prejudice by showing that the cleanup costs increased dramatically over a 10-year period. They also asserted that the passage of time made defending against the claims more difficult, and that the insured had denied them the right to investigate and had deprived them of the right to defend or settle the claims. By way of example, the carriers provided a list of 18 persons who they could not interview because they were now dead or unavailable. The carriers also noted that the cleanup costs had escalated drastically over the years before they were notified. The court of appeal rejected these arguments, finding that “the record does not support an inference that earlier notice would have changed anything.” 12 Cal. App. 4th at 762. It stated:

In order to demonstrate actual, substantial prejudice from lack of timely notice, an insurer must show it lost something that would have changed the handling of the underlying claim. If the insurer asserts that the underlying claim is not a covered occurrence or is excluded from basic coverage, then earlier notice would only result in earlier denial of coverage. To establish actual prejudice, the insurer must show a substantial likelihood that, with timely notice, and notwithstanding a denial of coverage or reservation of rights, it would have settled the claim for less or taken steps that would have reduced or eliminated the insured's
liability. 12 Cal. App. 4th at 763.

The court also held that when “an insurance company denies liability under a policy which it has issued, it waives any claim that the notice provisions of the policy have not been complied with.” Id. at 762. In other words, the court specifically concluded that because the carriers had denied coverage on grounds in addition to breach of the notice condition, there could not have been any prejudice. Simply put, earlier notice would have resulted in nothing but an earlier denial.

Indeed, as another court of appeal has explained:

[A]n insurer is not allowed to rely on an insured's failure to perform a condition of a policy when the insurer has denied coverage because the insurer has, by denying coverage, demonstrated performance of the condition would not have altered its response to the claim. Select Ins. Co. v. Superior Court , 226 Cal. App. 3d 631, 637, 276 Cal. Rptr. 598 (1990).

Carriers Argue Inapplicability Of 'Notice-Prejudice' Rule

Notwithstanding the above principles, insurance carriers often argue that the notice-prejudice rule is not applicable to all types of liability policies. For example, carriers typically claim that the rule does not apply to “claims made” or “claims made and reported” policies. A “claims made” policy typically is a policy in which coverage depends not on when an underlying event took place, but rather on whether a claim was made within that policy period. Under such a policy, coverage is triggered when a claim is made during the policy period. A “claims made and reported” policy adds an additional requirement to trigger coverage ' a requirement that the claim not only be made against the insured during the policy period, but also that the claim be reported to the carrier within the policy period or a specified time thereafter.

Many courts have held that the notice-prejudice rule does not apply to the “claims reported” provision of a “claims made and reported” policy. As one court explained, under a “claims made and reported” policy, the policy:

unambiguously provides [the insured's] ability to report claims ' would terminate at the end of the ' period. The extension clause gave [the insured] [a specific period within which] to report claims ', a benefit for which [the carrier] received a specific “end date” of coverage in exchange.

Industrial Indem. v. Superior Court , 224 Cal. App. 3d 828, 831, 275 Cal. Rptr. 218 (1990). See also Diluglio v. New England Ins. Co. , 959 F.2d 355, 359 (1st Cir. 1992) (“Since the reporting period prescribed in a 'claims-made' insurance policy defines the scope of coverage ', [we] conclude that prejudice may be presumed where notice is not provided within the policy period ' “).

However, the claims reporting requirement should be distinguished from the notice requirement also typically found in “claims made and reported” policies. Most “claims made and reported” policies have a separate condition that the insured provide “notice as soon as practicable” after a claim is made. In other words, as noted above, “claims made and reported” policies have two requirements applicable to notice ' a condition that requires that notice be given as soon as practicable after a claim is made, and the reporting requirement, which requires that the claim be reported to the carrier before the policy or reporting period expires. It is this latter requirement that courts have strictly enforced. Indeed, the Ninth Circuit has emphasized the importance of distinguishing between a “claims made” notice condition and a “claims made and reported” reporting requirement:

It is reasonable to conclude that a claims-made-and-reported policy differs from a general claims-made policy containing no requirement that the claim be reported within the policy period. We hold that this is a reasonable interpretation of California law. The reporting requirement serves two different purposes in the two policies. The notice provision on a general claims made policy, as in an occurrence policy, often requires notice “as soon as practicable.” This serves to “facilitate the timely investigation of claims by bringing an event to the attention of the insurer and allows an inquiry 'before the scent of factual investigation grows cold.'” In contrast, in a claims-made-and-reported policy, notice is the event that actually triggers coverage. Pension Trust Fund for Operating Engineers v. Federal Ins. Co., 307 F.3d 944, 956-57 (9th Cir. 2002).

Based on this distinction, the Ninth Circuit concluded that the notice-prejudice rule would apply to the notice provision of a “claims made” policy. Id.

The Ninth Circuit's holding is in accord with established California precedent. One of the leading California cases is Northwestern Title Security Co. v. Flack, 6 Cal. App. 3d 134 (1970). In Northwestern, the insured delayed approximately one year in notifying the carrier of a claim and more than four months in notifying the carrier of the filing of a lawsuit against it. The carrier contended that notice under its claims-made policy was barred because of the insured's delay in giving notice. The court of appeal rejected this argument, citing to the California Supreme Court's decision in Campbell:

Campbell stands for these propositions: (1) that breach by an insured of a cooperation or notice clause may not be asserted by an insurer unless the insurer was substantially prejudiced thereby; (2) that prejudice is not presumed as a matter of law from such breach; [and] (3) that the burden of proving prejudicial breach is on the insurer '

6 Cal. App. 3d at 141.

The court noted that the insurance carrier's burden of establishing substantial prejudice “is not carried by a showing of possibility of prejudice to the insurer. Rather, actual prejudice must be shown.” Id. The court then stated:

[The carrier] makes the policy argument that we should enunciate a strict rule of construction as regards the fulfillment of conditions precedent to indemnity found in claims-type policies. He argues that the cases which hold that an insurer may assert defenses based upon a breach by the insured of a policy condition only where the insurer was substantially prejudiced thereby, have been enunciated in “occurrence-type” policies where the obligation of the insurer is fixed in time by reference to the happening of an occurrence occasioning loss, such as an automobile accident ' In considering this argument we observe that, notwithstanding the generic differences between the two types of policies, there is not indication in Campbell or the other cases ' that a different rule can apply in “claims-type” policies. The cases make it clear that the subject rule applies to all cases in which the insurer asserts a defense based upon a breach by the insured of a cooperation or notice clause. Id. at 143-44.

Claims Made Near the End Of the Reporting Period

Furthermore, courts have not strictly enforced claims reporting requirements, at least with respect to claims made near the end of the reporting period. For example, in Root v. American Equity Specialty Insurance Co. , 130 Cal. App. 4th 926, 30 Cal. Rptr. 3d 631 (2005), the court addressed a malpractice policy that covered claims first made against the insured and reported in writing to the company while the policy is in force. The insured was named in a lawsuit just days before the policy expired and reported the suit after the policy expiration when he read that it had been filed. The court noted that the case involves “one of the worst nightmares faced by most every attorney, doctor, accountant or other professional covered by a malpractice insurance policy: the possibility of no malpractice coverage under a 'claims made and reported' policy where a claim is made very late in the policy period and the insured learns of the claim under highly ambiguous circumstances, so the claim is not reported until there is confirmation of that claim, which is shortly after the policy has expired.” Id. at 929.

The court then observed that “[t]he definition of 'claim' in the policy is ambiguously open-ended. The policy doesn't say that the mere filing of a suit is not a claim. It merely says that a claim is a demand for money ' [T]here could be a situation in which an insured might have two 'claims' against him or her based on just one malpractice suit.” Id. at 933. The court concluded that “the insured could be whipsawed ' into having no coverage under policies on either side of a policy period expiration divide. Ambiguities in insurance contracts aren't supposed to work that way.” Id. at 933-34.

Conclusion

The notice-prejudice rule should apply, as a minimum, to notice requirements in liability policies, even if they are claims made policies. As for the reporting requirements in claims made and reported policies, an insured should seek to comply with reporting requirements, but, depending upon the circumstances, still may be entitled to coverage even if there is a delay in reporting.

Kirk Pasich, a member of this newsletter's Board of Editors, is a partner in the Los Angeles office of Dickstein Shapiro LLP. He is the chair of the firm's Insurance Coverage Practice and represents insureds in complex coverage matters.