Insurance Coverage Disputes
Policy and claim disputes, from insurer denials to disagreements about defense, payment, and coverage.
Insurance Coverage Disputes
Policy and claim disputes, from insurer denials to disagreements about defense, payment, and coverage.
Insurance Coverage Disputes
Policy and claim disputes, from insurer denials to disagreements about defense, payment, and coverage.
A claim has arrived. Your insurer says it isn’t theirs.
You forward a lawsuit and receive a letter citing several policy provisions. It raises questions about the claim, the policy period, and what the insurer may pay. Meanwhile, the underlying case still needs a response.
We review the complete policy, the claim, and the correspondence together. What coverage was requested? What has the insurer accepted, reserved, or refused? Which facts and provisions support each position?
That assessment helps define the next step with the insurer while keeping the underlying matter in view.
A claim has arrived. Your insurer says it isn’t theirs.
You forward a lawsuit and receive a letter citing several policy provisions. It raises questions about the claim, the policy period, and what the insurer may pay. Meanwhile, the underlying case still needs a response.
We review the complete policy, the claim, and the correspondence together. What coverage was requested? What has the insurer accepted, reserved, or refused? Which facts and provisions support each position?
That assessment helps define the next step with the insurer while keeping the underlying matter in view.
A claim has arrived. Your insurer says it isn’t theirs.
You forward a lawsuit and receive a letter citing several policy provisions. It raises questions about the claim, the policy period, and what the insurer may pay. Meanwhile, the underlying case still needs a response.
We review the complete policy, the claim, and the correspondence together. What coverage was requested? What has the insurer accepted, reserved, or refused? Which facts and provisions support each position?
That assessment helps define the next step with the insurer while keeping the underlying matter in view.
The work behind a coverage position
The work behind a coverage position
The work behind a coverage position
Examine declarations, policy forms, endorsements, exclusions, limits, deductibles or retentions, and relevant applications. Match the disputed claim to the wording actually issued.
Examine declarations, policy forms, endorsements, exclusions, limits, deductibles or retentions, and relevant applications. Match the disputed claim to the wording actually issued.
Examine declarations, policy forms, endorsements, exclusions, limits, deductibles or retentions, and relevant applications. Match the disputed claim to the wording actually issued.
Analyze the insurer's stated grounds, requested information, and unresolved questions. Prepare a reasoned response supported by policy terms, facts, and applicable law.
Analyze the insurer's stated grounds, requested information, and unresolved questions. Prepare a reasoned response supported by policy terms, facts, and applicable law.
Analyze the insurer's stated grounds, requested information, and unresolved questions. Prepare a reasoned response supported by policy terms, facts, and applicable law.
Address disagreements about responsibility for defense costs, counsel, settlement, or payment of a covered loss. Assess each obligation under the policy and the specific claim.
Address disagreements about responsibility for defense costs, counsel, settlement, or payment of a covered loss. Assess each obligation under the policy and the specific claim.
Address disagreements about responsibility for defense costs, counsel, settlement, or payment of a covered loss. Assess each obligation under the policy and the specific claim.
Review the communications already sent, relevant dates, and outstanding requests. Prepare tenders, coverage submissions, supporting records, and follow-up correspondence within the agreed scope.
Review the communications already sent, relevant dates, and outstanding requests. Prepare tenders, coverage submissions, supporting records, and follow-up correspondence within the agreed scope.
Review the communications already sent, relevant dates, and outstanding requests. Prepare tenders, coverage submissions, supporting records, and follow-up correspondence within the agreed scope.
Examine the claimed loss, policy provisions, valuation materials, and supporting financial records. Identify where adjuster, accounting, or technical evidence is needed.
Examine the claimed loss, policy provisions, valuation materials, and supporting financial records. Identify where adjuster, accounting, or technical evidence is needed.
Examine the claimed loss, policy provisions, valuation materials, and supporting financial records. Identify where adjuster, accounting, or technical evidence is needed.
Develop the coverage position, settlement proposal, pleadings, discovery, and evidence for agreed proceedings. Assess whether the facts support additional claims concerning the insurer's handling of the matter.
Develop the coverage position, settlement proposal, pleadings, discovery, and evidence for agreed proceedings. Assess whether the facts support additional claims concerning the insurer's handling of the matter.
Develop the coverage position, settlement proposal, pleadings, discovery, and evidence for agreed proceedings. Assess whether the facts support additional claims concerning the insurer's handling of the matter.
Commercial policies can impose reporting and cooperation duties when a claim arises. The policy and claim type determine the requirements; an ongoing disagreement does not make those provisions irrelevant. California Department of Insurance: commercial claims guidance.
Commercial policies can impose reporting and cooperation duties when a claim arises. The policy and claim type determine the requirements; an ongoing disagreement does not make those provisions irrelevant. California Department of Insurance: commercial claims guidance.
Commercial policies can impose reporting and cooperation duties when a claim arises. The policy and claim type determine the requirements; an ongoing disagreement does not make those provisions irrelevant. California Department of Insurance: commercial claims guidance.
Two questions can require separate work.
One question is how to respond to the person asserting the underlying claim. Another is what the insurer must do under its policy.
We identify those workstreams when assessing the engagement, including the role of existing defense counsel and anyone the insurer has appointed. Taking on a coverage dispute does not itself establish who is handling the underlying case.
The agreed work might be a written coverage assessment, a tender, a response to a denial, settlement negotiations, or a defined phase of litigation. You should understand the issue being pursued and the next decision before committing to that work.
Two questions can require separate work.
One question is how to respond to the person asserting the underlying claim. Another is what the insurer must do under its policy.
We identify those workstreams when assessing the engagement, including the role of existing defense counsel and anyone the insurer has appointed. Taking on a coverage dispute does not itself establish who is handling the underlying case.
The agreed work might be a written coverage assessment, a tender, a response to a denial, settlement negotiations, or a defined phase of litigation. You should understand the issue being pursued and the next decision before committing to that work.
Two questions can require separate work.
One question is how to respond to the person asserting the underlying claim. Another is what the insurer must do under its policy.
We identify those workstreams when assessing the engagement, including the role of existing defense counsel and anyone the insurer has appointed. Taking on a coverage dispute does not itself establish who is handling the underlying case.
The agreed work might be a written coverage assessment, a tender, a response to a denial, settlement negotiations, or a defined phase of litigation. You should understand the issue being pursued and the next decision before committing to that work.
Related practices
Related practices
Related practices
FAQ
FAQ
FAQ
The letter's wording matters. The full correspondence and any earlier acceptance or denial are useful background for review. We identify what the insurer says it will do, the issues it is keeping open, and the provisions it relies on before characterizing its position.
A denial alone does not establish the full legal assessment. We examine the policy, facts, investigation, reasons given, and applicable law before advising whether a coverage challenge or additional claim is supported.
Useful background includes the complete policy and endorsements, the claim or lawsuit, all insurer letters, the notice you sent, and records supporting the loss. Any settlement proposal, response date, other potentially relevant policy, or existing lawyer's contact information also helps establish the position. A short summary of the coverage issue and any deadline is enough to begin.
We can discuss the appropriate coordination when scoping the work. It is useful to know who is responsible for the underlying defense, what the insurer has agreed to fund, and which decisions need attention.
Yes. We review the proposal alongside the policy's consent and notice provisions, insurer correspondence, and the underlying claim. That assessment helps identify coverage questions to address before deciding, in coordination with counsel handling the underlying matter.
Individual matters are always fixed fee. We agree on the work or phase and its fee before beginning, including whether the scope is an assessment, insurer response, negotiation, or proceedings.
Your introduction to Cove
Start with a conversation about what you need.
If you decide to move forward, we’ll agree on the work and its fixed fee before we begin.
Have a particular matter in mind? Tell us about it.
Share what you’re working through or working toward.
Send relevant documents ahead of time so we can come prepared.
Your introduction to Cove
Start with a conversation about what you need.
If you decide to move forward, we’ll agree on the work and its fixed fee before we begin.
Have a particular matter in mind? Tell us about it.
Share what you’re working through or working toward.
Send relevant documents ahead of time so we can come prepared.
Your introduction to Cove
Start with a conversation about what you need.
If you decide to move forward, we’ll agree on the work and its fixed fee before we begin.
Have a particular matter in mind? Tell us about it.
Share what you’re working through or working toward.
Send relevant documents ahead of time so we can come prepared.