Coverage Opinions and Policy Language

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Issue. Particular policy language frequently is at the center of insurance-based litigation. Commercial General Liability (CGL) policies lead the list of interpretation cases. CGL policies are followed closely by all forms of liability policies (whether free-standing such as professional liability policies or as coverage embedded in broader policies such as auto).

Coverage issues also arise as to:

  • Auto policies (including liability and uninsured and underinsured coverage)
  • Homeowners policies
  • Disability policies
  • Health policies
  • Life policies
  • Annuity (including variable annuities) policies
  • Reinsurance contracts

In addition, issues arise in connection with the application form relating to these policies as completed by the agent or the insured.

Mr. Hager has provided extensive testimony in cases with policy language interpretation issues, including their related applications.

Specific Expert Skills as to Language Interpretation

  • Tracking specific policy language to: (a) case law; (b) statutory provisions; (c) drafting intent; (d) insurance industry literature; and (e) academic/textbook commentary.
  • As Insurance Commissioner, Mr. Hager annually oversaw the approval of some 50,000 insurance policy forms, including every word of every form. This approval process included word-by-word and sentence-by-sentence and paragraph-by-paragraph examination of the following types of policies (including their accompanying application forms): GCL, all forms of professional liability policies including errors and omission and director and officer policies, automobile policies, homeowners policies, disability policies, health and long term care polices, life insurance policies, annuities and certain reinsurance policies. Further, his department had responsibility to regulate insurer construction of policy language as to insureds.
  • As CEO of NCCI, Mr. Hager had responsibility to annually file numerous standard industry-wide workers compensation policy forms and provisions nationwide, including responsibility for every word of every such form.
  • As General Counsel and Director of Government Relations to the American Academy of Actuaries, Mr. Hager worked daily with the actuarial profession. Ultimately most coverage language is approved by company actuaries in that pricing must be made commensurate with the related coverage.

Contact Bill Hager at 561-306-5072 or via email to discuss your case.