Because insurance policies are contracts, the analysis begins with the actual policy language and the facts that trigger it.
Who Is Insured?
Coverage can depend on definitions of named insured, additional insured, resident relative, permissive user, employee, driver, member, or other status.
A person or company may believe they are covered because of a business relationship or certificate of insurance, while the policy itself may define coverage differently.
Duty to Defend and Duty to Indemnify
Liability policies can create separate questions about whether the insurer must provide a defense and whether it must ultimately pay a judgment or settlement.
Those duties are related but not identical. The allegations of the underlying complaint and the policy language can be important in evaluating the defense obligation.
Exclusions and Endorsements
Many coverage disputes turn on exclusions, exceptions to exclusions, or endorsements that modify the standard policy form. Reading only the declarations page can therefore be misleading.
The complete policy should be obtained and reviewed.
Multiple Policies
A loss may involve primary and excess coverage, additional insured coverage, employer policies, personal policies, commercial policies, or competing insurers.
Other insurance clauses, priority rules, tender, contribution, and allocation issues can determine which insurer responds first or how responsibility is divided.
Automobile Coverage Disputes
Auto cases can involve permissive use, household definitions, commercial use, rideshare activity, uninsured motorist coverage, underinsured motorist coverage, exclusions, and policy limits.
The coverage question should be addressed alongside the underlying liability claim rather than treated as an afterthought.
Resolving a Coverage Dispute
Potential approaches include policy analysis, correspondence with the carrier, tender of defense, negotiation, arbitration where required, declaratory judgment litigation, or breach of contract claims.
Illinois law may also permit additional statutory relief in a case involving vexatious and unreasonable insurer conduct, but such relief is not automatic.
If you are facing a dispute over whether an insurance policy applies, Michael J. Lucas & Associates, LLC can review the policy language, underlying facts, and insurer's position and help you evaluate the available options.
Areas We Serve
Michael J. Lucas & Associates, LLC assists clients throughout Boone County, Cook County, DuPage County, Kane County, Lake County, McHenry County, and Will County.
Our office serves clients throughout Northern Illinois, including Addison, Algonquin, Antioch, Arlington Heights, Aurora, Barrington, Bartlett, Batavia, Belvidere, Bloomingdale, Bolingbrook, Buffalo Grove, Carpentersville, Cary, Chicago, Crystal Lake, Deerfield, Des Plaines, Downers Grove, Elgin, Elk Grove Village, Elmhurst, Evanston, Fox Lake, Fox River Grove, Frankfort, Geneva, Glen Ellyn, Glenview, Grayslake, Gurnee, Hanover Park, Hampshire, Harvard, Highland Park, Hoffman Estates, Huntley, Joliet, Lake Barrington, Lake Forest, Lake in the Hills, Lake Zurich, Libertyville, Lincolnshire, Lisle, Lockport, Lombard, Marengo, McHenry, Mokena, Mount Prospect, Mundelein, Naperville, New Lenox, Northbrook, Palatine, Park Ridge, Plainfield, Poplar Grove, Prospect Heights, Rolling Meadows, Romeoville, Roselle, Schaumburg, Shorewood, South Elgin, St. Charles, Streamwood, Sugar Grove, Vernon Hills, Waukegan, West Chicago, Wheaton, Wheeling, Wilmette, Winfield, Wood Dale, Woodridge, and Woodstock.