“Based On”… What Exactly? NJ Appellate Division Examines Phrase and Estops Insurer From Disclaiming Coverage for 20-Month Delay

Three judges sitting behind bench

Anthony L. Miscioscia and Timothy A. Carroll analyze C.M.S. Investment Ventures, Inc. v. American European Insurance Company.

August 20, 2019
Anthony L. Miscioscia and Timothy A. Carroll - White and Williams LLP

On May 28, 2019, the New Jersey Superior Court, Appellate Division examined the phrase “based on” in an assault-and-battery exclusion, finding that the phrase means “to make, form, or serve as the foundation of any claim, demand or suit.” C.M.S. Investment Ventures, Inc. v. American European Insurance Company, No. A-2056-17T3, 2019 N.J. Super. Unpub. LEXIS 1215, at *8-9 (N.J. Super. Ct. App. Div. May 28, 2019) (CMS). The CMS case is also notable because the Appellate Division held that a 20-month delay in disclaiming coverage was unreasonable and therefore warranted estoppel.

In CMS, the insured was allegedly warned by its tenant about a faulty ground-floor window that failed to lock properly. Afterward, an intruder broke into the tenant’s apartment and sexually assaulted the tenant, who sued the insured on a premises liability claim. Before she filed suit, the tenant sought payment from the insured’s CGL insurer directly. The insurer denied coverage based on the assault-and-battery exclusion and closed the file, but never informed the insured. Later, the tenant sued the insured, which sought a defense and indemnity from its insurer, which again denied coverage based on the exclusion. The insured then sought a declaration of coverage on grounds that the exclusion was ambiguous, and the insurer “was estopped from denying coverage, because it waited [20] months to inform CMS of its coverage decision.” The trial court ruled in the insured’s favor which led to the appeal in CMS.

Reprinted courtesy of Timothy Carroll, White and Williams LLP and Anthony Miscioscia, White and Williams LLP
Mr. Miscioscia may be contacted at misciosciaa@whiteandwilliams.com
Mr. Carroll may be contacted at carrollt@whiteandwilliams.com



714.701.9180

Arrange No Cost Consultation










Subscribe to Construction Defect Journal

Construction Defect Journal Archives - Recent CD News for Construction Claims Professionals

 

Construction Defect Journal is aggregated from a variety of news sources, article submissions, contributors, and information from industry professionals.

No content on this site should be construed as legal advice or expert opinion. By viewing this site you agree to be bound by its terms and conditions

 

Copyright 2019 - Construction Defect Journal – All Rights Reserved