(November 2022)
Collapsible Menu Introduction CG 00 33–Coverage Forms
Analysis Section I–Liquor
Liability Coverage 1. Insuring Agreement Section III–Limits of
Insurance |
Liquor liability responds
to the vicarious liability of the entity who serves alcohol to a person for injury
and/or damages that the served person causes. Who is deemed liable and the
extent of any liability varies among states and is based on dram shop, liquor
control, or alcoholic beverage laws. While the laws differ, most state that the
owner of the liquor or alcoholic beverage business can be held liable for
injury or damage an intoxicated person causes if the party that provided the
liquor caused or contributed to the person's intoxication.
There are two ISO Liquor Liability Coverage Forms that can provide the
necessary coverage. CG 00 33 is the Occurrence Coverage Form. It covers
liability or damage losses that occur during the policy period, regardless of
when the insurance company is notified of the loss or claim. The key to this
coverage approach is the date of loss or when the loss occurs.
CG 00 33 is the Claims-Made Coverage Form. Coverage triggers by the
actual filing date or receipt of the claim, in addition to the date of loss or
injury. It handles any covered loss or claim filed during the policy period,
regardless of the date of the occurrence, subject to the retroactive date on
the declarations. While the retroactive date can be any date, for the most
complete coverage it should be the first date when claims-made coverage applied
to the risk. Any other date will result in a gap of coverage because an
occurrence coverage form applies to any loss or damage that occurs prior to
that date while claims-made coverage applies to only occurrences that take place
after the retroactive date.
Related Article: Compare: ISO Commercial General Liability
Coverage Forms: CG 00 01 (Occurrence Basis) to CG 00 02 (Claims-Made Basis)
CG 00 33–Liquor Liability Coverage Form–Occurrence Basis is analyzed
first. It is followed by a summary analysis of CG 00 34–Liquor Liability
Coverage Form–Claims-Made Basis that addresses only the differences between it
and CG 00 33.
This analysis is of the 04 13 edition of these coverage forms. Changes from
the12 07 editions are in bold print.
Related Court Case: Liquor Liability Exclusion Held to Overcome Coverage for Car Parking
CG 00 33 opens by stating
that certain provisions in it restrict coverage. It encourages the insured to
carefully read the coverage form in order to understand its rights and duties
and to determine what is covered and not covered. It also points out that the
terms you and your to refer to the named insured and that an insured is any
person or entity that qualifies as such under Section II–Who Is an Insured. The
terms we, us, and our refer to the insurance company that provides the
coverage. It refers to Section V–Definitions because understanding the
definitions is critical to understanding CG 00 33.
a. The
insurance company agrees to pay amounts the insured is legally obligated to pay
as damages because of injury that CG 00 33 covers. The liability for the injury
or damage must be imposed on the insured because it sells, serves, or furnishes
alcoholic beverages. The insurance company also has the right and duty to
defend the insured against any suit that seeks damages but only if coverage
applies to the damages alleged in the suit. Payment does not exceed the limits
of insurance.
The insurance
company's right and duty to defend end when the coverage form’s limits of
insurance are used up by paying judgments and settlements.
There
are no other obligations to pay or to perform any other acts or services other
than those stated in Supplementary Payments.
b. Coverage
applies to injury that occurs during the policy period and in the coverage
territory. If an injury is a reoccurrence of an injury that started in a prior
policy period, coverage applies only if neither an insured under Paragraph 1.
nor any other authorized employees knew about that prior injury.
c. Injury
that occurs during the policy period includes any continuation, change, or
resumption related to that injury after the policy period ends.
d. Injury
is considered known and to have occurred at the earliest date of the following that
an insured or one of its authorized employees:
|
Example: Joe’s Bar and Grill is a newly opened business. Joe
purchases CG 00 01–Commercial General Liability Coverage Form to cover the
business but delays purchasing liquor liability coverage until he can afford
it. An incident occurs two days before the liquor liability coverage is to go
into effect. One of Joe's bartenders serves alcohol to Sam, who is clearly
intoxicated. He falls while leaving the establishment, strikes his head, and is
seriously injured. He sues Joe for his medical bills based on Joe's bartender
having served him alcohol when he was already obviously intoxicated. Joe's CG
00 01 does not respond because of its liquor liability exclusion. Joe’s CG 00
33 denies the claim because the loss occurred before its inception date. |
Note:
The chart below illustrates that CG 00 33 provides only liquor liability
coverage. It is in addition to CG 00 01 and does not replace it. It fills one
gap in CG 00 01.
Type of Liability |
Covered by CG 00 01? |
Covered by CG 00 33? |
Premises Liability |
Yes |
No |
Products Liability |
Yes |
No |
Completed Operations Liability
|
Yes |
No |
Personal Injury Liability
|
Yes |
No |
Liquor Liability |
No (if in the liquor business)
|
Yes |
Related Court Cases:
Liquor
Liability Exclusion Held Applicable to Nonprofit VFW Post
Liquor
Liability Suit Based on Failure to Restrain Patron Did Not Circumvent Exclusion
This insurance coverage
does not apply to any of the following except as noted:
a. Expected or Intended Injury
Coverage
does not apply to injury that is expected or intended by the insured. This
exclusion has an exception that covers bodily injury that results from the
insured using reasonable force to protect persons or property.
|
Example: Amy owns the Li'l Drinkin' Shack and hires Fred to be
the bouncer. Patrick, a very intoxicated customer, attempts to attack Jeri,
another customer. Fred intervenes to
protect Jeri but ends up making the injury worse. Jeri’s family sues Li’l Drinkin’s Shack for Jeri’s
injuries and coverage applies because Fred was attempting to protect Jeri
from Patrick. |
Note:
The primary reason for this exclusion is to keep the insurance company from
becoming involved with non-accidental losses, which is in the public interest.
It ensures that the insured will not use the insurance coverage for gain, such
as theft, to inflict injury on a competitor, as an instrument of revenge, or to
cause any other intentional harm. This exclusion's wording continues to be
challenged and interpreted by the courts. ISO does not currently have an
endorsement available to buy back this coverage or to delete this exclusion.
Related
Article: Expected or Intended Injury Exclusion
b.
Workers Compensation and Similar Laws
There is no coverage for any
requirement or obligation of the insured imposed by any workers compensation,
disability benefits, unemployment compensation or similar law.
Example: Joe’s Micro
Brewery always asks its employees to help test new beers. Sue and a few
waitresses participate in the event but Sue has a few too many and slips and
falls as she tries to stand up. She sustains serious injuries to her right
leg and cuts to her face. Sue receives workers compensation benefits but wants
more. She sues Joe’s but coverage is denied under the CG 00 33 due to the
exclusion. |
Note:
The intent of this exclusion and the Employer’s Liability exclusion is to
eliminate the possibility of CG 00 33 indemnifying the insured for an injury
that workers compensation or employer’s liability policies cover.
c.
Employers’ Liability
Bodily
injury to an employee of the insured as a result of employment or performance
of duties in conjunction with conduct of the insured’s business is excluded.
Bodily injury to the employee’s spouse, children, parents, brothers, or sisters
as a consequence of that employee’s bodily injury is also excluded. This
exclusion applies whether the insured is liable as an employer or in any other
capacity, or whether it must share damages with or repay someone else who must
pay damages because of the injury.
Example: Sue's
husband, Jim, takes a different approach. He sues Joe's for the family’s loss
of income and cost of childcare during her rehabilitation. As in the previous
situation, there is no coverage. |
Example: Crystal was at Joe’s the night of Sue’s
accident. She was a temporary waitress hired through an employment
agency. When Sue started to fall, she grabbed an intoxicated Crystal who fell
along with her. When Crystal sues Joe’s, coverage is still not available because
Crystal has coverage under the agency’s workers compensation. |
d.
Liquor License Not In Effect
Coverage
does not apply to injury due to selling, serving, or furnishing alcoholic
beverages if the required liquor license is not in effect.
Notes:
This
exclusion is consistent with other coverage forms because providing alcoholic
beverages without a license is illegal and insurance coverage does not apply to
illegal activities.
Previous
editions of CG 00 33 required that a liquor license had to expire, be
suspended, cancelled, or revoked. The intent was to deny coverage if a license
was required but not in effect. However, the previous wording was ambiguous. This
is very clear.
Example: The
state liquor board suspends Joe's Bar and Grill’s liquor license because he
sold alcohol to minors many times. Joe continues to operate without the
required license. Another minor is served alcohol, becomes intoxicated, and causes
injury. The minor's parents sue Joe. Because of this language, this claim is excluded
because the loss occurred when Joe did not have a valid liquor license. |
e.
Your Product
There
is no coverage for injury that arises out of the insured's product. However, this
exclusion has an exception. It does not apply to injury that the insured or an
insured's indemnitee may be liable for because of any of the following:
Examples:
|
f.
Other Insurance
When
other insurance is available to cover any injury that is covered under this
coverage part, this coverage part will not pay anything. This applies even if
that other insurance’s limits have been exhausted.
The
only exception is when that other insurance covers liability imposed on the
insured due to any act of providing alcoholic beverages.
g.
War
There
is no coverage for bodily injury or property damage caused directly or
indirectly in any way by war, undeclared war, and civil war. This includes
warlike action by a military force. This exclusion also applies to actions a
government takes to prevent or defend against an expected or actual attack by
any government or other authority that uses military personnel or agents. It
also applies to rebellion, revolution, insurrection, or unlawful seizure of
power and the action the government takes to prevent or defend against any of
these.
The Insuring Agreement above
explains the insurance company’s obligations and it has no other obligations
except for following Supplementary Payments. There are seven supplementary
payments. The insurance company pays these amounts only when it investigates or
settles claims or during its defense of suits brought against an insured. These
payments do not reduce the limits of insurance.
1.
If named or designated as an insured on the declarations:
a. Individual. The individual and the individual's
spouse are insureds.
Note: There is no reference to business
operations. This means the individuals named do not necessarily have to be in
businesses.
Example: Joe Johnson owns Joe’s Microbrewery as an individual.
Both Joe and his wife are insureds. Joe also owns a different sole
proprietorship individually where he brews small amounts of beer. Joe and his
wife are insureds with respect to that operation as well. However, Joe is
also involved in a dance club he and his brother own as a partnership. In this
case, the partnership is not included as an insured. |
b. Partnership
or joint venture. The named insured is an insured. The insured’s members and
partners and their spouses are also insureds but only when they are conducting
the named insured’s business.
Example: In the example above, if Joe makes his brother a partner
in Joe’s Microbrewery, both partners and their spouses are covered to the
extent of their duties as partners in the business. However, there is no
coverage for the sole proprietorships or for any other partnerships that
involve either of these partners. |
c. Limited
liability company. The limited liability company is an insured. Members of the
company are insureds but only when they are conducting the named insured’s
business. The named insured's managers are also insureds but only with respect
to their duties as managers.
d. Any
other organization. That organization is an insured. Executive officers and
directors are insureds but only with respect to their duties as such.
Stockholders are also insureds but only for the very limited liability they
have as stockholders.
e. (04 13 addition) A trust. The trust is an
insured. The named insured’s trustees are also insureds but this is limited to
only their duties as trustees of the trust.
2.
The following are also insureds:
a. The named insured's employees are insureds. This
does not include executive officers of an organization or managers of a limited
liability company. However, the employees are insureds only for acts within the
scope of their duties that relate to conduct of the business. No employee is an
insured for any of the following injury:
Example:
Shari and Emma work for Joe's Microbrewery.
Shari had a rough night and Emma provided her with some liquid comfort. Shari
was in an accident on the way home. She sued Joe’s because of it providing the
alcohol and also sued Emma because she served the alcohol to her. Emma is not
an insured for this action. Removing this action keeps this type of injury
within the confines of Workers Compensation as the exclusive remedy,
Employers Liability, or a similar coverage. |
Example:
Continuing
the example above, Shari’s injuries are so serious that she dies. Emma's family files a claim against
Emma and Joe's for its emotional distress as a result of their loss. Emma is
not an insured and the claim against her is denied. The claim against Joe’s
is also not covered but that is under the exclusion section. |
No employee is an insured for property damage to property
owned or occupied by, or rented or loaned to that employee, any other employee,
or by any partner or member of a partnership, joint venture, or limited
liability company.
b. Any party that has proper temporary legal
custody of a deceased named insured's property. However, this is limited to
liability that arises out of or is caused by maintaining or using that property
and only until a proper legal representative is appointed.
c. A properly appointed legal representative has
all the named insured's rights and duties if the named insured dies. However,
this is limited to its duties as a properly appointed legal representative.
3.
Any newly formed or acquired organization that the named insured owns or has
majority interest in is a named insured if that organization has no other
insurance. This provision's coverage ends 90 days after the formation or
acquisition or at the end of the policy period, whichever occurs first.
Coverage does not apply to injury that occurred before the named insured formed
or acquired the organization.
This
does not apply to newly formed or acquired partnerships, joint ventures, or
limited liability companies.
Note: ISO has introduced an endorsement
to provide this coverage to newly formed or acquired limited liability
companies.
Related
Article: Liquor Liability Coverage Forms Available Endorsements and Their
Uses
Nobody is an insured with
respect to conduct of any current or previous partnership, joint venture, or
limited liability company that is not listed as an insured on the declarations.
1. The most the
insurance company pays are the limits of insurance on the declarations. This is
subject to the rules outlined below and is regardless of the number of
insureds, claims made, suits brought, or number of parties that make claims or
bring suits.
Example: Joe Johnson has CG 00 33. The
named insured on the declarations is Joe Johnson and Joan Johnson d/b/a Joe’s
Microbrewery and Joe’s Bar. An injury to a customer results in a suit. The suit
that claims damages names the two owners, Joe and Joan. Coverage applies to
both Joe and Joan but the limits apply once for both of them and not
separately to each. |
2. The most the
insurance company pays for the total of all injury that results from providing
alcoholic beverages is the Aggregate Limit on the declarations.
Note: Coverage ends
when this limit is used up by paying or settling claims and judgments during
the policy period.
Example: Joe's Liquor Liability Coverage Form has limits of $200,000
for Each Common Cause and $1,000,000 for the Aggregate Limit. Coverage is effective
01/10/19 and the losses for the year to date are as follows: |
|
Date of Loss |
Amount of Loss |
02/05/19 |
$195,000 |
04/02/19 |
$84,000 |
06/22/19 |
$200,000 |
07/11/19 |
$71,000 |
07/28/19 |
$141,500 |
08/17/19 |
$178,000 |
10/30/19 |
$130,500 |
Total Losses |
$1,000,000 |
A $200,000 claim is
submitted for a loss that occurred on 11/13/22. It is denied because the
aggregate limit has been used up by paying claims during the current policy
period. |
3. The Each Common
Cause Limit is the most the insurance company pays for all injury that one or
more persons or organizations sustain because alcoholic beverages were provided
to a person. This is subject to the Aggregate Limit.
Example: Mavis, Ann, and Shirley each purchase a bottle of wine
at the Friendly Tavern and Package Store. They spend the afternoon together
at a park, consume the wine, and drive home. All three are injured in
accidents. Their parents sue Friendly because all three are under the legal
drinking age. Each one purchased her own bottle of wine. As a result, the
Each Common Cause Limit is available for each suit, subject to the Aggregate
Limit. |
Related Court Case: Teen Tragedy: Was Each Drink an Occurrence?
This section also
clarifies how the limits of insurance apply. They apply separately to each
consecutive annual period and to any remaining period of less than 12 months.
This begins with the inception date on the declarations, unless extended after
issuance for any additional period of less than 12 months. If that occurs, the
additional period is treated as part of the last preceding period for the
purpose of determining the limits of insurance.
Example: The original 12-month policy period ran from June 1 to
June 1. During the second policy period, the insured requested that the policy
period be extended to January 1 to match its accounting year. The limits
apply separately to the first annual 12-month policy period of June 1 to June
1. They also apply separately to the second policy period that was extended
an additional six months, from the original June 1 expiration date to the new
January 1 date. From that point on, the annual 12-month period of January 1
to January 1 has a separate set of limits. If a short-term policy had been
issued in place of the six-month extension, it would have had its own limits.
Because the original policy period was extended, the original limits applied
to both the original period and the extension period. |
The insurance company is
not relieved of its obligations if the insured or its estate becomes bankrupt
or insolvent.
The named insured has a number of duties to perform if a claim or demand
for coverage occurs:
a. The named insured is responsible for making sure that the insurance
company is notified of any injury that may result in a claim as soon as practicable.
As a minimum, the notice should include information with respect to how, when,
and where the event took place along with the names and addresses of all
injured parties and any witnesses. The notice should also describe the nature
and location of the injury.
b. With respect to claims made or suits brought, the named
insured must immediately record its details, the date it was received, and
notify the insurance company as soon as practicable. The named insured is also
responsible for seeing that the insurance company receives written notice of
the claim or suit as soon as practicable.
Note: “As soon as practicable” is used in the
above in lieu of “as soon as possible” or immediately. This term means that the
named insured has some time in which to act but that its actions should be
timely.
Related Court Cases:
Does Untimely Notice Bar Recovery?
Late Notice Exclusion Requires
"Prejudice"
c. Every insured involved in or with the claim must:
Related
Court Case: Insured's Failure to Cooperate Relieved Carrier of Its
Obligation to Pay Claim
d. No insured may voluntarily make any payments, assume any obligations, or
incur any expenses other than first aid without the insurance company's
consent. If it does, it does so at its own cost or expense.
No party has the right to bring or join the
insurance company in any way into a suit. The insurance company cannot be sued
by any party until all of the policy’s terms and conditions have been met.
Suit can be brought against the insurance
company to recover on an agreed settlement or on a final judgment against the
insured. However, the liability of the insurance company is limited to damages that
are payable under CG 00 33’s terms and the applicable limit of insurance.
An agreed settlement is a settlement and
release of liability that the insured, the insurance company, and the claimant
or the claimant's legal representative sign.
Note: The wording of this condition appears to be in conflict with Exclusion.
f. Other Insurance described above.
The insurance company's
obligations to pay are limited if there is other valid and collectible
insurance that applies to the loss, as follows:
a. Primary Insurance
This
insurance is primary and the insurance company's obligations are not affected
unless any other insurance that applies to the loss is also primary. It then
shares with that insurance described under Method of Sharing.
Example: Mairum’s Clothing held a fashion show at its shop one
afternoon for select customers to view the latest imported merchandise lines.
Light appetizers, wine, tea, and coffee were served. Mairum's obtained a
liquor license and also purchased a single event liquor liability policy
because of local ordinances. A young lady attending the event who was under
age 21 was involved in an automobile accident after the event. Her blood
alcohol content was more than twice the legal limit and she did not have any
auto insurance coverage. The subsequent legal action named Mairum’s because
it served liquor to a minor during the fashion show. Mairum's CG 00 33 and CG
00 01 both responded. Because both are ISO coverage forms and both are
primary, the contribution by equal shares method applied and each contributed
50% of the amount claimed, up to their limits of insurance. |
b. Method
of Sharing
If the other
insurance permits contribution by equal shares, this insurance also does. Each
insurance company contributes equal amounts until its limit of insurance is
used up or the loss is paid, whichever occurs first.
If the other insurance does not include
contribution by equal shares, contribution is by limits. Under
contribution by limits, contribution is proportioned based on a developed ratio.
Ratios are determined by dividing each insurance company's limit by the total
limits available. The loss is then apportioned between the various policies
based on that ratio.
Other
insurance can be complicated and involve situations that lead to litigation.
Related
Court Case: Other Insurance Clauses Do Not Cancel Each Other Out
a. The insurance company calculates all premiums
according to its rules and rates.
b. The advance premium on the declarations is only
a deposit premium. At the end of each audit period, the insurance company
determines the actual earned premium for the period and notifies the first
named insured. The date on the billing notice is the date the company expects
to receive the premium billed. However, if the advance and audit premiums are
more than the earned premium, the insurance company refunds the excess to the first
named insured.
c. The first named insured is required to keep the
records and information the insurance company needs to do the premium
calculations and must send copies of them to the company when it requests.
Note:
Audit period is not clearly defined or explained. It can be monthly, quarterly,
annually, or any reasonable period the first named insured and the insurance
company agree to.
. |
Example: The policy term runs from January 1 to January 1 and is
subject to quarterly audit. The deposit premium charged is expected to
approximate the final earned premium for the policy term. An audit is done at
the end of each quarter to determine that quarter’s exposures. The insurance
company calculates the earned premium based on the audit, deducts it from the
deposit premium, and sends a statement to the first named insured that
includes that quarter’s calculations. At the point where the earned premium
exceeds the deposit, the company sends a statement that includes a bill for
the amount due. The first named insured is responsible for paying the amount
billed. |
Note: ISO has
introduced CG 99 09–Premium Audit Noncompliance Charge. This is an optional
form that results in a charge being made against named insureds who do not
respond to audit information requests.
Related Article: Liquor Liability Coverage Forms
Available Endorsements and Their Uses
By accepting this policy
as issued, the named insured agrees that the statements on the declarations are
complete and accurate. The named insured also agrees that such statements are
based on representations it made to the insurance company and that the policy
is issued based on those representations.
Note: This condition is used to void coverage and to prevent the
named insured from making the argument, after a loss, that the Declarations was
issued in error.
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Contractor
Paints Itself into a Corner
Other than the limits of
insurance and any rights and duties that apply specifically to the first named
insured, the insurance provided applies to each named insured as if it was the
only named insured. It also applies separately to each insured against whom a
claim is made or a suit is brought.
8.
Transfer of Rights of Recovery
Against Others to Us
Any rights the insured has against others to
recover all or part of any payment the insurance company made transfer to the
company. The insured must preserve those rights and not do anything after the
loss occurs to impair them. The company can request that the insured bring suit
or transfer those rights to it and help it enforce them.
Related Court Case: Trash Talking:
Subrogation Waiver Debated
9.
When We Do Not Renew
If the insurance company
decides to not renew, it must mail or deliver written notice stating so to the
first named insured on the declarations at least 30 days before the expiration
date. If the notice is mailed, proof of mailing is sufficient proof of notice.
Note: This paragraph is modified by specific endorsements in many
states with respect to the number of days of advance notice of non-renewal
required, what is considered acceptable as proof of mailing, and valid reasons
to terminate or not renew coverage. Each state’s requirements must be evaluated
carefully when considering changing or modifying this condition.
Defined words are used
throughout the coverage form. Restricting their meaning to such definitions provides
a way for everyone to have a clearer understanding of the coverage intended. There
are ten defined terms.
1. Bodily injury
This is
bodily injury, disability, sickness, or disease a person sustains. Death that
occurs as a result of bodily injury, sickness, or disease is also considered
bodily injury regardless of when the death occurs.
This is all of the
following:
This term employee is
broadened to include leased workers. It does not include temporary workers.
4. Executive officer
This is a person who
occupies any officer position that the named insured's charter, constitution,
by-laws, or similar governing documents created.
In liquor liability
coverage, the term “injury” is used instead of “occurrence.” If there is no
injury, there is no coverage. Therefore, it is a very important term. As used
in this coverage form, injury is damages. The only damages considered are those
because of bodily injury or property damage. Care, loss of services and loss of
services are included within bodily injury or property damage.
Example: Frank buys many beers from his waitress, Mavis, over the
course of the evening. He becomes very intoxicated and while in his
intoxicated state he does the following: |
|
||
Action |
BI or PD |
Injury |
|
Proposes marriage to
the Mavis |
No |
No |
|
Antagonizes Mavis’
husband, Lonnie |
No |
No |
|
Stumbles over a table
and falls on Lonnie |
Yes |
Yes |
|
Signs a contract giving
his car to Mavis |
No |
No |
|
Falls in front of an
oncoming bus |
Yes |
Yes |
6. Leased worker
This is a person a labor leasing firm leases to the named
insured. There must be an agreement between the named insured and the labor
leasing firm. The duties the leased worker is to do must be related to conduct
of the named insured's business. Temporary workers are not considered leased
workers.
7. Property damage
Property damage is physical injury to tangible property and
includes the resulting loss of use because the property is damaged. Property
damage is also the loss of use of tangible property even if no property has
been physically injured. Loss of use is considered to have occurred at the time
of the injury or occurrence that resulted in the property not being used.
8. Suit
This is a civil proceeding that alleges damages for bodily
injury, property damage, or personal and advertising injury that this insurance
covers. Arbitration proceedings and any other alternative dispute resolution proceeding
that claims such damages is also considered suit provided that the insurance
company agrees that the insured should participate in them.
9. Temporary worker
There are two types of temporary worker. One type is
furnished to the named insured to substitute for a permanent employee. The employee
that the temporary employee substitutes for must be only temporarily away from
work. Another type is a person who is furnished for seasonal or short-term
needs.
Related Court Case: Leased Worker Considered a
Temporary Employee
Vehicles are never considered
containers. Real property is never considered your product.
CG 00 34–LIQUOR LIABILITY COVERAGE FORM (CLAIMS-MADE BASIS)
This analysis addresses only the parts of the claims-made coverage form
that differ from the occurrence coverage form. Those differences are found in
the following sections:
Note: The WHO, WHAT,
WHERE, and HOW aspects of coverage are unchanged. All differences are based on
WHEN.
SECTION I – LIQUOR LIABILITY
COVERAGE
1. Insuring Agreement
Paragraphs b. and c. replaces paragraphs b., c., and d.
b. Coverage applies to injury only if:
c. Claims made by persons or
organizations that seek damages are treated as having been made when the notice
of claim is first received and recorded by any insured or the insurance
company, or when the insurance company makes a settlement, whichever occurs
first. All claims for damages because of injury to the same person, including
the death of that person, are treated as having been made at the time that the
first of those claims was made against any insured.
Example: Angelo is struck by a car being driven by Leona on 3/1/23.
Leona had spent the evening at Cruisin’ In and had purchased quite a few
rounds. Angelo is severely injured. The first notice Cruisin In’ receives is
when a claim for Angelo’s medical bills is presented on 09/01/23. Angelo’s
wife follows up with notification of her claim for loss of consortium on
2/15/24. Angelo dies on 05/18/25 and his family files a wrongful death claim
against the insured. On 12/01/25, Angelo’s workers compensation carrier
subrogates against the insured for the costs of the injuries he sustained
that it paid. Each of these claims is treated as having the initial claims-made
date of 09/01/23. |
Only the lead language
for item b. is changed. Under the Claims-made basis it refers to a claim being
received while under the occurrence basis it refers to a claim being made or a
suit being filed.
Subparagraph b. Excess
Insurance has an additional provision that is not in the occurrence coverage
form. It states that this insurance is excess over any other insurance coverage
if it is written on any other basis than claims-made and is effective before
this coverage's effective date. However, this is only if either of the
following applies:
This basically means that
if claims-made coverage replaces occurrence coverage, the occurrence coverage
form is primary and the claims-made coverage form is excess in cases where
coverage overlaps because of establishing the retroactive date.
Note: This condition in the claims-made coverage
form is not in the occurrence coverage form. It details the claims-made claim
information the insurance company is required to release for all periods that
it provided coverage on that basis, the parties to whom it is required to release
the information, and the conditions under which it must release the
information. The detailed analysis follows.
The insurance company provides the first named insured information that
relates to any claims-made liquor liability coverage issued to it during the
previous three years. The required information is:
Reserve amounts are based on the insurance company's judgment. They are
subject to change at any time and without notice and should not be considered
as final settlement amounts.
Note: It is extremely important to remember that none of this information should
be disclosed or provided to any claimant or its representative without the
insurance company's consent.
If the insurance company decides to cancel or not renew, it provides
this claim information 30 days or more before the cancellation or non-renewal
date. In other cases, it provides this information only after the first named
insured requests it in writing. The insurance company must respond only if it
receives the request no later than 60 days after the expiration date. It must
then provide the information not more than 45 days after it receives the
request.
The insurance company carefully develops and maintains claim and
occurrence information for its own business purposes. It does not make any
representations or warranties to any party with respect to its accuracy.
Cancellation or non-renewal is still effective even if the information provided
is not accurate.
SECTION V–EXTENDED REPORTING PERIODS
This section is in only the claims-made coverage form. It explains the
extended reporting periods and terms available if the coverage is cancelled, not
renewed, or replaced by coverage with a retroactive date later than the one on
this coverage form. It also applies if coverage is renewed on other than a
claims-made basis.
This section also explains how the limits of insurance apply and how the
premium for the extended reporting period is charged. The detailed analysis
follows.
1. The insurance company provides one or more described Extended Reporting
Periods if any of the following applies:
Note: The extended reporting period does not apply
if the named insured requests the change in the retroactive date or if coverage
on a different basis replaces claims-made coverage.
2. Extended Reporting Periods do not change the nature of the coverage
provided or extend the coverage period. These periods only apply to claims for injury
that occurs before the end of the coverage period and after any retroactive
date on the declarations.
3. A Basic Extended Reporting Period is included automatically and without
any additional premium charge. It begins at the end of the coverage period. It
lasts for:
This period does not apply to claims covered under any subsequent insurance
coverage the named insured purchases or that would be covered except for the
limit of insurance that applies to such claims being used up.
4. The Basic Extended Reporting Period does not increase or reinstate the
Limits of Insurance.
5. A Supplemental Extended Reporting Period is available by endorsement and
for an additional premium charge. Its duration is unlimited and begins when the
Basic Extended Reporting Period ends.
The named insured must request this endorsement in writing not later
than 60 days after the end of the policy period. This period does not take
effect unless the named insured pays the additional premium by the due date.
The insurance company calculates the additional premium according to its
rules and rates. In doing so, it considers the nature of the exposures,
previous types and limits of insurance, limits of insurance that remain to pay
future damages, and other relevant factors. In any event, the additional
premium is not more than 200% of the annual premium charged for this coverage
form.
The endorsement establishes the terms that apply to the Supplemental
Extended Reporting Period consistent with this section. It must include a
provision that essentially states that the insurance available for claims first
received during the period is excess over any other valid and collectible
insurance in force after the Supplemental Extended Reporting Period begins.
6. The insurance company provides the supplemental aggregate limit of insurance
described below if the Supplemental Extended Reporting Period is in effect. The
limit applies only for claims first received and recorded during the
Supplemental Extended Reporting Period. It is equal to the dollar amount on the
declarations in effect at the end of the policy period for the aggregate
entered dollar amount.
The Each Common Cause Limit continues to apply.
Note: Once the Supplemental Extended Reporting
Period has been requested and the premium paid, it cannot be cancelled by either
party.