Local: (805)-371-3680 | Toll Free: (800) 240-CHIV
Facebook
LinkedIn
Chivaroli Insurance Services
  • INSURANCE COVERAGE
    • Medical Professional Liability
    • Commercial Auto Insurance
    • Errors & Omissions Insurance
    • Commercial General Liability
    • Business Owners Policy (BOP)
    • Representations & Warranties
    • Directors’ & Officers’ Liability
    • Fiduciary Liability Insurance
    • Terrorism Risk Insurance
    • Commercial Property
    • Commercial Crime
    • Difference in Conditions
    • Workers Compensation
    • Employment Practices Liability
    • Stop Loss Insurance
    • Security & Privacy (Cyber) Liability
    • Products Liability
    • Personal Lines Insurance
  • OTHER SERVICES
    • Alternatives
    • Consulting Services
    • Credentialing Requests
    • Risk Management
    • Wholesale Brokerage
  • RESOURCES
    • Healthcare Resources
    • Insurance Resources
    • Terms & Definitions
  • NEWS
  • ABOUT
  • CONTACT

D&O Insurance: Contract Exclusion Does Not Preclude Coverage for Intentional Misrepresentation Claim

January 7, 2015Chivaroli and Associates Insurance ServicesArticle Archives

As seen on The D&O Diary:

By Kevin LaCroix on December 29, 2014

A recurring D&O insurance question is whether or not a policy’s contract exclusion precludes coverage for claims that the insured induced the claimant into entering a contract through negligent or intentional misrepresentations. In a interesting December 22, 2014 opinion (here), District of Rhode Island Judge John J. McConnell, Jr., applying Rhode Island law, held that even a contract exclusion with the broad “based upon” or “arising out of” preamble language did not preclude coverage for a portion of a jury verdict holding that the insured’s intentional misrepresentations had induced the claimant to enter into the disputed contract. As discussed below, Judge McConnell’s opinion provides a useful and interesting perspective on this recurring question about the scope of the contract exclusion’s preclusive effect.

 

In 2004, TranSched Systems undertook negotiations to acquire certain software assets from Versys Transit Sollutions. During the course of these discussions, Versys was represented by Versys’ Vice President Sheryl Miller and its Vice President of Product Development and Chief Technology Officer, Lorin Miller. In February 2005, the two companies entered an Asset Purchase Agreement (APA) and related documents transferring ownership of the software assets from Versys to TranSched.

 

The software assets were not delivered as provided in the APA. TranSched initiated litigation in Delaware alleging that prior to the parties’ entry into the APA the two Versys representatives had made material misrepresentations about the software assets and also that Versys had breached the APA. After Versys received the complaint, it submitted the lawsuit as a claim under its D&O insurance policy.

 

The Delaware lawsuit went to trial and the jury found against Versys on three grounds: (1) intentional misrepresentation; (2) breach of contract regarding misrepresentations and warranties under the APA; and breach of the covenant of good faith and fair dealing. The jury awarded damages of $500,000. The trial judge awarded TranSched costs and prejudgment interest of over $170,000.

 

TranSched was unable to collect the judgment from Versys, which is no longer in business. TranSched attempted to collect the judgment from Versys’s D&O insurance carrier. The insurer denied coverage for the judgment and the TranSched filed an action in the District of Rhode Island seeking to establish that the insurer’s policy provided coverage for the amount of the judgment.

 

The insurer contended that coverage for the judgment was precluded from coverage by two policy exclusions, the Limited Contract Exclusion and the Fraud Exclusion.

 

The Limited Contract Exclusion provides that there is no coverage under the policy for any Claim “based upon, arising from, or in consequence of any actual or alleged liability of an Insured Organization under any written or oral contract or agreement, provided that this Exclusion …shall not apply to the extent that an Insured Organization would have been liable in the absence of the contract agreement.”

 

The Fraud Exclusion precludes coverage for Claims “based upon, arising from, or in consequence of any deliberately fraudulent act or omission or any willful violation of any statute or regulation by such Insured, if a final and non-appealable judgment or adjudication adverse to such Insured establishes such a deliberately fraudulent act or omission or willful violation.” The Severability of Exclusions clause provides further that with respect to the Fraud Exclusion, “only facts pertaining to and knowledge possessed by any past, present or future Chief Financial Officer, President, Chief Executive Officer or Chairperson of any Insured Organization shall be imputed to any Insured Organization to determine if coverage is available.”

 

The December 22 Opinion

 

In his December 22, 2014 memorandum opinion, District of Rhode Island Judge McConnell, applying Rhode Island law, held that while the breach of contract exclusion precluded coverage for the breach of contract and breach of the implied covenant of good faith portions of the jury’s verdict, neither of the two exclusions on which the insurer sought to rely precluded coverage for the intentional misrepresentation portion of the jury’s verdict.

 

In concluding that the Limited Contract Conclusion did not preclude coverage for the intentional misrepresentation portion of the jury’s verdict, Judge McConnell cited several prior decisions in which courts had concluded that intentional misrepresentations are not precluded from coverage under a contract exclusion “where the misrepresentations were made before the transaction and the transaction was generated by and was a consequence of a misrepresentation.” (Emphasis in original, citations omitted). Judge McConnell said he found “the reasoning in these cases to be persuasive and applicable to the facts of this coverage dispute.”

 

Judge McConnell went on to say that the contract exclusion is “limited to actual liability arising under the contract.” He added that the “evidence at trial sufficiently supports TranSched’s assertion that the intentional misrepresentation claim did not arise out of the contract, but concerned only pre-transaction conduct,” noting further that “the APA was not a cause of the intentional misrepresentation claim, it was the result of it, and any tortious conduct is not covered under the exclusion because it preceded the APA and was independent of the contract itself.”

 

With respect to the Fraud Exclusion, Judge McConnell rejected the insurer’s attempt to circumvent the Severability Exclusion by arguing that it was not attempting to impute any conduct to Versys but rather was focusing on the conduct of Versys itself. Judge McConnell said that to support this interpretation, he would have to “ignore the Severability of Exclusions clause” and would have to find that “any misleading statement representation or omission by any employee … would trigger the fraud exclusion.” He added that “the fraud exclusion, without the severability clause, could work an inequitable result when one considers how many employees a company has and the fact that the exclusion as written makes the company responsible for all of its employees’ misconduct without providing any coverage.”

 

Based on his review of the evidentiary material presented Judge McConnell said that “it is clear that the case mainly focused on the vice presidents’ roles in driving the transaction,” and that because “their conduct does not bind Versys on the terms of the exclusion, the fraud exclusion does not apply in this case.”

 

As a result of the Judge McConnell’s conclusion that the jury verdict was awarded on both covered and uncovered claims, he determined that there would have to be an allocation. He ordered the parties to submit the allocation to mediation using either the services of the Magistrate Judge assigned to the case or of a mediator of their own choosing.

 

Discussion

This case represents the relatively unusual circumstance that the insurance coverage questions are being considered after the entry of a jury verdict in the underlying claim. It is much more frequently the case that these kinds of issues are being disputed after the underlying case has been settled. Though the jury verdict does make this case distinct from many other situations in which these kinds of questions arise, Judge McConnell’s ruling may nevertheless be useful and even instructive in other cases in which the extent of the preclusive effect of the policy’s contract exclusion is in dispute.

 

In that regard, it is important to note that though there were breach of contract allegations, and though all of the allegations in the underlying lawsuit related to the transaction in connection with which the relevant contract had been entered, Judge McConnell did not simply conclude that the broad preamble of the exclusion meant that the exclusion’s preclusive effect applied to all of the transaction-related allegations.

 

As I have noted in prior posts (for example, here), I have been concerned by a number of recent court decisions in which courts have interpreted D&O insurance policy contract exclusions with a broad preamble to sweep so broadly as to preclude coverage not only for breach of contract claims but also for misrepresentation claims relating to the same transaction in which the contract arose.

 

Here, even though the contract in question followed the alleged misrepresentations, and even though the contract in question arose from and was induced by the alleged misrepresentations, Judge McConnell concluded that the contract exclusion did not preclude coverage for the misrepresentation claims. As he put it, the misrepresentations “did not arise out of the contract, but concerned only pre-transaction conduct,” adding that the APA contract “was not a cause of the intentional misrepresentation claim, it was the result of it, and any tortious conduct is not covered under the exclusion because it preceded the APA and was not independent of the terms of the contract itself.”

 

Judge McConnell’s conclusion in this regard (and the conclusions of the courts on whose opinions he relied) stands in contrast to the cases in which courts have interpreted contract exclusions with a broad preamble so broadly as to preclude coverage even for claims alleging that the contract resulted from pre-contract inducements.

While circumstances will vary and while there may be factual issues that affect the analysis in specific situations, there is an element of convincing logic to Judge McConnell’s analysis that the contract exclusion – even an exclusion with a broad “based upon” or “arising out of” preamble – does not apply to preclude coverage for claims involving conduct that preceded the entry of the contract. This logic applies even if the allegation is that the pre-contract conduct was an inducement for the parties to enter the contract. As Judge McConnell said, liability for these types of inducement claims does not arise out of the contract, it is the other way around; the contract arose out of the inducements.

As I have noted in prior posts, the prior cases in which courts have applied contract exclusions to preclude coverage even for negligent or fraudulent inducement claims arguably are applying the contract exclusions so broadly as to preclude coverage for the very types of claims for which the policy’s coverage was intended.

I have long thought that the cure for this overly broad application of the contract exclusion would be to amend the exclusion’s preamble to provide that the exclusion’s preclusive affect applies only to claims “for” breach of contract.

However, Judge McConnell’s opinion makes clear that even if a contract exclusion uses the broader “based upon or arising out of” language, the policy exclusion does not apply to all claims asserted merely because there is a transaction involved. His conclusion that the exclusion does not apply to pre-transaction conduct provides an important distinction on which policyholders can seek to rely in contending that even a contract exclusion with a broad preamble does not preclude coverage merely because a transaction is involved.

On a final note, it is worth observing that Judge McConnell concluded that the policy’s fraud exclusion did not preclude coverage even though this case involved the rather unusual situation in which there had actually been a final adjudication of an intentional misrepresentation. His ruling in that regards was reliance on the severability clause that limited the persons whose conduct could be imputed to the company. Judge McConnell’s ruling on the fraud exclusion not only underscores the critical importance of the inclusion of these types of severability provisions, but the analysis in his opinion highlights the unfairness that would be involved if the policy did not include a severability provision of this type. His analysis also highlights how important it is to limit the number of persons whose knowledge or conduct will be imputed to the entity for purposes of determining the applicability of the conduct exclusions.

For more information, contact Chivaroli & Associates.

Chivaroli and Associates Insurance Services
Chivaroli & Associates Insurance Services is a full-service brokerage and consulting firm that specializes in the custom design and placement of property and casualty insurance and alternative risk funding solutions for healthcare organizations.
Previous post 2014 Was Landmark Year for Health Data Breaches Next post Hospitals Are Facing Cyber Threats
Sign up for Chivaroli & Associates Newsletter
* = required field
unsubscribe from list

Categories

  • Article Archives
  • General Article
  • Private
  • Uncategorized

Archives

  • May 2025
  • February 2025
  • December 2024
  • November 2024
  • October 2024
  • August 2024
  • July 2024
  • June 2024
  • May 2024
  • April 2024
  • March 2024
  • January 2024
  • December 2023
  • November 2023
  • October 2023
  • September 2023
  • August 2023
  • July 2023
  • June 2023
  • April 2023
  • March 2023
  • February 2023
  • January 2023
  • December 2022
  • October 2022
  • September 2022
  • August 2022
  • July 2022
  • June 2022
  • May 2022
  • April 2022
  • March 2022
  • February 2022
  • January 2022
  • November 2021
  • September 2021
  • August 2021
  • July 2021
  • June 2021
  • May 2021
  • April 2021
  • March 2021
  • February 2021
  • January 2021
  • November 2020
  • October 2020
  • September 2020
  • August 2020
  • July 2020
  • June 2020
  • May 2020
  • April 2020
  • March 2020
  • February 2020
  • January 2020
  • August 2019
  • July 2019
  • June 2019
  • March 2019
  • February 2019
  • January 2019
  • December 2018
  • November 2018
  • August 2018
  • July 2018
  • June 2018
  • May 2018
  • April 2018
  • March 2018
  • February 2018
  • December 2017
  • November 2017
  • October 2017
  • August 2017
  • July 2017
  • June 2017
  • May 2017
  • April 2017
  • March 2017
  • February 2017
  • January 2017
  • November 2016
  • October 2016
  • September 2016
  • August 2016
  • July 2016
  • June 2016
  • May 2016
  • April 2016
  • March 2016
  • February 2016
  • December 2015
  • November 2015
  • October 2015
  • September 2015
  • August 2015
  • July 2015
  • June 2015
  • April 2015
  • February 2015
  • January 2015
  • December 2014
  • November 2014
  • October 2014
  • September 2014
  • August 2014
  • July 2014
  • June 2014
  • May 2014
  • April 2014
  • March 2014
  • February 2014
  • January 2014

Chivaroli and Associates Insurance Services is a full-service brokerage firm specializing in the custom-design and placement of insurance and alternative risk funding solutions for your healthcare organization.

Facebook
Twitter
LinkedIn
YouTube

Contact Us Today

Address:
200 North Westlake Blvd., Suite 101
Westlake Village, CA 91362
Phone:
805-371-3680
E-mail:
mail@chivarolitr.wpengine.com

Resources

Health Care
Insurance
Terms & Definitions
News
About

Policies

Cookie Policy
Disclaimer

Recent News

  • The Council’s Q1 P/C Survey Shows Signs of Premium Softening
  • Premium Hikes Continued in Q4 2024, Latest Survey Shows 
  • ‘Nuclear’ Medical Malpractice Verdicts on the Rise
  • Pay Now, Deliver Later: Some Women Are Prepaying for Their Baby
© 2025 All rights reserved. Powered By Insurance Agency Website by Stratosphere