Newsletter

Dishonesty Exclusion Precludes Coverage for Claim Based in Part Upon Knowingly Wrongful or Fraudulent Acts

April 2013

The United States District Court for the Eastern District of New York, applying New York law, has held that a dishonesty exclusion precluding liability “based in whole or in part” on knowingly wrongful or fraudulent conduct barred coverage for a lawsuit alleging at least some knowingly wrongful or fraudulent conduct on the part of the policyholder. Silverman Neu, LLP v. Admiral Ins. Co., 2013 WL 1248629 (E.D.N.Y. Mar. 28, 2013). The court emphasized the broad scope of the lead-in language, holding that because some of the allegations in the complaint were based upon knowingly wrongful or fraudulent conduct, the insurer was completely relieved of its duty to defend.

An insurer issued a claims-made professional liability policy with a duty to defend to an accounting and auditing firm. The insured's audit clients included two debt management and credit counseling firms for which the insured filed Internal Revenue Service (IRS) forms in support of their nonprofit status. The insured's clients were sued in a class action alleging violations of the Credit Repair Reorganization Act (CROA), which settled for approximately $260 million dollars. The class action court established a constructive trust for the amount of the judgment. Subsequently, a putative class of customers of the credit counseling companies filed a lawsuit against the insured auditing firm, among other defendants, for allegedly knowingly filing forms with the IRS that misstated the nature of the credit counseling firms' status and facilitated the firms' ability to market themselves. In the litigation against the insured, the plaintiffs sought recovery of proceeds from the constructive trust, from which the firm was allegedly paid monies, as well as recovery for violations of CROA.

The insurer denied coverage for the underlying litigation on the basis of a dishonesty exclusion and a financial services exclusion; that the claims did not arise from a “professional incident” as required in the insuring agreement; and that the amounts sought in the underlying litigation did not qualify as “damages” under the policy's insuring agreement. The firm's successor entity then sued the carrier, seeking a declaratory judgment that the insurer had a duty to defend it in the underlying litigation.

On cross-motions for summary judgment, the court held that the insurer had no duty to defend on the basis of the policy's dishonesty exclusion. The court assumed arguendo that the claim implicated the policy's insuring agreement and that the claim was first made during the policy period. The dishonesty exclusion precluded coverage for claims “based in whole or in part on any knowingly wrongful, dishonest, fraudulent, criminal or malicious act committed by or at the direction of any ‘Insured' in the course of providing ‘professional services.'” The policyholder conceded that the complaint, at least in part, alleged fraud and knowingly wrongful acts, but argued that the insurer nonetheless had a duty to defend because the complaint could be construed as also alleging negligence. The court disagreed, attaching importance to the language “in whole or in part” in the exclusion. Because at least some of the allegations in the complaint were based on knowingly wrongful, dishonest or fraudulent acts, the insurer lacked a duty to defend notwithstanding other allegations of arguably negligent conduct.

Read Time: 3 min
Jump to top of page

Wiley Rein LLP Cookie Preference Center

Your Privacy

When you visit our website, we use cookies on your browser to collect information. The information collected might relate to you, your preferences, or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. For more information about how we use Cookies, please see our Privacy Policy.

Strictly Necessary Cookies

Always Active

Necessary cookies enable core functionality such as security, network management, and accessibility. These cookies may only be disabled by changing your browser settings, but this may affect how the website functions.

Functional Cookies

Always Active

Some functions of the site require remembering user choices, for example your cookie preference, or keyword search highlighting. These do not store any personal information.

Form Submissions

Always Active

When submitting your data, for example on a contact form or event registration, a cookie might be used to monitor the state of your submission across pages.

Performance Cookies

Performance cookies help us improve our website by collecting and reporting information on its usage. We access and process information from these cookies at an aggregate level.

Powered by Firmseek