Coverage and policy interpretation.

Disputes that turn on what the policy says and how the carrier applied it.

Property & Catastrophe Fair claims practices and standards of care Coverage and policy interpretation

About this practice area

What the policy says, and how it was applied.

Coverage disputes ask what the insurance contract promises and whether the insurer honored it. They turn on the policy language, the declarations & endorsements, the conditions the insured had to meet, and the way the insurer read and applied all of them to the facts of the claim.

Common questions include notice and reporting under claims-made policies, the reach of exclusions, deductibles, and self-insured retentions, waiver of policy conditions, the duty to defend, and what an agent told the insured about the coverage being bought. Between insurers, coverage questions decide which carrier bears a loss, including extra-contractual exposure above policy limits.

Coverage and bad faith often travel together. An insurer that misreads its own policy may also be accused of handling the claim unreasonably, and the expert’s task is to separate what the contract required from how the claim was handled.

The policy beside the facts of the claim: thin threads match two clauses to two facts, and the controlling provision, labelled, is read across to the claim as one solid line ending in one solid mark

Engagements

Reading the contract against the claim.

Mr. Bingham has served as an insurance coverage and underwriting expert witness, in expert reports and sworn testimony, including a term life dispute in which his report addressed underwriting as well as claim issues.

Testifying expert · Report

Claims handling and coverage in a major class action

80,000page record

68-pagereport, 327 citations

Fair claims practices

Excess carrier’s equitable subrogation and bad-faith claims against a primary carrier

94-pagereport, 445 citations

57-pagerebuttal, 142 citations

Settledbefore the scheduled deposition

Coverage and policy interpretation

Term life death claim: underwriting and claim issues

Underwritingand claim issues

Coverage and policy interpretation

Other matters

Uninsured/underinsured motorist claim: bad faith and breach of contractTestifyingFair claims practicesRead moreShow less

Retained by a major personal lines carrier on an uninsured/underinsured claim where the policyholder was alleging bad faith and breach of contract. This state court case was settled upon production of Glynloen’s report.

Notice and reporting under a claims-made policyTestifyingCoverage and policy interpretationRead moreShow less

Engaged by a major carrier to offer expert opinions in support of claim denial asserting breach of contract, specifically notice and reporting issues on a claim made policy. Mr. Bingham’s report cited in detail the breaches, offered a timeline, and described the usual, customary, and ordinary practice for insurance carriers.

Also listed under: Claims Handling Review

Insurer recouping a large deductible after waiving conditionsTestifyingCoverage and policy interpretationRead moreShow less

Retained by a hospital to opine on policy interpretation, claims documentation, and fair claim practices of an insurer attempting to recoup a large deductible after waiving contract terms and conditions.

Circuit Court of the Twelfth Judicial Circuit, Will County, Illinois

Also listed under: Testimony record

Agent misrepresentation of policy termsTestifyingCoverage and policy interpretationRead moreShow less

Retained as an expert for policyholder suing agent for misrepresentation of policy terms and other errors and omissions allegations.

Also listed under: Defense of TPAs, Agencies, and Counsel

Property & Catastrophe

First-party property losses: hail & wind, fire, winter storm, wildfire & mudslide, tornado, and civil unrest, often with business-interruption components and claim records that run to hundreds of thousands of pages.

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Fair claims practices and standards of care

Whether the handling met the state’s fair claims practices statutes and regulations, the industry standard of care, and the carrier’s own written claim-handling guidelines.

View Fair claims practices and standards of care →