Hepler Broom, LLC

Be Careful What You Say: Insurer Estopped from Asserting Coverage Defenses Based on Agent’s Representations

January 16, 2018

We all say things we regret. But sometimes, those things we say can be used against us. The same goes for insurance companies. So held the Illinois Appellate Court, Second District, in its recent unpublished decision in Country Preferred Ins. Co. v. Badri-Monaghan, 2017 IL App (2d) 170134-U. The court started the year with a decision finding an insurance company was estopped from asserting a coverage defense based on statements made to the insured by the agent. The policy required the insured to submit a written demand for arbitration, which she failed to do. The evidence showed, however, that she failed to do so based on statements made by the carrier’s captive agent. That agent apparently informed the insured that he had submitted her underinsured motorist coverage claim and “was going to make sure that everything was set up.” No one mentioned an arbitration demand requirement as a prerequisite to coverage.

Later, the insured hired an attorney to assist her with her insurance and other claims. She relayed to her attorney what the agent had told her: that he already had set up her underinsured motorist claim.

The trial court held, and the appellate court agreed, that the agent’s statements that the insured was not required to do anything else to submit her claim estopped the insurer from declining coverage based on the insured’s failure to submit a written demand for arbitration. This was true even though the insured failed to submit medical bills or return calls regarding her claim. This also was true even though the insured was represented by counsel.

Though the Second District made its decision in Badri-Monaghan an unpublished order, there is a lesson to be learned: be careful what you say. Making representations to an insured regarding what is needed for a claim can be held against the carrier seeking to enforce conditions to coverage down the line.

COVID-19 Updates

HeplerBroom LLC COVID-19 Response

HeplerBroom has been diligently working on its response and continuity plan to the COVID-19 pandemic in order to keep the health and safety of our employees, their families, and our clients as our top priority.

To help ensure everyone’s continued health and well-being, effective Tuesday, March 17, 2020, all attorneys and staff will be working remotely until March 31. This is an unprecedented and dynamic situation, and HeplerBroom is committed to observing governmental suggestions and requirements concerning public health while continuing to provide legal service second to none.

To ensure this, the firm has identified essential personnel in each office who will make certain that critical firm functions that cannot be done remotely continue to be handled. We have put in place protocol for those essential personnel to make sure they are keeping healthy per the CDC cleaning and sanitizing recommendations. All teams have back-up personnel and procedures that we will follow to make sure all deadlines are met and clients receive the same great service and work product that we have always been proud to provide.

HeplerBroom’s IT department has been working hard to make sure all remote employees are set up with equipment and access from home to limit disruption to our clients. Maintaining security and confidentiality has remained, and will continue to remain, at the forefront of all processes and procedures, at all levels throughout the firm.

The firm has created emergency communication measures to communicate any changes to this plan to employees and are communicating on a regular basis with any and all new resources and helpful information during this uncertain time.

During these fluid and unpredictable times, HeplerBroom will continue its commitment to great service and results for our clients, all while keeping safe and healthy.

Wishing you and your families good health.