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When Directors’ and Officers’ Insurance Isn’t What You Think It Is

When Directors’ and Officers’ Insurance Isn’t What You Think It Is | A Wake-up Call for Community Association Board Members

Over the last several months, I have encountered several situations in which condominium and homeowners’ association board members were shocked to learn the true nature of the directors’ and officers’ liability coverage they believed was designed to protect them. In each case volunteer board members were named individually in lawsuits filed by dissatisfied owners. Little did they know that after the claims were made, they discovered that the policy they had relied upon did not provide the broad protection they assumed existed.

These board members believed they had purchased traditional directors’ and officers’ liability insurance. Instead, they learned that the policy functioned more like a limited legal defense program than a comprehensive liability policy. The distinction can be significant. When a board member is sued, the expectation is often that the insurance company will not only provide a legal defense but may also cover litigation-related expenses and, when appropriate, pay settlements or judgments. Yet many policies contain extensive limitations, exclusions, conditions, and reimbursement obligations that can dramatically restrict coverage.

The lesson for every community association board is simple: Do not assume your insurance coverage provides protection simply because of the insurance declaration page, which sets out the policy limits. Board members have a fiduciary obligation to understand the scope of the association’s insurance program, particularly the exclusions that may eliminate coverage when it is needed most.

Too often volunteer board members believe insurance matters are being handled by someone else. Some assume their management company has reviewed the coverage. Others assume the association attorney has already analyzed the policy. While managers and attorneys can certainly provide valuable assistance, the responsibility for understanding the association’s insurance program ultimately rests with the board itself.

One recent example is a policy issued by a well-known legal defense insurance company. The policy expressly provides that it is a legal expense policy and not a traditional liability policy. According to the policy language, coverage is triggered only when a claim is made against the insured and the association’s existing insurance coverage has been denied or determined not to apply. The clear language of the policy further established that it does not indemnify the insured for money damages, judgments, or other damages that may be awarded in the lawsuit.

In addition, the policy provided the following:

      • The insurer selects the attorney, not the board.
      • Coverage is limited to a maximum of three claims or lawsuits during a 12-month policy period. (This limitation can be quite problematic during complicated association litigation when multiple members sue.)
      • Coverage is only available after required underlying insurance policies have first been notified and have denied coverage and such denial of notice is provided within a set period of days. (Therefore, even if coverage would otherwise be afforded, if there is a delay in providing the notice of denial from other insurance carriers, the claim can be denied!)

Only a review of the actual insurance policy at issue will determine the extent of the coverage provided. Under many such policies’ limitations and exclusions section, the insureds (meaning either the association and/or the actual board members named in the litigation) remain responsible for numerous litigation expenses. The bare bones “director and officer liability policies” being sold may exclude the following:

      • Expert witness fees and costs
      • Deposition fees and costs
      • Paralegal costs
      • Copies and fax charges
      • Legal research costs
      • Travel expenses within Florida
      • Telephone and long-distance charges
      • Data processing charges
      • Standard U.S. mail postage
      • Transcript costs
      • Court reporter fees
      • Attorney travel expenses outside Florida
      • Trial exhibits
      • Expert witness and nonexpert witness fees
      • Overnight delivery charges
      • Surveillance expenses
      • Investigator fees
      • Service of process fees
      • Court fees and court costs
      • Messenger fees
      • Appeal-related expenses
      • All other litigation-related expenses not specifically assumed by the insurer in the policy.

The policy may even provide that if the insurer advances certain costs, then those amounts may be required to be reimbursed by the insured within 30 days. Failure to reimburse such expenses may result in the insurer ceasing payment of further legal fees associated with the claim! For many associations these expenses can become substantial, particularly in complex litigation requiring expert testimony, extensive discovery, or appeals.

Policy Exclusions Every Board Member Should Understand

Director and officer liability insurance policies can contain numerous exclusions which limit when a defense will be provided. Following are examples:

      • Claims or lawsuits that occurred before the policy’s effective date
      • Lawsuits filed outside the State of Florida
      • Claims not timely reported to the insurer
      • Appellate proceedings and appeals
      • Class action lawsuits
      • Federal court lawsuits, except limited categories involving service animals, emotional support animals, housing discrimination, or Americans with Disabilities Act compliance
      • Claims arising after the policy expiration date
      • Cases in which the insured is the plaintiff
      • Post-judgment proceeding
      • Fair Debt Collection Practices Act claims
      • Claims involving properties not listed as scheduled locations
      • Workers’ compensation-related claims
      • Disability benefit claims
      • ERISA-related (Employee Retirement Income Security Act) claims
      • Unemployment compensation claims
      • Intellectual property disputes involving copyrights, patents, trademarks, trade secrets, or trade dress
      • Environmental damage claims
      • Claims in which the insured employs its own attorney to handle the defense, subject to limited exceptions
      • Claims against current or former board members where the association has sued that board member
      • Claims involving pollution-related allegations
      • Lawsuits between current and former board members suing each other vs. the association suing a former board member
      • Lawsuits where the association is suing its own board members
      • Claims not first reported to underlying insurance carriers in accordance with those policies
      • Claims where the insured declines representation by the insurer’s designated attorney
      • Certain lawsuits between master associations and sub-associations
      • Certain lawsuits between sub-associations
      • Claims exceeding the policy’s three-claim annual limitation
      • Claims involving injuries or deaths arising from specified boating and water-sport activities.

When read together, these exclusions significantly narrow the circumstances under which coverage may be available.

Conditions, Reporting Requirements, and Timely Notice Requirements Can Be Just As Important As Exclusions

One of the most overlooked aspects of insurance policies is that conditions can effectively eliminate coverage even when the claim itself appears covered. For example, a policy may require the following:

      • Existing general liability insurance coverage to remain in force
      • Claims to be reported first to the association’s underlying insurance carriers
      • Written denial letters from those carriers within a specific time period
      • Reporting of those denials to the legal defense insurer within specified time periods
      • Submission of lawsuits within designated reporting deadlines
      • Full cooperation with the appointed attorney.

Failure to satisfy any of these requirements could potentially prevent coverage from being afforded at all. For that reason boards should review not only the exclusions section of every policy but also the conditions, reporting requirements, and notice provisions.

The Danger of Assumptions

The greatest risk facing many boards is assuming coverage exists without reading the policy. Every insurance policy contains exclusions, but are such exclusions reasonable? In light of the exclusions, does the association have proper insurance coverage? At the end of the day, the responsibility for understanding the association’s insurance program ultimately rests with the board itself.

Board members owe fiduciary duties to the community they serve. Part of fulfilling those duties includes developing a working understanding of the association’s insurance protections and limitations. A declaration page and premium invoice tell only a small part of the story. Only the policy itself will set out the exclusions, conditions, endorsements, limitations, and definitions that often determine whether coverage actually exists when a claim arises.

A Final Reminder

Every condominium and homeowners’ association board should schedule a meeting with its insurance agent at least annually. Do not, as so many boards do, just accept whatever policy is being sold. When is the last time your insurance agent asked to meet with the board? When is the last time your board received a detailed review of the insurance coverage provided and their exclusions?

During a meeting with the association’s insurance agent, the board should carefully review not only its directors’ and officers’ coverage but also every insurance policy maintained by the association. Ask what is covered. Ask what is excluded. Ask what conditions must be satisfied before coverage applies. Ask whether endorsements have modified the policy language.

The importance of this review cannot be overstated. Not long ago another community association was stunned to learn that it had no coverage for a significant water loss because prior claims had resulted in a water-damage exclusion being added to its policy. When another casualty event occurred and water migrated throughout a multi-story building, the board discovered there was no insurance coverage for the resulting damage. The exclusion was there all along, but no one had reviewed it. In all likelihood that gap in coverage could have been filled by another insurance provider. But after the casualty occurs, it is far too late.

Insurance policies are contracts. The protection they provide is determined not by assumptions but by the words written on the page. A board that takes the time to understand those words before a claim occurs will be far better prepared than the board that waits until after a lawsuit, casualty loss, or coverage denial arrives. An annual policy review with the association’s insurance agent is not merely a best practice. In today’s increasingly complex insurance environment, it is an essential part of responsible community governance. Remember to also consider inviting the association’s attorney to the meeting with the insurance agent because often your attorney’s expertise will focus on additional inquiry and thereby make the time spent with the insurance agent more worthwhile.

Condominium Unit Owner Insurance – The Risks of Not Purchasing Insurance for Your Unit

Condominium Unit Owner Insurance

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The risks of not purchasing insurance for your condominium unit

Do you think you do not need condominium insurance because your condominium association has it? You would be so very wrong if you do! It has happened more times than I can count—the supply line that feeds the toilet ruptures in the upstairs unit while the owner of the unit is out of town, the upstairs unit owner forgot that he or she started to fill the tub and it overflows, or the upstairs unit owner ignores a broken toilet, all of which result in water flowing down into the unit below. Next thing you know, the remediation workers arrive and start ripping out the soaked, damaged drywall in the units below and after cutting holes in the drywall use their industrial-sized blowers to dry things out to prevent mold.

Meanwhile, the downstairs unit owners want to have a “word” with the upstairs unit owner to discuss who is going to pay for the repairs. They demand a copy of the upstairs unit owner’s insurance policy. The owner of the upstairs unit where the leak occurred smiles and explains, “The condominium association has insurance. They’ll take care of it.” Right? Wrong! Even if the condominium association has the duty of repair to portions of the damaged property, typically the damaged common elements, the upstairs unit owner is not off the hook because both the condominium association and its insurance company can often “subrogate” their financial damages against the upstairs unit owner and so, too, can the downstairs unit owners and their insurance companies. At the end of the day, the upstairs owner who caused the damages could have significant financial liability. (In plain English, to “subrogate” a claim means that one party goes after the other for their financial damages for having caused the damage in the first place.)

So, now that I have your attention, most especially if you are a unit owner who does not have insurance for your unit—in the example described above, not only can the upstairs unit owner bear significant financial liability, but even their condominium unit is at risk of being foreclosed to satisfy a judgment against them—and there is no homestead protection! Because the upstairs unit owner decided not to purchase insurance, he could actually lose his unit in a foreclosure. The following explanation is why:

By way of oversimplification, the Condominium Act, more specifically, §718.111(11)(f), Florida Statutes, requires the condominium association to insure everything that the unit owner is not responsible to insure. The unit owner is responsible to insure

… all personal property within the unit or limited common elements, and floor, wall, and ceiling coverings, electrical fixtures, appliances, water heaters, water filters, built-in cabinets and countertops, and window treatments, including curtains, drapes, blinds, hardware, and similar window treatment components, or replacements of any of the foregoing which are located within the boundaries of the unit and serve only such unit…  the association is not obligated to pay for any reconstruction or repair expenses due to property loss to any improvements installed by a current or former owner of the unit or by the developer if the improvement benefits only the unit for which it was installed and is not part of the standard improvements installed by the developer on all units as part of original construction, whether or not such improvement is located within the unit.

But, however, the unit owner’s insurance policy, typically referred to as an “HO-6 policy,” not only includes coverage for the items set forth above plus other personal items, but also includes liability coverage for having caused damages to the condominium property.

§718.111(11)(j)1–2, Florida Statutes, makes patently clear that

A unit owner is responsible for the costs of repair or replacement of any portion of the condominium property not paid by insurance proceeds if such damage is caused by intentional conduct, negligence, or failure to comply with the terms of the declaration or the rules of the association by a unit owner, the members of his or her family, unit occupants, tenants, guests, or invitees, without compromise of the subrogation rights of the insurer.

The provisions… regarding the financial responsibility of a unit owner for the costs of repairing or replacing other portions of the condominium property also apply to the costs of repair or replacement of personal property of other unit owners or the association, as well as other property, whether real or personal, which the unit owners are required to insure. (emphasis added.)

Furthermore, also pursuant to §718.111(11)(g)2, Florida Statutes,

…unit owners are responsible for the cost of reconstruction of any portions of the condominium property for which the unit owner is required to carry property insurance [set out above], or for which the unit owner is responsible, and the cost of any such reconstruction work undertaken by the association is chargeable to the unit owner and enforceable as an assessment and may be collected in the manner provided for the collection of assessments pursuant to § 718.116, Fla. Stat. (emphasis added.)

§718.116, Florida Statutes, is the unit fore-closure section of the Condominium Act which explains the steps necessary to foreclose against an owner’s unit for failing to pay assessments.

In condominium living, the general rule is that the party who has the duty of purchasing insurance for a particular portion of the condominium property also has the primary duty to repair the damages to such portion regardless of fault (unless the condominium association has opted out of that regime by a vote of the unit owners, which is a rarity). But, simply because the condominium association has insurance and may have that primary duty of repair after the insurable casualty event, that does not mean that the negligent unit owner that caused the damage will not be the primary target for reimbursement for expenses incurred by the condominium association’s insurance company or by the condominium association for its deductible and related expenses. The same concept applies for the downstairs unit owners, who could seek reimbursement from the upstairs unit owner for any necessary expense incurred because the upstairs unit owner was negligent.

There are typically two parts to the HO-6 insurance policy, the primary coverage for personal losses and the other for liability coverage. Condominium associations should consider amending their declaration to require every unit owner to have both personal and liability coverage, and at a minimum, liability coverage. Your condominium association should discuss this requirement with the condominium association’s insurance agent as well as review the possibility of amending the declaration of condominium with legal counsel.

Anytime a condominium association experiences a casualty event, in addition to reporting the claim to the insurance carrier, usually through the condominium association’s insurance agent, the condominium association should be in touch with its legal counsel to explore all the different aspects necessary to both repair and reimburse the condominium association for its financial losses. At the end of the day, owning a condominium unit and not having purchased insurance is similar to taking a rowboat out on a rough sea day without life preservers.

Elections, Insurance, and a Senseless Death

This season, more than any other of late, the issue of condominium election ballot verification reared up.  The condominium election process is unique and very regulated.  In addition to many other requirements, ballots are to be placed in an inner plain and unmarked envelope which is to be placed inside a larger envelope which must, as per Florida law, contain the unit owner’s name, address, unit number and signature.  As part of the election process, this information is later verified against the associations’ membership records to ensure that only the unit owner, or the unit owner’s designated voter, cast their ballot.  It is the plain inner envelope that guarantees anonymity.

Given the sheer volume of units in many condominium communities, which translates to the number of ballots that can be received, the process of tabulating the ballots can take hours.  To speed things up, some condominium communities prefer to verify the outer envelope information in advance of the election ballot tabulation that takes place during the annual members’ meeting.  That said, and what may come as a surprise to some, is that you cannot just start verifying the outer envelopes.  If you do, then your entire election is subject to challenge.  Tampering with the election materials creates an inescapable cloud over the entire election process from which there is no escape, but a new election.  It is so simple to avoid, too.

Section 61B-23.0021, of the Florida Administrative Code, details the verification process as follows: “Any association desiring to verify outer envelope information in advance of the meeting may do so as provided herein.  An impartial committee designated by the board may, at a meeting noticed in the manner required for the noticing of board meetings, which shall be open to all unit owners and which shall be held on the date of the election, proceed as follows. For purposes of this rule, “impartial” shall mean a committee whose members do not include any of the following or their spouses: 1) Current board members; 2) Officers; and 3) Candidates for the board. At the committee meeting, the signature and unit identification on the outer envelope shall be checked against the list of qualified voters.  The voters shall be checked off on the list as having voted.  Any exterior envelope not signed by the eligible voter shall be marked ‘Disregarded’ or with words of similar import, and any ballots contained therein shall not be counted.”  Now you know how to have your cake and eat it, too.  Just follow the simple procedures to verify the outer envelopes and you can be home in time for the 10:00 P.M. news.

Once you are elected to the board, make certain the directors’ and officers’ liability coverage is in place.  In most instances, a board member’s duty is to exercise their reasonable business judgment.  They can make decisions that later turn out great or bad, but so long as they acted reasonably under the circumstances, and without malicious intent, the association’s insurer typically stands by their coverage obligations. Noteworthy is that, as related to procurement of insurance, a condominium board member’s statutory duty as set out in s. 718.111(11), Fla. Stat, is one of “best efforts”. Casualties of all sorts can occur at any time. For example, just look to the recent tragedy that led to the death of Trayvon Martin.

Friends, family and clients are all asking, will George Zimmerman’s homeowners’ association be sued?  Yes, most likely it will.  That is one deep pocket not likely to be missed.  We could also see intentional tort claims brought against the individual directors by the victim’s family.  If such claims are victorious, then it’s the individual directors who are liable, not the association’s insurer.  Under the circumstances, as reported thus far, a finding of individual board member liability is not unlikely.

The more difficult question to answer is whether the HOA will have liability for its actions or failures to act?  Was the association, based on the acts of its boards (both past and present) negligent or grossly negligent (reckless disregard that rises to such a level so as to appear to be an almost willful violation of the safety of others)?  If so, the insurers would likely fight to pay only their fractionalized share of the association’s blame.  This is referred to as “contributory negligence” where each culpable party pays their share of the blame.  You might also hear about some court activity where the plaintiffs try to force the association to suffer its judgment separate from the other defendants.  Doing so could create opportunity for larger settlements and judgments.  Think of it this way, would you rather receive just $1,000 from 10 people, or have 10 people each give you $1,000?

In many ways, suing a homeowners’ association is like suing a successful, well capitalized corporation.  Without proper insurance coverage in place, a judgment against your association would also be your next special assessment.  Make sure your association’s insurance professional is made aware of all activities taking place in your community, from watch committee activity to use of the clubhouse by private organizations.  Crime and accidents occur everywhere, at any time, when you least expect it and without notice.  Advance planning is your only defense.