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Home / Insurance / Regulatory Estoppel – What is it and how can it be successfully produced in New York? | Legal insurance blog for property insurance

Regulatory Estoppel – What is it and how can it be successfully produced in New York? | Legal insurance blog for property insurance



Initially, it is advantageous to define exactly what is meant by the phrase "regulatory estoppel" in connection with insurance. This theory is a form of fair estoppel in which insurers are prevented or "stopped" from claiming an interpretation of an insurance provision that is contrary to the insurer's explanation of that provision to state insurance authorities when the insurer originally requested approval of the insurance. form from the state insurance department. In layman's terms, the insurance company is prevented from claiming that a specific insurance provision has a meaning other than the meaning that was originally presented to an insurance company or during a legal proceeding.

The theory was first adopted (or successfully appealed) in New Jersey Morton International v. General Accident Ins. Co. 1

34 N.J. 1, 629 A.2d 831 (1993), but has consistently received negative treatment in most jurisdictions since that decision. In New York, for example:

"[T] theory [of regulatory estoppel] … has received almost universal dissatisfaction. It has been consistently rejected by federal and state agencies across the country and has never been adopted by any court in New York. In fact, at least two courts in New York have completely rejected the theory … I only know of one court in New York that has suggested that the doctrine can be viable. But in that case, another policy provision, the court interpreted that there were no unequivocal statements about the meaning of the provision to justify the application of the theory. "[1]

As this case illustrates, however, there are precedents. in New York which potentially supports the sustainable application of regulatory estoppel against insurance companies on behalf of policyholders I Tozzi against Long Is. R. Co. provided the Court with a guide to successfully invoke this potential theory. To substantiate the theory, the Court stated:

“Judicial estoppel, or the doctrine of inconsistent positions, precludes a party who took a particular position in a previous legal proceeding and who secured a judgment in his or her favor from adopting an opposite position in another act simply because his or her interests have changed (citation omitted); The doctrine is invoked that estoppo parties adopt such opposing positions because the judiciary & # 39; can not tolerate this "playing" quickly and resolutely with the courts "" (quote omitted). The purpose of the application of the doctrine of legal estoppel is to preserve the integrity of legal proceedings by prohibiting successive claims of actually contradictory statements such as the truth. [2]

Consequently, the Court of Tozzi argued that in an appropriate case 1) a dispute may use the doctrine of estoppel to prove that an insurance company should refrain from enforcing a clear and unequivocal agreement under its terms due to the fact that in a previous proceeding the insurer received a judgment through an unequivocal claim of an opposite interpretation of a contract term in the said agreement, and 2) that invoking a legal estoppel can create insurance cover. [3]

Although regular estoppel has not yet been successfully appealed to in New York, vigilant advocates should keep the theory in mind when appropriate facts arise. Despite the negative treatment, attorneys from Merlin Law Group will not hesitate to be the first to successfully invoke the theory in New York if these facts are presented.

[1] Sher v. Allstate Ins. Co. 947 F Supp 2d 370 [SDNY 2013].

[2] Tozzi vs. Long Is. R. Co. 170 Other 2d 606 [Sup Ct 1996].

[3] Tozzi 170 Other 2d 606 at * 613 [Sup Ct 1996].


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