Showing posts with label Risk Management. Show all posts
Showing posts with label Risk Management. Show all posts

Tuesday, May 12, 2026

The Capacity Exclusion That Voided a $2M D&O Policy — and What Every Executive Should Know

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Key Takeaways
  • On May 11, 2026, the New Jersey Supreme Court affirmed that Berkley Insurance's capacity exclusion blocked a $2 million D&O (directors and officers liability) policy payout for Mist Pharmaceuticals and its chairman in a self-dealing dispute involving more than twelve affiliated entities.
  • A $12 million global settlement reached in June 2020 left the insured responsible for roughly $3 million in liability — with zero contribution from their insurer, despite a trial court initially ruling otherwise.
  • Berkley's practice of sending ten or more formal reservation-of-rights notices over five years of litigation proved decisive: the court found those communications definitively defeated the policyholder's waiver arguments.
  • For any executive who holds leadership roles at multiple organizations, the ruling is a direct signal that standard D&O policy coverage may contain a structural gap that most people never see until a claim arrives.

What Happened

$1,751,567.35. That's the precise dollar figure a New Jersey trial court initially ordered Berkley Insurance to pay Mist Pharmaceuticals — and it's a number that two higher courts subsequently erased entirely. According to Insurance Business America, the New Jersey Supreme Court issued its ruling on May 11, 2026, unanimously affirming the Appellate Division and delivering a complete victory to Berkley. The dispute centered on a directors and officers policy — D&O coverage is liability insurance that shields corporate executives from personal financial exposure when sued for alleged management misconduct — that Berkley issued to Mist Pharmaceuticals on April 21, 2014. That policy carried a $2 million limit covering the period from April 8, 2014 through November 30, 2015.

The underlying claims came from two investor groups — CelestialRX Investments and Krittaka Life Sciences — who alleged that Mist chairman Joseph Krivulka orchestrated a self-dealing arrangement funneling benefits through Akrimax Pharmaceuticals and more than twelve affiliated entities. Lawsuits filed in Delaware in 2015 and New Jersey in 2019 were ultimately resolved through a $12 million global settlement in June 2020. Of that total, approximately 25% — roughly $3 million — was specifically allocated to Mist Pharmaceuticals and Krivulka in his capacity as chairman. Berkley declined to contribute, citing a capacity exclusion in the policy that excluded claims arising from acts taken outside the executive's insured role at Mist. The trial court rejected that argument and entered judgment for the remaining policy limit plus $796,258.38 in attorney fees. The Appellate Division reversed. The Supreme Court agreed — creating a precedent that risk assessment professionals say will reshape how New Jersey courts read broadly worded D&O exclusions for years ahead.

directors and officers liability policy document - text

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Why It Matters for Your Coverage

That reshaping of legal precedent carries direct consequences for any executive who holds board seats or management roles at more than one organization. Think of a capacity exclusion like a job-description clause built into a liability policy: coverage follows you only when you are acting in the specific, insured role named in the agreement. Step outside that role — even briefly, even at a closely affiliated company — and policy coverage can evaporate entirely, regardless of how much premium has been paid over the life of the contract.

That is the structural risk the Mist dispute puts on full display. Joseph Krivulka simultaneously served as Mist's chairman and directed operations through Akrimax and its network of related entities. When the lawsuits arrived, Berkley's policy drew a hard line: the alleged misconduct was tied to his Akrimax-facing capacity, not his Mist chairmanship. Hunton Andrews Kurth, writing in the National Law Review, described this dynamic as creating a form of "double trouble" for executives in dual-capacity roles, explaining that D&O policies can fail to protect individuals when their alleged wrongful acts are inextricably tied to their roles at uninsured entities — leaving a significant coverage gap even where the individual is clearly named as an Insured Person under the policy.

Key Dollar Figures: Mist Pharmaceuticals D&O Dispute $12M Total Settlement $3M Mist/Krivulka Allocation (25%) $2M D&O Policy Limit $1.75M Trial Award (Reversed)

Chart: Four key dollar figures from the Berkley v. Mist Pharmaceuticals D&O dispute. The $12M total settlement dwarfs both the $2M policy limit and the $1.75M trial court award that was ultimately overturned on appeal.

The precedent reaches further than individual executives. Kennedy's Law, analyzing the Appellate Division ruling that the Supreme Court later affirmed, noted that New Jersey had never formally addressed this type of capacity exclusion before — making the decision a matter of first impression in the state. Going forward, courts will apply broad exclusionary language strictly when the wording is unambiguous and the insurer has consistently preserved its denial position throughout the claims process.

That consistent preservation carries its own lesson in risk assessment. Berkley sent no fewer than ten reservation-of-rights notices — formal communications that preserve an insurer's right to deny coverage later, even while providing a legal defense — over five years of litigation, and specifically warned at least six times that its correspondence should not be construed as a waiver. The Supreme Court found that this pattern definitively foreclosed the policyholder's estoppel and forfeiture defenses (legal doctrines arguing the insurer implicitly gave up its right to deny the claim by waiting too long to act). The paper trail was meticulous, and it won the case.

For small business owners doing an insurance comparison between standard D&O products, the practical implication is sharp. WTW's Insurance Marketplace Realities 2026 report notes that D&O pricing is currently trending flat to modestly lower on a case-by-case basis — which means executives with multi-entity exposure have a genuine market window to improve their policy coverage without a meaningful cost increase. The targeted solution coverage specialists consistently recommend is a Side A DIC policy (Difference in Conditions coverage — a supplemental layer that activates precisely when the primary D&O policy declines to pay). A properly structured Side A DIC addresses capacity-exclusion gaps directly, and in a flat-rate environment, pursuing that upgrade represents a concrete insurance savings opportunity that dual-role executives frequently miss until it is too late.

The AI Angle

Building on the coverage gap theme, the insurance industry is deploying artificial intelligence to reduce the kind of claims management disputes that defined the Berkley litigation. Underwriting platforms from firms like Verisk and Relativity6 now use machine-learning models to flag complex insured structures — including executives with board positions at multiple entities — during initial policy review. When those structures are detected, AI tools can prompt underwriters to insert more precise exclusion language or adjust pricing at issuance, reducing the ambiguity that leads to multi-year coverage battles and expensive risk assessment failures on both sides of the table.

On the claims side, AI-driven document review tools can parse thousands of reservation-of-rights letters and coverage correspondence in hours rather than months, building a clear timeline of how consistently a carrier preserved its denial position. That capability makes estoppel and waiver arguments — which already failed in the Berkley case — considerably harder to sustain going forward. As Smart Legal AI's recent coverage of AI's expanding role in legal technology explores, the combination of automated document analysis and tightening case law precedent is quietly rewriting the risk calculus for every corporate liability policy on the market. For policyholders, this means insurers will increasingly enter disputes with a far more airtight paper trail from day one — making early coverage clarity more important than ever.

What Should You Do? 3 Action Steps

1. Map Every Corporate Role You Hold Before Your Next Renewal

Compile a complete list of every board seat, advisory position, and management role you hold outside your primary employer — then present that list to your broker and ask specifically whether each role is covered, excluded, or unaddressed by your current D&O policy. If the policy language uses broad terms like "any capacity other than as an Insured Person," treat that as a functional exclusion until you get written confirmation otherwise. Running an insurance comparison across two or three competing D&O carriers on this single point alone can reveal meaningful differences in how capacity exclusions are drafted and what you're actually buying.

2. Add Side A DIC Coverage to Your Insurance Comparison

Side A DIC policies (Difference in Conditions — a supplemental coverage layer that pays when the underlying D&O declines to) are specifically structured to activate in scenarios like the Berkley v. Mist fact pattern. For any executive running roles at more than one organization, this is less an optional add-on and more a foundational risk management tool. The current flat-to-declining D&O pricing environment cited in WTW's 2026 marketplace report is a practical window to pursue insurance savings by bundling or renegotiating both layers together. Ask your broker to include Side A DIC terms in any insurance comparison to make sure your supplemental coverage doesn't carry parallel capacity-based carve-outs of its own.

3. Treat Every Insurer Letter as a Legal Document From the Start

The Supreme Court's ruling is a direct reminder that claims management correspondence is legally consequential from the moment it arrives. When an insurer sends a reservation-of-rights letter, it is formally preserving its right to deny coverage even while defending you — not sending a routine acknowledgment. Forward each letter to a coverage attorney or experienced broker immediately, document your response, and maintain a running file of all communications. The finding that ten-plus such notices over five years definitively defeats waiver arguments shows how heavily this paper trail can weigh in court. Never assume silence or continued defense equals acceptance of coverage. Always consult a licensed insurance agent for guidance specific to your policy coverage situation before responding to any formal carrier communication.

Frequently Asked Questions

What is a D&O capacity exclusion and how can it create a policy coverage gap for executives at multiple companies?

A capacity exclusion limits D&O coverage to actions an executive takes in their specific, named insured role at the covered company. If alleged wrongdoing is connected to a different role the executive holds — such as running an affiliated entity — the exclusion can eliminate coverage entirely, even if the individual is listed as an Insured Person under the policy. The Berkley v. Mist ruling established that New Jersey courts will enforce this language strictly when it is clearly worded and the insurer has consistently reserved its rights throughout the claims management process. Executives at multiple organizations should review this language carefully at every renewal.

Can a D&O insurer legally deny a claim if I sit on boards at multiple companies without a separate DIC policy?

Yes — and the Berkley case is precisely that scenario playing out at the New Jersey Supreme Court level. When the alleged misconduct is tied to activities through an affiliated or subsidiary entity not covered by the primary D&O policy, a clearly worded capacity exclusion gives the insurer legal grounds to deny even while the individual is a named Insured Person. A Side A DIC policy (Difference in Conditions) is the most direct solution, but only if the DIC policy itself doesn't contain parallel exclusions. An insurance comparison that reviews both layers side-by-side — examining exact exclusion language rather than just limits and premiums — is the right starting point. A licensed insurance agent can help identify which structures fit your exposure profile.

What is a reservation-of-rights letter in an insurance claims management dispute, and what happens if I ignore one?

A reservation-of-rights letter is an insurer's formal notice that it is providing a defense or acknowledging a claim while explicitly preserving its right to deny coverage later based on identified policy exclusions. It is not a denial — but it is not an acceptance either. Ignoring or misunderstanding these letters is costly: the Supreme Court found that Berkley's ten-plus such communications sent over five years of claims management definitively defeated the policyholder's argument that the insurer had waived its right to deny. If you receive one, treat it as a legal document, involve a coverage attorney immediately, and do not assume that continued defense payments signal coverage acceptance.

Does adding a Side A DIC policy produce real insurance savings compared to simply buying higher D&O policy limits?

For executives with multi-entity exposure, Side A DIC coverage typically delivers better protection per dollar than increasing primary limits — because it activates in scenarios where the primary policy refuses to pay at all, including capacity exclusion situations. Raising Berkley's $2 million limit would not have changed the outcome in the Mist case, because the insurer denied the claim outright before any limit calculation applied. The insurance savings opportunity is real in the current market: WTW's 2026 marketplace report notes pricing is trending flat to modestly lower, meaning bundling a Side A DIC layer can sometimes be done for minimal incremental cost relative to the coverage gap it closes. A qualified broker should run the risk assessment numbers for your specific multi-entity structure before you decide.

How does the NJ Supreme Court's D&O ruling change risk assessment for small business directors serving on multiple boards in 2026?

The ruling establishes — for the first time in New Jersey — that capacity exclusions in D&O policies will be enforced strictly when the language is clear and the insurer has preserved its rights throughout the dispute. For small business directors, this means the standard risk assessment of "I have D&O coverage, I'm protected" is no longer adequate if you hold roles at more than one entity. The policy coverage you carry may simply not extend to alleged misconduct tied to a second or third organization. The ruling also signals that courts will scrutinize claims management correspondence closely from the earliest stages of a dispute, making documentation habits a live legal issue long before any courtroom appearance. Consult a licensed insurance professional for a policy coverage review specific to your board structure.

Disclaimer: This article is for informational and editorial commentary purposes only and does not constitute insurance, legal, or financial advice. Facts are drawn from publicly reported court decisions and industry research sources. Always consult a licensed insurance agent or qualified attorney for personalized guidance on your specific policy coverage and risk management needs.

Saturday, April 25, 2026

Why AI Liability Coverage Leaves Enterprises Dangerously Exposed

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AI Liability Coverage Gap: Why Traditional Insurance Leaves Enterprises Exposed in 2026

AI technology corporate risk exposure - a black and white drawing of a man's head

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Key Takeaways
  • AI-related lawsuits in the U.S. surged 978.1% between 2020 and 2025, and Gartner projects over 2,000 global “death by AI” legal claims by end of 2026.
  • The Insurance Services Office (ISO) introduced endorsements CG 40 47 and CG 40 48 in early 2026, giving carriers legal language to explicitly exclude generative AI claims from standard CGL policies.
  • Major underwriters including AIG and W. R. Berkley began adding AI exclusions in late 2025, creating “silent AI” coverage gaps most businesses don’t know exist.
  • Gartner forecasts a 60% rise in enterprise AI governance controls by 2030 as insurers start requiring proof of AI risk management before granting explicit coverage.

What Happened

If your business uses AI—and in 2026, most do—your insurance may have quietly stopped covering some of your biggest risks. Here is what changed and why it matters to your bottom line.

In early 2026, the Insurance Services Office (ISO)—the organization that writes the standard policy language used by most commercial insurers across the United States—introduced two new endorsements: CG 40 47 and CG 40 48. These endorsements give insurance carriers the formal legal framework to explicitly exclude generative AI-related claims from standard Commercial General Liability (CGL) policies (think of CGL as the foundational “catch-all” liability policy most businesses carry to cover third-party injury or property damage claims). What was once a murky gray area is now becoming a clear contractual exclusion written into your policy coverage.

This regulatory move did not happen in a vacuum. Between 2020 and 2025, cumulative AI-related lawsuits in the United States exceeded 700 cases, with annual filings increasing by a staggering 978.1% over that period. Gartner projects more than 2,000 legal claims linked to “death by AI” incidents—cases where AI-driven decisions directly caused harm to real people—will be filed worldwide by the end of 2026 alone, driven by failures in healthcare, finance, and public safety sectors.

Major underwriters including AIG and W. R. Berkley had already begun introducing AI-related exclusions in corporate policies in late 2025, citing the potential for unpredictable, multibillion-dollar losses from systemic AI failures, deepfake-enabled fraud, and high-profile AI misfires. The insurance industry is drawing a hard line—and many enterprises are standing on the wrong side of it without even realizing it.

Why It Matters for Your Coverage

The industry shift described above is not a technical footnote buried in fine print—it represents a fundamental change in what your insurance actually protects, with serious consequences for the policy coverage your organization depends on every day.

Here is a plain-English analogy: imagine you install a new type of electrical system throughout your building, and your property insurer quietly updates its policy language to exclude fires caused by that specific system. Your building has not changed, your risk is very real—but your protection has silently shrunk. That is essentially what is happening to businesses that deploy AI tools while relying on traditional insurance policies designed for a pre-AI world.

Traditional insurance products—cyber policies, Technology Errors & Omissions (E&O) coverage (insurance that protects technology companies from claims arising out of mistakes or failures in their professional services), product liability, and CGL—were designed before enterprise-scale AI deployment was common. They consistently fail to address AI-specific harms such as:

  • Hallucinations causing financial loss—when an AI system confidently outputs false information that a business acts on to its detriment
  • Algorithmic bias—when AI makes systematically unfair decisions affecting customers, employees, or loan applicants
  • IP infringement from AI outputs—when AI-generated content inadvertently reproduces copyrighted material
  • Bodily injury from autonomous AI decisions—such as a medical AI recommending the wrong treatment or an autonomous system making a dangerous operational call

This is what insurance professionals call “silent AI” exposure—risks that are neither explicitly covered nor explicitly excluded, leaving both enterprises and their insurers in legal limbo when a claim actually arrives. John Farley, Managing Director of Arthur J. Gallagher & Co.’s cyber practice, explains the problem directly: “There are a few carriers that are starting to adopt those exclusions. We’re just at the very beginning and we have to watch this very closely. If AI exposures become excluded, we’re going to have to figure out where this exposure should be covered.”

There is also a structural gap most businesses overlook entirely: vendor contracts for AI tools typically cap the vendor’s liability at the contract value. If an AI system you licensed causes $5 million in harm to a third party, your vendor may only be legally responsible for the $40,000 annual subscription fee you paid. The uncapped remainder falls on your organization—and standard E&O policies frequently do not cover it.

For a meaningful insurance comparison in today’s market, examining premium price alone is dangerously insufficient. You must scrutinize exclusion language closely. Shawn Ram, Chief Revenue Officer at cyber insurer Coalition, warns: “Clarity is essential, as relying on legacy wording or exclusions can lead to silent AI exposures.” Gallagher Re has similarly noted that a growing category of AI-native risks—including hallucinations, algorithmic bias, and model drift—falls entirely outside the scope of standard policies.

The market data underscores why getting this right matters financially. The global AI in insurance market was valued at $4.59 billion in 2022 and is projected to reach $79.86 billion by 2032, growing at a CAGR of 33.06%. Some industry forecasts put the figure even higher—at $246.3 billion by 2035—reflecting how deeply AI is embedding itself across underwriting, claims, and risk management functions. As AI becomes more central to business operations, liability exposures will only grow in scale and complexity.

For businesses focused on insurance savings, here is the counterintuitive reality: skimping on proper risk assessment and coverage today could mean facing catastrophic, uninsured losses tomorrow. The upfront investment in the right policy coverage is the smarter long-term financial decision by a wide margin.

The AI Angle

Building on those coverage gaps, there is an important paradox worth understanding: AI is simultaneously generating the liability risks that insurers are fleeing—and powering the new tools that will determine who gets covered, at what price, and under what conditions.

On the underwriting side, AI-powered platforms like Cytora and Planck are enabling insurers to run automated risk assessment on businesses applying for coverage in real time, scanning public data, operational signals, and digital footprints to surface AI-related exposures before a policy is ever written. In practical terms, your insurer may already have a clearer picture of your AI risk profile than you do—and they may be pricing or excluding accordingly.

On the claims management side, automated adjudication systems can instantly cross-reference a new claim against AI exclusion endorsements. Disputes that once took months to identify may now be flagged for denial within days of a claim filing—a speed advantage that benefits insurers, not policyholders caught off guard.

For enterprises seeking insurance savings through smart, well-matched coverage choices, understanding how these automated underwriting and claims management systems work is no longer optional. Working with brokers who specialize in AI liability and can navigate these platforms is increasingly a strategic business advantage.

What Should You Do? 3 Action Steps

1. Audit Your Current Policies for AI Exclusion Language

Pull your current CGL, cyber, and Technology E&O policies and search specifically for language referencing “artificial intelligence,” “machine learning,” “generative AI,” or “automated decision-making.” Pay particular attention to endorsements added in late 2025 or early 2026—this is when major carriers began inserting AI-specific exclusions in volume. Do not assume that your policy coverage has remained the same just because your renewal premium stayed flat. Run a side-by-side insurance comparison across your current policies to map exactly where AI-related exposures now fall outside your coverage boundaries. A licensed commercial insurance broker can help interpret the language and identify gaps you might miss.

2. Commission a Formal AI Risk Assessment for Your Organization

Before you can purchase appropriate coverage, you need a clear picture of your actual exposure. Document every AI tool your organization uses—both internally developed and third-party licensed—and map the potential harms each could cause to customers, employees, or the public. Review vendor contracts carefully to identify where liability caps leave your organization holding uncapped legal exposure. A formal risk assessment is not just best practice today—Gartner forecasts that by 2030, property and casualty insurers will require proof of strong AI risk controls as a precondition for explicit AI liability coverage, a shift projected to drive a 60% rise in enterprise AI governance frameworks. Building those controls now positions your organization for both legal protection and future insurability.

3. Ask Your Broker About Standalone AI Liability Coverage

Standard policies are moving toward exclusion, but a new generation of specialty AI liability products is emerging from the surplus lines market (specialized insurers that take on unusual or high-risk exposures that standard carriers decline). Ask your broker specifically about affirmative AI coverage—policies that explicitly define what AI risks are covered, rather than just listing what is excluded. Inquire about claims management procedures for AI-specific incidents such as hallucination-related financial harm or algorithmic bias disputes, and get all coverage confirmations in writing rather than relying on verbal assurances or legacy policy assumptions.

Frequently Asked Questions

Does my commercial general liability (CGL) insurance policy still cover AI-related lawsuits filed against my business in 2026?

It depends on whether your specific carrier has adopted the new ISO endorsements CG 40 47 or CG 40 48, introduced in early 2026, which allow insurers to explicitly exclude generative AI-related claims from standard CGL policies. Major carriers including AIG and W. R. Berkley began adding AI exclusions in late 2025 ahead of these endorsements. Do not assume your policy coverage is unchanged—review your current policy documents carefully, look for any endorsements added at your most recent renewal, and consult a licensed insurance agent who can give you a clear answer based on your specific insurer and policy language.

What is “silent AI” exposure and how does it create dangerous gaps in my existing business insurance policy coverage?

“Silent AI” exposure refers to AI-related risks that are neither explicitly covered nor explicitly excluded by your current policies, creating an unresolved gray area that typically gets decided in the insurer’s favor when a claim is filed. As Shawn Ram of Coalition explains, “relying on legacy wording or exclusions can lead to silent AI exposures.” The new ISO endorsements introduced in 2026 are converting many of these gray areas into confirmed exclusions. A careful insurance comparison across multiple carriers—specifically focused on which ones offer affirmative AI coverage versus which ones are simply adding exclusions—is the most effective way to identify and close these gaps before a claim forces the issue.

How much have AI-related lawsuits increased in the U.S. and what does that surge mean for my business insurance premium in 2026?

AI-related lawsuits in the U.S. grew by a documented 978.1% between 2020 and 2025, with cumulative filings exceeding 700 cases. Gartner projects more than 2,000 additional global “death by AI” legal claims by end of 2026. This litigation explosion is driving insurers to tighten underwriting standards, add exclusions, and in some cases exit the AI risk space entirely. For businesses that deploy AI tools, this environment means greater scrutiny during risk assessment at renewal time, potential premium increases for specialty AI coverage, and significant uninsured financial exposure if your current policies have been updated with exclusions you have not reviewed. A licensed insurance agent can advise on what this specifically means for your premium and coverage options.

What type of insurance policy actually covers AI hallucinations, algorithmic bias claims, and AI-generated IP infringement in 2026?

The coverage landscape for these specific AI harms is fragmented and fast-moving. Standard CGL, cyber, and Technology E&O policies are increasingly excluding these risks rather than building affirmative coverage for them. Specialty AI liability policies are emerging from the surplus lines market, and some technology-focused insurers are developing products that explicitly address hallucination-caused financial loss, bias-related discrimination claims, and IP infringement from AI-generated content. Your best path forward is working with a broker who specializes in technology liability, conducting a comprehensive policy coverage review across all your current lines, and explicitly asking about affirmative AI coverage products. Always verify how claims management works for AI-specific incidents before purchasing any new policy.

Will my business be required to prove AI safety controls to qualify for insurance coverage by 2030, and can that earn me insurance savings?

According to Gartner, yes—by 2030, property and casualty insurers are expected to require organizations to demonstrate strong AI risk controls as a formal condition for receiving explicit AI liability coverage, a shift projected to drive a 60% rise in enterprise AI governance controls across industries. This mirrors how cyber insurers began requiring multi-factor authentication and endpoint detection as coverage prerequisites starting in the early 2020s. Businesses that build robust AI risk frameworks and conduct regular risk assessment now will be better positioned for insurability in the future—and early movers may benefit from meaningful insurance savings as insurers reward proactive governance with more favorable underwriting terms and premiums. Consult a licensed insurance agent for guidance tailored to your organization’s specific AI use cases and risk profile.

Disclaimer: This article is for informational purposes only and does not constitute insurance advice. Always consult a licensed insurance agent for personalized guidance.

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