When Uncle Sam Comes Calling

Government regulators and agencies are vested with increasingly significant powers to investigate—and potentially prosecute—companies and individuals suspected of wrongdoing.

Such investigations are fraught with insurance implications, including, critically, whether and when such an investigation constitutes a claim under an insured’s professional liability policy, thereby triggering a carrier’s defense obligations.

Not surprisingly, the answer depends on the policy’s definition of “claim,” and also varies by jurisdiction. Yet, there are common considerations that often guide courts in making such determinations.

While some policies include governmental subpoenas or other investigations in their definition of “claim,” the most common definition is “a demand for monetary or non-monetary relief.”