The Reinsurance Relationship—How Special Is It?
December 2000
The legal duty of utmost good faith is an
ancient doctrine that continues to evolve. While some have written off the duty
in these modern times, most insurance and reinsurance professionals still adhere
to its precepts. This article examines this duty that is so fundamental to the
reinsurance relationship and how it has changed over the years.
by Larry
P. Schiffer
LeBoeuf,
Lamb, Greene & MacRae, L.L.P.
How different or special is the reinsurance relationship compared to other
business transactions? Does it rise to the level of trust normally associated
with a fiduciary relationship like that of a trustee and beneficiary? Are there
special rules of behavior that apply only to the reinsurance relationship?
Over the years, commentators and courts have described the reinsurance relationship
in various ways. Among the attributes that stand out when describing the reinsurance
relationship is the duty of utmost good faith or uberrimae fidei. This commentary will provide
a basic overview of the duty of utmost good faith and will briefly discuss how
it has evolved over the years.
What Is the Duty of Utmost Good Faith?
Fundamental to the reinsurance relationship is the duty of utmost good faith.
At its core, the duty requires the ceding insurer to disclose to the reinsurer
all material facts about the risk being reinsured. It is said that the duty
of utmost good faith is implicit in every reinsurance contract and that it supplements
all other express and implied contractual obligations. This means that the duty
of utmost good faith goes beyond the traditional duty of good faith and fair
dealing implicit in every contract.
Some commentators and courts have extended this duty beyond the disclosures
at the inception of the reinsurance relationship. The duty of utmost good faith
has been applied to the parties' conduct during the life of the reinsurance
contract, the underwriting and administration of ongoing business, the obligation
to give notice of a claim, and to the duty of the reinsurer to pay under the
reinsurance contract.
The duty also has been said to be reciprocal. In other words, the duty runs
to both the cedent and the reinsurer. This formulation of the duty of utmost
good faith goes to the nature of the reinsurance relationship after the contract
has been executed. It is more closely aligned with the notion that the reinsurance
relationship is a partnership, where each party to the contract shares in the
risk underwritten and reinsured.
Where Did the Duty of Utmost Good Faith Originate?
The duty of utmost good faith has its roots in marine insurance. Marine insurers
had little or no information about the risks that they were insuring because
the vessels often were in seas far away from the underwriters. To enable marine
insurance to develop, a doctrine arose that required the ship owner to disclose
every known material fact about the risk, without any inquiry being made by
the underwriter, so that the underwriter could proceed with confidence to insure
the risk.
Early on, the marine rule was applied equally to marine reinsurance, where
the reinsurer had even less information than the insurer. If the ceding company
failed to disclose a material fact, whether intentionally or innocently, the
reinsurance contract was voidable by the reinsurer. The rationale is that the
cedent is in the best position to know of any circumstances material to the
risk and, therefore, must disclose that information to the reinsurer. The duty,
therefore, requires the cedent to place the reinsurance underwriter in the same
position as the cedent and to give the reinsurance underwriter the same means
and opportunity of judging the risk.
The Duty of Utmost Good Faith in the Modern Era
Today, courts have extended the rule in marine insurance and reinsurance
cases to non-marine reinsurance. Most of the court cases involve claims of rescission
for misrepresentation or concealment of material information in the negotiation
of the reinsurance contract. The basic rule remains the same—the cedent must
disclose all material facts concerning the original risk, and the failure to
do so renders the reinsurance contract voidable.
Many courts have stated that the cedent's duty is an affirmative one and
that the reinsurer has no duty of inquiry. The burden is on the cedent to disclose
all facts that materially affect the risk. Some courts continue to hold the
reinsurance contract subject to avoidance even if the cedent innocently failed
to disclose a material fact. Other courts, however, have held that under state
law, a claim of fraud may not be founded on innocent misrepresentation and concealment
in the non-marine context.
What Is Material?
The big question in determining whether there has been a violation of the
duty of utmost good faith and whether the reinsurance contract should be rescinded
is whether the undisclosed information was material. Some courts have stated
that a fact is material if it would have prevented the reinsurer from entering
into the reinsurance contract or would have prompted the reinsurer to change
the terms of the contract before execution. The test used by some courts is
whether a reasonable cedent would have believed the fact to be material to the
reinsurer at the time of contracting. This is important because, under this
formulation, whether the reinsurer claims the fact was material is irrelevant.
It is only what a reasonable cedent believed the reinsurer would consider material
that counts.
Some of the facts found material by the courts have been:
- The failure to disclose the cedent's insolvent status
- The undisclosed offer to the underlying insured to extend coverage or
provide an unusual policy term
- The failure to disclose recommendations made in a property survey report
In each of these cases, the courts held that these undisclosed facts were
known by the cedent to be material to the reinsurer and that disclosure of the
facts would have either prevented the reinsurer from entering into the reinsurance
contract or would have prompted the reinsurer to change the terms or request
a higher reinsurance premium. If, however, the cedent had no reason to believe
that the reinsurer would consider a fact material to the nature of the risk,
then there is no violation of the duty, and the contract will not be avoided.
The Duty of Utmost Good Faith Post-Contract
Although the duty of utmost good faith originally concerned the information
available about the risk at the creation of the reinsurance contract, the duty
has been applied to span the entire relationship between the cedent and the
reinsurer. Because the cedent remains closest to the risks as the underlying
business is written and is most familiar with the underlying claims as they
are adjusted, many commentators and courts have stated that the cedent must
continue to exercise utmost good faith in its ongoing dealings with the reinsurer.
Thus, claims of breach of the duty of utmost good faith have been made concerning
a cedent's handling of underlying losses, its attempts to settle those losses
through industry mechanisms, and the timing of notice of these efforts to its
reinsurers.
The theory behind this expansion has been articulated as an economic one.
The duty of utmost good faith allows the reinsurer to avoid having to duplicate
the claims, actuarial, and underwriting staffs of the cedent. Under this theory,
the continuing duty of the cedent to keep the reinsurer apprised of all information
material to the risk, including claims and administrative information, is necessary
for the reinsurance market to function efficiently.
Conclusion
Although an ancient doctrine, the duty of utmost good faith continues to
evolve. While some commentators and courts have written off the duty in these
modern, technological times, most insurance and reinsurance professionals still
adhere to its precepts. The lesson taken from the court decisions analyzing
the duty of utmost good faith is simple—cedents and reinsurers should continue
to act as partners by keeping each other informed and by disclosing all relevant
information material to the relationship. If the lines of communication remain
open, fewer disputes will occur.
Opinions expressed in Expert Commentary articles are those of the author and are
not necessarily held by the author’s employer or IRMI. This article does not purport
to provide legal, accounting, or other professional advice or opinion. If such advice
is needed, consult with your attorney, accountant, or other qualified adviser.