One of the perennial D&O insurance issues is the question of coverage for investigative costs. Several recent cases have taken a close look at these recurring issues.  In the following guest post, my good friend Kara Altenbaumer-Price (pictured) examines recent developments in this area and the important factors that can affect the analysis. Kara is the Director of Complex Claims & Consulting for insurance broker USI.  


Many thanks to Kara for her willingness to publish her article here. I welcome guest posts from responsible commentators on topics relevant to this blog. Any readers who are interested in publishing a guest post on this site are encouraged to contact me directly.



The potentially high cost of internal investigations has increased demand for insurance coverage. This article explores how investigation costs may, at least in part, not be covered by traditional directors and officers (D&O) policies, and options that may provide greater protection.



Traditional D&O insurance policies afford some level of investigations coverage.  As with any insurance arrangement, however, the parties must carefully assess whether the risk being covered is the same risk that they seek to have covered.  Thus, while companies may believe they have purchased so-called “investigations coverage,” these policies are often seriously lacking in comparison to the number, size, complexity, and cost of modern investigations.  These limitations can be so consequential that the insured’s expectations for the policy will not be substantially met.  This article addresses a number of the gaps between common expectations and commonly available policies and suggests how companies and individuals can more accurately locate the extent of coverage that they desire.



Before discussing some of the pertinent aspects of investigation insurance products, we turn to a   2010 U.S. federal court ruling that illustrates some of the issues and potentially costly gaps in investigations coverage that can arise for any company, public or private. The case addressed a not atypical sequence of investigation-related events that gave rise to significant costs for a public company. Office Depot found itself the subject of an inquiry by the U.S. Securities and Exchange Commission (SEC) related to potential violations of Regulation FD (Fair Disclosure). This regulation requires that public companies release the same information — at the same time — to the public as they do to investors and securities professionals. Office Depot chose to cooperate with the SEC by voluntarily providing requested documents and making its officers and employees available for sworn testimony without the issuance of subpoenas. About the same time, an internal whistleblower raised issues related to Office Depot’s accounting. The Company self-reported the allegations to the SEC, which expanded its investigation. Office Depot’s audit committee also began an internal investigation, which led to a financial restatement



The SEC later issued a Formal Order of Investigation against the Company, which included “allegations of wrongful conduct generally attributable to [Office Depot’s] officers and directors” but did not identify any individuals by name. The Formal Order led to subpoenas issued to the Company and a group of its current and former officers and directors, some of whom had previously voluntarily testified in the informal investigation. Two years later, the SEC reached a settlement with the Company and issued Wells Notices informing several Company officers of charges the SEC planned to bring against them.



Over the course of the SEC and internal investigations, Office Depot incurred costs of over U.S. $20 million and turned to its D&O carriers for reimbursement. The primary carrier acknowledged coverage for approximately U.S. $1 million in costs incurred by officers and directors in responding to SEC subpoenas and Wells notices and costs incurred in several related shareholder securities lawsuits, but denied coverage for the Company’s voluntary response to the SEC or the internal investigation. The company then sued its primary insurance carrier; the excess carrier intervened into the suit. The issue in the litigation was whether the costs of voluntarily responding to the SEC and conducting an internal investigation related to the same issues were covered by the policy. The court held that “the disputed investigatory costs do not fall within the … policy’s definition of loss ‘arising from’ a covered ‘Securities Claim’ made against [Office Depot], or a covered ‘Claim’ made against one of its officers, directors or employees.



First, the court held that the informal SEC investigation and the company’s internal investigation did not meet the policy’s definition of “securities claim.” Specifically, the policy language exempted an “administrative or regulatory proceeding against or investigation of” the Company unless “such proceeding is also commenced and continuously maintained against an Insured Person.” The court determined that the use of the term “proceeding” and the absence of the term “investigation” in the carve-back language for proceedings involving both the Company and insured individuals meant that coverage did not include investigations, whether formal or informal. Second, the court held that while the policy did provide coverage for investigations of insured individuals, it did not provide such coverage unless the individuals were “‘identified in writing’ by the investigating authority as a person against whom a civil, criminal, administrative or regulatory proceeding ‘may be commenced’ or in case of an investigation by the SEC … after service of a subpoena upon such Insured Person.” The court agreed with the carriers’ assertion that “[b]ecause the SEC informal and formal investigations began well before either one of these discrete signal points, …the investigations do not fall within the Policy’s definition of a ‘Claim.’” It did not matter that three individuals ultimately received Wells Notices. Third, the Company had argued that “relation back” language in the policy served to pull pre-claim costs into coverage. The language at issue was a common provision in the policy providing that when an insured notifies the carrier of facts that could later give rise to a claim and a claim does indeed later arise, the claim relates back to time of the original “notice of circumstances.” The court held that the relation back language in the notice of circumstances portion of the policy related only to determining when the claim was made for determining the applicable policy period for a “claims made” policy. Office Depot had a substantial retention — or deductible — on its primary D&O policy, effectively resulting in no loss transfer in this case.



The implications for D&O insurance coverage related to investigations are significant. In order to ensure the maximum coverage possible for costs associated with investigations, several portions of a policy must be addressed. In considering these changes, it is also important to remember that D&O insurance policies are not off-the-shelf products. Instead, they differ widely from carrier to carrier and insured to insured and can — and should — be tailored to meet a given company’s needs.



Definition of claim


Generally, a D&O policy does not provide coverage until a “Claim” has been made against a company. More importantly, costs incurred before a formal “Claim” has occurred under the policy do not apply toward a company’s self-insured retention, nor do they get retroactively picked up later by the policy. What constitutes a claim is a defined term under each D&O policy and almost universally includes lawsuits, written demands for monetary relief, and administrative proceedings in court or before an administrative body. Policies differ widely, however, in how they cover — or not — government investigations. Many provide coverage upon the receipt of a subpoena, a Wells Notice, or a target letter. As was discussed above, however, these triggers imply a formal investigation and can occur very far into an investigation.



Indeed, significant legal costs can be spent in trying to prevent an informal investigation from becoming formal, and policy language varies widely in how it covers — or doesn’t cover — these costs. This can be avoided by ensuring that the definition of “Claim” in your policy incorporates government investigations and, if possible, informal investigations. In 2010, at least one major insurance company released a new D&O policy form that provided for coverage of informal investigations of insured individuals by updating its public company D&O form to include coverage for certain “preclaim” inquiries. The policy defines “pre-claim inquiry” as a “verifiable request for an Insured Person … to appear at a meeting or interview or produce documents that, in either case, concerns the business of that Organization or that Insured Person’s insured capacities.” The request must come from a government enforcement body, or the entity or its board must request that individual to appear in relation to an inquiry into or investigation of the entity by an enforcement body. Interestingly, the policy goes on to define “pre-claim inquiry costs” independently of “defense costs” so as to exclude the costs of responding to document requests if the documents are in the control of the company, meaning that coverage for document production is only provided if those documents are in the control of an individual insured, which very few documents will be. By specifically including coverage for the costs associated with attending a request for an interview by an enforcement body, the policy seems to be focused only on the costs of lawyers’ preparation time. The policy, in its unendorsed form, excludes coverage for all   investigations — formal or informal — of the company unless those investigations are also maintained against insured persons.



A number of other carriers responded to this insurer’s new policy. For example, one released an endorsement that provides coverage for individuals incurred in responding to “a request by an Enforcement Unit for an Insured Person to appear for an interview or meeting with respect to the Insured Capacity of such Insured Person or an Organization’s business activities.” Like the policy discussed earlier, this insurer’s endorsement also includes scenarios in which the company requests that an insured individual appear for an interview or meeting in relation to a government inquiry. The endorsement specifically excludes coverage for costs associated with a “document production demand or discovery request.” This exclusion is notable since the cost of producing potentially millions of pages of documents in a large investigation can be substantial.



Co-defendant language


A number of D&O policies that provide investigations coverage either restrict coverage to insured individuals or require individuals to be co-defendants before a company’s costs in defending itself could be covered. The trigger in these policies is usually when an insured individual is named in a Wells Notice or target letter or, in some cases, when an insured individual receives a subpoena. In addition to the late coverage trigger discussed above, this language presents an additional problem in that it does not match up with the reality of how investigations are pursued. It is rare for a government investigation to name an individual up front. Instead, if anyone is named in the early stages, it is the entity itself. Even when it is clear to the entity’s lawyers and forensic accountants that one or more individuals are the targets of an investigation, the D&O policy is not triggered unless the individuals are named.



Because individuals do not have the same incentive to cooperate that entities do, individuals are often named only as an investigation is nearing its end. As a result, if such language is included, as is demonstrated by the Office Depot case above, little to no coverage may be afforded even if “investigations coverage” was purchased.



Definition of loss


Presuming that a policy does provide investigations coverage, a policy will still only cover those costs that are defined as “loss” under the policy. Loss will almost universally be defined to include costs associated with defending any Claim under the policy. While “defense costs” is often undefined, some policies do explicitly define it. In order to ensure broad investigations coverage, it is important to consider all the costs of defending an investigation, not just legal fees. Significant fees can be spent on forensic accountants, document production vendors, and other specialists in responding to the often very in-depth investigations of a government regulator. It is important to consider all of these costs when defining “loss” and “defense costs” under a D&O policy and, where possible, explicitly define the costs to include non-lawyer defense costs.



Conduct exclusions and adjudication language


D&O policies typically contain certain conduct exclusions that prohibit coverage in cases of certain intentional conduct, such as fraud, criminal conduct, or intentional violations of the law. Mere allegations of such conduct, however, do not prevent coverage. Instead, each policy should contain language that defines when these conduct exclusions are triggered. For example, policies may state that a guilty plea triggers the conduct exclusion, while others may state that a determination by a court that the conduct occurred triggers the exclusion.



In the context of investigations coverage, the broadest trigger is “final adjudication in the underlying action,” meaning that the conduct exclusion will not be triggered until a court

involved in the enforcement action at issue makes a final adjudication of wrongdoing. This prevents a carrier from bringing a declaratory coverage action in another court in order to cut off defense costs. Also, because the vast majority of government investigations are settled without court involvement or are filed in a court simultaneously with an agreed settlement, in many cases the conduct exclusions will never be triggered. Two changes in SEC enforcement methods may have particular impact on these conduct exclusions.



First, the SEC is considering releasing more detailed findings of its investigations. Currently, when an investigation is settled, often only a brief release is issued stating the statutory violations and a bare bones recitation of the factual allegations. Releasing more detailed factual findings could lead to coverage issues as additional facts are laid out that could implicate conduct exclusions. Second, changes made in 2010 to the SEC’s Enforcement Manual designed to spur cooperation provide leniency — or in some cases, immunity — to individuals who provide valuable evidence to the SEC. It is likely that more individuals will “confess” to the SEC in order to obtain these benefits. This could create coverage issues in policies containing certain conduct exclusions. Additionally, cooperation by one individual implies that other individuals will be negatively impacted by that individual’s testimony. As more individuals cooperate and as others become the “target” of that cooperation, the need for separate legal representation rises, also causing an increase in defense costs.



Civil fines and penalties coverage


Historically, the insurance market has considered civil fines and penalties to be uninsurable for public policy reasons. Recently, however, the demand for investigations coverage and increased competition among D&O carriers has led some carriers to offer civil fines and penalties coverage. While it is still unclear when and how much these policies will pay out in the event of claims, it is important to understand that such coverage is now available.



When evaluating such coverage, however, companies should read the policy terms very closely to understand exactly what is being offered for the price. Endorsements may appear to be broad, but may be limited by the statutes under which coverage is provided. For example, a number of carriers are now offering coverage for a certain amount of civil fines and penalties assessed under the U.S. Foreign Corrupt Practices Act (FCPA).



However, the language of a given endorsement, when read closely, may reveal that it provides coverage only to insured individuals and only for civil penalties assessed by the U.S. Department of Justice (DOJ). Another important consideration in fines and penalties  coverage is the actual language of the FCPA and similar statutes, as well as the reality of settlements and whether such insurance could be tapped at all under the terms of a government settlement. The statute states that whenever a civil fine or penalty “is imposed … upon any officer, director, employee, agent, or stockholder of an issuer, such fine may not be paid, directly or indirectly, by such issuer.” Also, it is now standard language in SEC settlement documents that individuals stipulate that their companies will not pay their fines, including any payments from insurance proceeds. Arguably, this issue may be solved by assigning a portion of the D&O premium to the fines and penalties coverage and requiring that premium amount to be paid by individual officers and directors.



Separate investigations policies


In addition to updating its public company D&O form, a major insurer has also released a new stand-alone policy designed to cover investigation costs. The policy addresses one of the primary issues present in expanding investigations coverage — the eroding of insurance limits for use by officers and directors when the company’s investigations costs are transferred to insurance. The policy provides up to $25 million in coverage for investigations by the SEC, DOJ, and similar authorities into violations of the Securities Act of 1933 and the Securities Exchange Act of 1934 or any of the acts’ associated rules and regulations. It covers both formal and informal government investigations and can be endorsed to provide up to $5 million coverage for investigations related to violations of the FCPA. In addition to investigation costs, the policy also covers insurable settlements other than disgorgement, fines, penalties, or remediation costs. A separate policy gives companies the option to look only to an investigations policy for coverage and choose not to seek coverage under their D&O policies, even if some coverage is provided.



A major insurance broker also announced the creation of a policy that covers legal, accounting, auditing and consulting costs associated with FCPA investigations. Although the insurance carrier underwriting the FCPA Corporate Response form was not publicly named, the form is designed to cover both FCPA and UK Bribery Act investigation costs incurred by both insured individuals and the company. Although it is not clear from the literature released on the policy, it appears to cover informal investigation costs, at least to some degree. Similar policy releases from other insurance carriers are likely as corporate demand increases.



When considering the options for transferring a portion of the risk associated with investigations to insurance, companies must consider the broader implications of this decision as well. When an insurance policy is expanded to cover investigation costs, that may, in practice, offer better protection for the company than to individual officers and directors. This can arise if most or all of the policy’s coverage is consumed by the company. This can leave little or no money for insured individuals to defend themselves in the investigation or in any follow-on civil litigation from shareholders. When assessing whether to purchase investigations coverage, companies may also consider whether overall limits should be increased, or whether additional limits should be set aside for insured individuals only under the “Side A” portion of the D&O policy reserved for losses incurred by individuals that the company cannot indemnify due to insolvency or law, to ensure adequate limits remain available.