Case Citation
Legal Case Name

Melissa Anderson v. Thomas Aul Case Brief

Wisconsin Supreme Court2015Docket #2636858
361 Wis. 2d 63 2015 WI 19 862 N.W.2d 304 2015 Wisc. LEXIS 22 Insurance Law Contracts Professional Responsibility

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Case Brief Summary & Legal Analysis

General Brief
3 min read

tl;dr: An attorney failed to report a malpractice claim within his “claims-made-and-reported” policy period. The court held that state notice-prejudice statutes do not apply to this type of policy, meaning the insurer could deny coverage without showing it was prejudiced by the late reporting.

Legal Significance: Establishes that a “claims-made-and-reported” policy’s reporting requirement is a fundamental term defining the scope of coverage, not a mere notice provision subject to statutory notice-prejudice rules. This protects the viability of this specific, limited-risk insurance product.

Melissa Anderson v. Thomas Aul Law School Study Guide

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Case Facts & Court Holding

Key Facts & Case Background

Attorney Thomas Aul was insured by Wisconsin Lawyers Mutual Insurance Company (WILMIC) under a “claims-made-and-reported” professional liability policy for the period of April 1, 2009, to April 1, 2010. The policy explicitly and repeatedly stated that it covered only those claims “first made against the insured and reported to the [insurance company] during the policy period.” In December 2009, Melissa and Kenneth Anderson, through their new counsel, sent Aul a letter demanding $117,125 for alleged legal malpractice, constituting a “claim” under the policy’s terms. Aul received this claim well within the policy period. However, Aul did not report the claim to WILMIC until March 2011, nearly a year after the policy had expired. When the Andersons later sued Aul, WILMIC intervened, seeking a declaratory judgment that it had no duty to provide coverage because the claim was not reported during the policy period as required by the contract. The Andersons argued that Wisconsin’s notice-prejudice statutes, Wis. Stat. §§ 631.81(1) and 632.26(2), precluded WILMIC from denying coverage without showing it was prejudiced by the late notice.

Court Holding & Legal Precedent

Issue: Do Wisconsin’s notice-prejudice statutes, which generally bar an insurer from denying coverage for late notice without a showing of prejudice, apply to the reporting requirement of a “claims-made-and-reported” insurance policy?

No. The court reversed the court of appeals, holding that the notice-prejudice Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat n

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Legal Issue

Do Wisconsin’s notice-prejudice statutes, which generally bar an insurer from denying coverage for late notice without a showing of prejudice, apply to the reporting requirement of a “claims-made-and-reported” insurance policy?

Conclusion

This case solidifies the distinction between notice provisions and coverage-defining reporting requirements, Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim

Legal Rule

Wisconsin's notice-prejudice statutes, Wis. Stat. §§ 631.81(1) and 632.26(2), do not apply Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irur

Legal Analysis

The Wisconsin Supreme Court concluded that the reporting requirement in a "claims-made-and-reported" Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariatur. Excepteur sint occaecat cupidatat non proident, sunt in culpa qui officia deserunt mollit anim id est laborum. Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud

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Flash Summary

  • Wisconsin’s notice-prejudice statutes do not apply to the reporting requirement of
Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Ut enim ad minim veniam, quis nostrud exercitation ullamco laboris nisi ut aliquip ex ea commodo consequat. Duis aute irure dolor in reprehenderit in voluptate velit esse cillum dolore eu fugiat nulla pariat

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