Draft Coverage Position Memorandum

---
name: draft-coverage-position-memorandum-silica-mass-tort
task_id: insurance/draft-coverage-position-memorandum
description: Agents drafting a coverage position memorandum for a latent-disease mass tort claim should assess trigger, allocation, occurrence characterization, exclusions, notice, excess tender, and reservation-of-rights issues, and present the analysis in a memorandum organized by issue.
activates_for: [planner, solver, checker]
---

# Skill: Draft Coverage Position Memorandum for Latent Disease Mass Tort Claim

## 1. Subject-matter triage

- Confirm the governing policy period(s), insuring agreements, limits, exclusions, endorsements, reservation-of-rights correspondence, and the operative complaint before analyzing coverage.
- Identify whether the claim is a latent-disease mass tort, because the trigger, allocation, and occurrence analyses may differ from an acute-injury claim.
- If multiple insureds, policy years, layers, or claimant groups are in play, enumerate them before analysis and keep the coverage analysis separate for each relevant group.

## 2. Failure modes the skill is correcting

- The memo identifies trigger and allocation issues but fails to connect them to the actual tower of coverage across all implicated policy years.
- The memo treats occurrence characterization as a label rather than analyzing how the chosen theory changes per-occurrence and aggregate exposure.
- Exclusions are discussed abstractly without tying them to the pleaded facts, the policy wording, and the governing jurisdiction’s doctrine.
- Notice, late tender, and excess notice issues are not analyzed as distinct defenses with separate consequences.
- Reservation-of-rights defects are noted without assessing whether they undermine the insurer’s position, create estoppel risk, or support a bad-faith narrative.
- The memo recites conclusions without naming the controlling rule, case, statute, or policy language that supports each proposition.
- The memo reads as a summary instead of ending with concrete coverage positions and next-step recommendations.

## 3. Legal frameworks / domain conventions that apply

- Continuous-trigger analysis: for latent bodily-injury claims, evaluate whether coverage is triggered at exposure, progression, latency, manifestation, or continuously across those stages under the governing jurisdiction’s rule.
- Allocation framework: once triggered periods are identified, determine whether the jurisdiction uses pro rata, all sums, joint-and-several, time-on-risk, limits-on-risk, or another allocation method, and apply that rule consistently to the identified periods.
- Occurrence characterization: analyze whether the facts support a single occurrence, multiple occurrences, or exposure-by-exposure occurrences under the governing cause or effect test, then compare the coverage consequences under each theory.
- Limit structure: assess per-occurrence limits, aggregate limits, completed-operations or similar aggregates, deductible or self-insured retention provisions, and any exhaustion language that affects the coverage tower.
- Exclusions: evaluate potentially relevant exclusions using the actual policy wording and controlling doctrine, including expected-or-intended injury, known-loss, pollution, fungus/mold, workers’ compensation or employer-liability, asbestos or silica-specific endorsements if present, and any other disease-related limitations in the materials.
- Notice and cooperation: analyze whether the insured satisfied notice, suit, cooperation, and tender obligations, and apply the governing notice-prejudice rule if available.
- Excess-layer tender: if primary limits may be implicated, determine whether notice or tender to excess insurers is required now, when it should be made, and what consequences follow from delay.
- Reservation-of-rights and insurer conduct: review the claim-handling record for inconsistent positions, unsupported reservations, incomplete investigations, or misleading characterizations that may affect waiver, estoppel, or bad-faith exposure.
- Punitive or extra-contractual exposure: if the underlying demand or complaint includes punitive relief or other extraordinary damages, assess insurability under the governing law and policy language.
- Controlling-authority discipline: every coverage conclusion should be tied to the specific policy language and the controlling statute, regulation, or case law supporting the rule applied.

## 4. Analytical scaffolds

1. Coverage map: identify each implicated policy, insured, layer, attachment point, limit, and aggregate feature, then map the claimed loss against that structure.
2. Trigger: determine the earliest and latest potentially triggered periods and whether the jurisdiction recognizes continuous trigger for the alleged disease.
3. Allocation: apply the governing allocation rule to the triggered periods and explain how the result affects each year or layer.
4. Occurrence theory: test single-occurrence and multiple-occurrence characterizations under the governing cause-or-effect doctrine, then compare the resulting limit consequences.
5. Exclusions and defenses: analyze each potentially applicable exclusion, late notice defense, known-loss or expected-intended defense, and cooperation argument against the pleaded facts and correspondence.
6. Reservation-of-rights review: assess whether the letter identifies the correct defenses, uses accurate policy language, and preserves rights without overreaching or internal inconsistency.
7. Excess and exhaustion: determine whether primary coverage may be exhausted or exposed and whether excess notice or tender is required to protect the insured’s position.
8. Insurer-conduct assessment: evaluate whether claim-handling defects, investigation gaps, or reservation defects materially weaken the coverage denial or support settlement leverage.
9. Bottom-line position: state the coverage position clearly as to defense, indemnity, reservation, contribution, tender, and any litigation posture.
10. Action plan: convert the analysis into concrete next steps for coverage counsel and claims personnel.

## 5. Vertical / structural / temporal relationships

- Track the claim temporally from alleged exposure through injury progression, complaint filing, notice, reservation of rights, and any later correspondence or tender events.
- Separate the question of when injury occurred from when the claim was made, reported, or tendered; these are distinct coverage questions.
- If multiple policy years or layers are implicated, state the sequence in which coverage is reached and whether any later layer depends on exhaustion, allocation, or consent conditions.
- If the record contains multiple correspondents or shifting coverage positions, compare them chronologically and note any inconsistency that affects the insurer-conduct analysis.

## 6. Output structure conventions

- Write a memorandum organized by issue, not a narrative summary.
- Begin with a short executive summary stating the recommended coverage position and the main reasons.
- Include a coverage tower section that identifies the implicated policies, limits, and layer relationships.
- Include separate sections for trigger, allocation, occurrence characterization, exclusions/defenses, notice and late tender, excess-layer issues, and reservation-of-rights / insurer-conduct analysis.
- For each legal proposition, name the controlling authority or policy provision supporting it.
- When multiple policy years, claimants, or layers matter, address them in discrete subparts rather than blending them into a single conclusion.
- End with a Recommended Actions section that states the next steps in imperative form, identifies the responsible role, and ties each step to a timing anchor or milestone.
- Keep the tone practical and litigation-aware; the memo should state where the coverage position is strong, where it is vulnerable, and what evidence or correspondence would shift the analysis.