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Understanding Duty to Defend and Duty to Indemnify
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The letter arrived from the insurer 3 weeks after the property management company had tendered a claim for defence. It confirmed that the insurer would provide legal counsel to defend the lawsuit filed against the company, but it also stated that the insurer reserved all rights under the policy, specifically citing the pollution exclusion as a potential ground for denying indemnity. The property management company, a mid-sized commercial operator managing 14 multi-unit residential buildings across a metropolitan area, had never received such a letter before and was uncertain what it meant for the claim or for the company's exposure.

The underlying lawsuit had been filed by a former tenant of one of the managed properties. The tenant alleged that prolonged exposure to mould in their rental unit had caused respiratory illness and other health effects. The statement of claim asserted that the property management company had been negligent in failing to address moisture infiltration and visible mould growth despite repeated complaints over a period of approximately 8 months. The tenant sought damages for personal injury, medical expenses, and loss of income.

When the property management company notified its commercial general liability insurer, the insurer acknowledged that the claim potentially engaged the policy's coverage for bodily injury arising from an occurrence. The insurer assigned defence counsel and confirmed it would fund the defence. However, the reservation of rights letter noted that the policy contained a pollution exclusion and that mould might constitute a pollutant or contaminant within the meaning of that exclusion. If the facts as ultimately determined established that the tenant's injuries resulted from exposure to a pollutant, the insurer might have no obligation to pay any judgment or settlement, regardless of having provided the defence.

The property management company now faced parallel uncertainties. On one track, the liability question: whether the company was legally responsible for the tenant's alleged injuries and, if so, in what amount. On a second track, the coverage question: whether the policy would respond to pay that liability or whether the pollution exclusion would apply. The insurer's defence counsel would handle the first question. The second question remained open, and the company was advised to consider retaining independent counsel to monitor and protect its coverage interests. The defence would proceed for the next 16 months under this arrangement, with the property management company cooperating fully while awaiting resolution of both the claim and the coverage dispute.

The Duty to Indemnify and the Reservation of Rights

What the Duty to Indemnify Is

The duty to indemnify is the insurer's obligation to pay damages that the insured becomes legally obligated to pay as a result of a covered occurrence. It is the second of the two duties, and it is the narrower one. While the duty to defend is triggered early in the process by the possibility of coverage, the duty to indemnify is determined late in the process based on the actual facts as they are ultimately established by the court or agreed to in a settlement.

This timing difference is the key to understanding the entire framework. The duty to defend looks forward, at what the claim might turn out to be based on the allegations in the pleadings. The duty to indemnify looks backward, at what the claim actually turned out to be based on the evidence and the findings of fact. A claim that looked like it could be covered when the pleadings were filed may turn out not to be covered once the facts are fully known. The duty to defend existed because the possibility was real. The duty to indemnify may not exist because the actuality falls outside the coverage.

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