Robert Helfand

Robert Helfand

Carlton Fields

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Washington Weighs In On The Scope Of Insurance Regulators’ Authority

In January, we reported that California’s Supreme Court had embraced a problematic approach to the state’s Unfair Insurance Practices Act—one that allows the Commissioner of Insurance to create new statutory torts by...more

2/17/2017 - Auto Insurance Bodily Injury Car Accident Denial of Insurance Coverage IFCA Insurance Industry Insurance Regulations Lost Wages Medical Expenses PIP Coverage Regulatory Oversight Summary Judgment Unfair Competition Unfair or Deceptive Trade Practices Uninsured and Under-Insured Motorists

California’s High Court Gives Insurance Regulators New Tools To Broaden Authority

Nearly two years ago, a California appellate court invalidated a rule promulgated by the state’s Insurance Commissioner, on the ground that the regulator lacks authority to prohibit “deceptive acts or practices” which are not...more

1/30/2017 - Appeals CA Supreme Court Denial of Insurance Coverage Homeowner's Insurance Injunctive Relief Insurance Commissioners Insurance Industry Insurance Litigation Property Damage Property Insurance Replacement Costs UIPA Unfair Competition Law (UCL) Wildfires

Second Time Lucky: In Phantom Vehicle Cases, Ohio Insureds Can Now Corroborate Their Own Testimony

Hit-and-run drivers don’t always hit; some motorists recklessly cause accidents without making contact, then vanish from the scene. Victims in such cases can often obtain coverage under the uninsured motorist (UM) provisions...more

1/20/2017 - Auto Insurance Car Accident Denial of Insurance Coverage Evidence Hit-and-Run Insurance Industry Motor Vehicles Negligence Summary Judgment Uninsured and Under-Insured Motorists

Minnesota Discovers Limits To Its Regulator’s Power Over Insurers

In Minnesota, the Commissioner of the Department of Commerce regulates the insurance industry, and he has a statutory right to conduct investigations “related to the duties and responsibilities entrusted to” him. Last month,...more

1/16/2017 - ALJ Consumer Financial Products Financial Services Industry Insurance Industry Regulatory Oversight Request For Information Surveys

Too Soon! First Circuit Finds No Duty To Defend Before Suit Is Filed

Can something short of the filing of a complaint trigger an insurer’s duty to defend? It’s not an idle question. Uncertainty on this issue could produce an unintended breach, and, in some jurisdictions, breach of the duty to...more

12/30/2016 - Breach of Contract Consumer Protection Laws Demand Letter Denial of Insurance Coverage Diversity Jurisdiction Duty to Defend Homeowner's Insurance Insurance Industry Insurance Litigation Negligence Professional Liability Insurance

Ask the Public Adjustor: Covering Life with Wisdom*

Dear Public Adjustor: I’m often proud of my dad, like when he stood up to the PTA about The Catcher in the Rye. But lately he has me worried. He’s sacrificed an entire season’s corn crop to build a ballfield in the...more

12/1/2016 - Insurance Industry Property Insurance Public Adjusters

Title Bout: Second Circuit Limits Parties’ Control Over Construction Of Policies

Like other contracts, insurance policies are divided into parts, and most of the parts appear under headings or captions. A separate contract term (known as a “titles clause” or a “headings clause”) sometimes specifies that...more

11/18/2016 - Appeals Denial of Insurance Coverage Hurricane Sandy Insurance Industry Insurance Litigation Mass Transit Natural Disasters Policy Terms Property Damage Property Insurance Reinsurance Severe Weather Transit Authority Transportation Industry

Point of Interest: Sixth Circuit Complicates Sureties’ Duty Of “Good Faith”

A hefty body of law declares that “suretyship is not insurance,” and so that sureties are not subject to claims for the tort of insurance bad faith. E.g., Upper Pottsgrove Township v. Internat’l Fidelity Ins. Co., 976...more

11/14/2016 - Bonds Covenant of Good Faith and Fair Dealing Good Faith Insurance Industry Suretyships

Connecticut Workers’ Compensation Carriers May Pursue Justice

Workers’ compensation statutes impose liability without fault on the employers of men and women who are injured on the job. They also permit employers to recoup the costs they incur from any third parties who actually caused...more

10/24/2016 - Appeals Bodily Injury Construction Industry Employees Employer Liability Issues Equitable Subrogation Indemnity Insurance Insurance Industry Insurance Litigation Workers Compensation Awards Workers' Compensation Claim Workplace Injury

HUD Advocates Broad “Disparate Impact” Liability for P&C Insurers

In February 2013, the U.S. Department of Housing and Urban Development adopted a “Discriminatory Effects Rule,” which established liability under the Fair Housing Act for conduct that is otherwise lawful, but which has a...more

10/21/2016 - Affordable Housing Casualty Insurance Discrimination Disparate Impact Fair Housing Act (FHA) HUD Insurance Industry Property Insurance Race Discrimination Residential Real Estate Market

Postdiluvian Perils: Second Circuit Weighs Coverage For Losses Suffered After The Waters Recede

As this blog has reported, exclusions and limits for flood coverage have generally held up against the tide of claims arising from Superstorm Sandy. Now that the water is gone, however, new losses have been discovered, and...more

9/26/2016 - All-Risks Insurance Amtrak Demolition Flood Insurance Flooding Hurricane Sandy Insurance Industry Insurance Litigation Natural Disasters Policy Limits Property Damage Property Insurance Railways Severe Weather Summary Judgment Transportation Industry

Subcontractor Exception Torpedoes Insurers’ Defense To Faulty Workmanship Claim

As this blog has reported, a line of cases deciding coverage disputes over faulty workmanship runs against (or, at least, around) a basic rule for interpreting insurance policies. Under that rule, the scope of coverage is...more

9/19/2016 - Breach of Contract Commercial General Liability Policies Condominiums Construction Contracts Construction Defects Construction Industry Construction Project Faulty Workmanship Insurance Industry NJ Supreme Court Policy Exclusions Popular Property Damage Subcontractors

No Health Insurers Need Apply: Health Plan Can’t Recover Medical Costs From NY No-Fault Insurer

Under no-fault laws, automobile policies typically must cover the cost of certain medical services provided to policyholders who have been injured in covered accidents. New York’s insurance laws also permit those costs to be...more

7/25/2016 - Aetna Auto Insurance Car Accident Equitable Subrogation Health Insurance Insurance Industry Medical Expenses No-Fault Insurance

Ask the Public Adjustor: Covering Life with Wisdom*

I’ll come right out and admit it: I was a crasher at last night’s party. Though they helped me bluff my way in, every stitch of clothing I wore was borrowed, and the limo … it’s a long story, but let’s just say Uber. Then I...more

7/5/2016 - Commercial General Liability Policies Declaratory Judgments Denial of Insurance Coverage Drug Compounding Insurance Industry Insurance Litigation Nutritional Supplements Pharmaceutical Industry Prescription Drugs

Round Up The Usual And Customary Suspects: Insurers May Determine UCR Prices By Shopping At Retail Outlets

For more than a decade, medical providers have tried to limit the discretion of automobile insurers to pay less than the billed amount for services and equipment offered to injured insureds. Most of these efforts involve...more

6/20/2016 - Auto Insurance Bodily Injury Insurance Industry Medical Reimbursement Medical Supplies PA Supreme Court Putative Class Actions State Farm

Colorado Takes A Stand Against Unauthorized Settlements

The “notice-prejudice” rule gives a pass to policyholders who breach the notice or cooperation provisions of their policies, if the breach is found not to have prejudiced the insurer. Sometimes, the late notice does not...more

5/23/2016 - Breach of Contract CO Supreme Court Insurance Industry No-Voluntary-Payments Clause Notice Prejudice Rule Property Insurance Real Estate Market Settlement Travelers Property Casualty Co.

Ninth Circuit Leaves it to Policyholder to Pay Eddie Haskell’s Attorneys’ Fees

Moral hazard lurks around the edges of many disputes about liability coverage. Everyone agrees in principle that insurance shouldn’t help bad actors benefit from their wrongdoing, but parties often clash over where the...more

4/15/2016 - Actors Attorney's Fees Class Action Commercial General Liability Policies Compensatory Damages D&O Insurance Insurance Industry Motion Picture Industry Movies Punitive Damages Restitution SAG

Price Optimization Class Actions Produce First Rulings

In recent weeks, two courts ruled on motions to dismiss the first wave of class action lawsuits based on alleged price optimization of auto insurance rates. In both Stevenson v. Allstate Ins. Co., No. 15-cv-04788 (N.D. Cal....more

4/1/2016 - Allstate Auto Insurance Class Action Farmers Insurance Injury-in-Fact Insurance Industry Insurance Rates Price Optimization Primary Jurisdiction Doctrine

We Don’t Feel Your Pain: Massachusetts Limits Recoveries By Workers Compensation Insurers

When an injured employee sues a third party for negligence, the law usually permits her employer’s workers compensation insurer to share in the recovery. Last month, in DiCarlo v. Suffolk Construction Co., Nos. SJC-11854 and...more

3/14/2016 - Economic Loss Doctrine Insurance Industry MA Supreme Court Pain and Suffering Tort Workers Compensation Awards Workplace Injury

“‘Tis As Easy As Lying”: Pennsylvania Court Rescinds Policy of Corporate Giant

Claims, arguments and tactics that are familiar from coverage disputes with consumers are increasingly being used against carriers by large corporate insureds—often with the assistance of well-known plaintiffs’ firms. Once in...more

3/1/2016 - Commercial Insurance Policies Food Contamination Food Manufacturers Heinz Insurance Industry Rescission Void ab initio

The Gift of the Magistrate: An Insured Jeweler Gets a Jury for the Holidays

A jeweler was insured against the “physical loss” of its property, except when the property was sold under a “deferred payment” agreement, or when the loss was caused by a “dishonest act.” The jeweler regularly delivered...more

12/28/2015 - Denial of Insurance Coverage Insurance Industry Policy Exclusions Summary Judgment

No Contractor Is An Island: Florida Court Narrowly Applies “Your Work” Exclusion

When an insurer issues a Commercial General Liability policy to a contractor, the policy typically excludes coverage for the cost of repairing or replacing the contractor’s own defective work, but covers the cost of repairing...more

12/14/2015 - Commercial General Liability Policies Construction Defects Construction Industry Faulty Workmanship Insurance Industry

Can Insurers Sue for 'Reverse Bad Faith'? Allowing claims would restore strategic balance in policy disputes

The insurance relationship is contractual, but when policyholders claim insurers failed to honor their obligations, they typically invoke the tort of "bad faith." When courts try to explain this anomaly, they cite features of...more

12/8/2015 - Bad Faith Breach of Duty Covenant of Good Faith and Fair Dealing Insurance Industry

Wall-to-Wall Ads: Florida Court’s Broad Definition of “Advertisement” Expands Scope of Advertising Injury Coverage

“Advertising injury” can be tricky. In theory, the term applies to the type of harm that can be inflicted through advertising media—defamation, disparagement, violation of privacy rights or misappropriation of intellectual...more

11/16/2015 - Advertising Injury Commercial General Liability Policies Insurance Industry Insurance Litigation Trademark Infringement

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