Business Torts Insurance

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Retail Hospitality Newsletter - Late Fall 2016

Sudden cardiac arrest (“SCA”) is the largest cause of natural death in the United Statesand is responsible for approximately half of all heart disease deaths. SCA, however, is not a “heart attack” (i.e. an artery blockage)...more

A Liar and A Cheat? 3 Ways to Pay...

Seyfarth Synopsis: Insurer gets to pick its remedy when hospital engages in dishonest billing and illegal kickbacks…to the tune of $41 million. Judge Lynn Hughes of the U.S. District Court for the Southern District of...more

Delaware Superior Court Limits Fraud Exclusion

This is an important decision because it limits the use of the typical fraud exclusion in a D&O policy to avoid liability to the insured. The insured David Murdoch was found to have breached his fiduciary duty to Dole Foods...more

The Ghost of Systems Past: “Big Data” Suits Loom, But Old Data Issues Remain Unresolved

2017 could be big for litigation over “Big Data” applications in insurance. This past year saw the filing of several “price optimization” class actions, and claims against a fraud detection tool, similar to the ones used by...more

Court Tosses Time-Barred Rico Claims Alleging Captive Reinsurance Kickback Scheme

Plaintiffs asserted class claims for RICO violations based on allegations that Bank of America referred borrowers to private mortgage insurance providers in exchange for kickbacks, funneled through a captive reinsurance...more

U.S. Supreme Court Rules That Seal Violations Do Not Require Dismissal of Qui Tam False Claims Act Suits

On Tuesday, the Supreme Court issued an anxiously anticipated False Claims Act (“FCA”) decision in State Farm Fire & Casualty Co. v. United States ex rel. Rigsby, holding that a violation of the statute’s seal requirement...more

Supreme Court Rejects Mandatory Dismissal for an FCA Seal Breach

The Supreme Court held that a relator’s breach of the seal in a qui tam case does not require mandatory dismissal of the complaint, but the Court declined to articulate what factors are appropriate to consider in determining...more

Supreme Court Holds That Violations of the False Claims Act’s Seal Requirements Do Not Require Automatic Dismissal

On December 6, 2016, the Supreme Court of the United States ruled unanimously in State Farm Fire and Casualty Co. v. United States ex rel. Rigsby that violations of the False Claims Act’s (FCA) seal requirement do not require...more

Ohio Appeals Court Dents Plaintiffs’ Class Certification Motion

Four independent auto body shops sued Progressive Casualty Insurance Company in state court in Cleveland. Their gripe? They claimed that they repaired Progressive-covered vehicles but that Progressive tortiously interfered...more

The Illinois Supreme Court Opens Door to Claims Against Government Entities for Flood Losses

Floods lead to costly claims for insurance companies. Unfortunately, subrogated insurers are frequently precluded from pursuing governmental entities that cause flooding because they enjoy immunity from tort claims. So, for...more

Product Contamination: Strong Underwriting is Key

In 2011, the Food Safety Modernization Act, regarded by many as a major reform of the food safety provisions of the Federal Food, Drug and Cosmetic Act, significantly expanded the powers of the U.S. Food and Drug...more

Litigation Alert: The Fifth Circuit Limits Coverage under the Computer Fraud Provision of Insurance Policies

Last week, the U.S. Court of Appeals for the Fifth Circuit narrowed the conduct covered under an insurance policy’s computer fraud provision by vacating the judgment in favor of the insured, Apache Corp., and rendering...more

AXA Prevails at First Post-Jones v. Harris Excessive Fee Trial

In its 2010 opinion in Jones v. Harris, L.P., the United States Supreme Court embraced the so-called Gartenberg standard for assessing an investment adviser’s fiduciary liability for excessive mutual fund fees under Section...more

Arizona Court of Appeals Reverses $1 Million Award of Punitive Damages in Insurance Bad Faith Case for Alleged “Institutional Bad...

In Sobieski v. Am. Standard Ins. Co. of Wisconsin, 2016 WL 5436588 (Ariz.App. Sept. 29, 2016), despite upholding a bad faith judgment for an insurer conducting an unreasonable investigation and denying a claim, the Arizona...more

What Standard Governs the Dismissal of a Relator's Claim for Violation of the False Claims Act's Seal Requirement in an Action...

In the aftermath of the destruction caused by Hurricane Katrina in 2005, Cori and Kerri Rigsby accused State Farm Fire and Casualty Company of falsely misclassifying wind damage as flood damage, among other misdeeds, leaving...more

In the Tenth Circuit, Colorado’s On-Going Debate over the “Fairly Debatable” Defense

A recent Tenth Circuit Court of Appeals decision, The Home Loan Investment Co. v. St. Paul Mercury Ins. Co., 827 F.3d 1256 (10th Cir. 2016), demonstrates that, although multiple jurisdictions may recognize similar defenses...more

NEW UPDATE: Is Your Workers’ Compensation Program Unlawful?

In two previous posts, on April 19, 2016 and June 21, 2016, we reported on the EquityComp workers’ compensation program offered by Berkshire Hathaway subsidiaries Applied Underwriters (Applied) and California Insurance...more

UnitedHealth Plan Holders Win Class Certification in ERISA Lawsuit

The District Court for the Northern District of California recently granted certain members of UnitedHealth health plans class certification in their suit alleging improper denial of benefits. Plaintiffs in the putative...more

5 Wishes for Securities Litigation Defense: Early Damages Analysis and Discovery

The fifth of my “5 Wishes for Securities Litigation Defense” (April 30, 2016 post) is to move securities class action damages expert reports and discovery ahead of fact discovery. This simple change would allow the...more

"Assuming" the Obvious: Exclusion for “Assumption of Liability in a Contract” Does Not Apply to Breach of Professional Services

In what it described as a case of first impression, the Northern District of California ruled that a professional liability policy that excluded the insured’s “assumption of liability obligations in a contract or agreement”...more

Collateral lies: The lie is dishonest but the claim is not

The Supreme Court rules that a collateral lie embellishing a valid claim does not amount to a fraudulent claim. Versloot Dredging BV and another (Appellants) v HDI Gerling Industrie Versicherung AG and others [2016] UKSC...more

California Supreme Court Clarifies Constitutional Limits on Punitive Damages

In Brandt v. Superior Court, the California Supreme Court held that when a plaintiff proves that an insurance company withheld policy benefits in bad faith, attorneys' fees reasonably incurred to compel payment of the...more

5 Wishes for Securities Litigation Defense: Greater Director Involvement in Securities Litigation Defense and D&O Insurance

One of my “5 Wishes for Securities Litigation Defense” (April 30, 2016 post) is greater involvement by boards of directors in decisions concerning D&O insurance and the defense of securities litigation, including...more

D&O Insurance—Issues to Consider Before a Claim Arises

In Depth - Directors and officers (D&O) liability insurance remains a vital issue for companies and their directors and officers as potential sources of liability continue to evolve. More securities lawsuits were filed...more

South Carolina District Court Finds There Is No Separate Cause Of Action For Apportionment Under South Carolina’s Contribution...

Plaintiff Companion Property and Casualty Insurance Company (“Companion”) participated in a fronted insurance program with Redwood and Freestone. Reinsurance collateral trusts were established for Companion’s benefit and...more

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