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Supreme Court Limits ERISA Reimbursement Rights: Insurers Will Need to be Diligent

On January 20, 2016, the United States Supreme Court held that an ERISA plan could not satisfy its reimbursement rights from a participant’s general assets. ERISA plans’ reimbursement rights are now so limited that...more

Aetna vs. BASM: Pigs Get Fat and Hogs Get Slaughtered

On April 13, 2016, a jury in Santa Clara, California awarded Aetna, Inc. $37.4 million from Bay Area Surgical Management, LLC (“BASM”), six of its affiliated surgery centers and its three principals. Aetna had accused the...more

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

Important Court Decision For No-Fault Insurers -- Federal Court Rejects Argument To Limit Insurers’ Right To Seek Judicial Relief...

We are pleased to inform you of a very favorable recent caselaw development in the no-fault insurance area, in which our firm played a significant role. Specifically, on March 24, 2016, in the case of Liberty Mutual Fire...more

Florida’s Second District Upholds Policy Requirement Regarding Payment Of Subsurface Repairs In Sinkhole Claim

In Citizens Prop. Ins. Corp. v. Amat, 2016 Fla. App. LEXIS 2412 (Fla. Dist. Ct. App. 2d Dist. Feb. 19, 2016), the Second District remanded a final judgment awarding damages in a sinkhole claim for subsurface repairs without...more

Supreme Court Protects Health Insurers From Onerous State Claims Reporting

On Tuesday, March 1, 2016, the Supreme Court issued a ruling in Gobeille v. Liberty Mutual, finding that states do not have the authority to require self-insured plans (like Liberty Mutual Insurance Co.) to collect and report...more

Property Insurance Diminution in Value Class Action: Georgia Federal Court Certifies Class

One of the issues I’ve been covering on this blog is a series of putative class actions in Georgia arising out of a Georgia Supreme Court decision in 2012, which held that diminution in value of real property is potentially...more

Insurance Insight - Broad duty to defend applied despite late notice

Even when an insurer receives very belated notice of a suit against its insured, it can face harsh consequences if it does not take action to provide a defense. ...more

Supreme Court of Missouri Reverses Trial Court Order Setting Aside Default Judgment Against Insurance Company

Bate v. Greenwich Insurance Company 464 S.W.3d 515 (Mo.banc June 16, 2015) The Supreme Court of Missouri, en banc, reversed a trial court order setting aside a default judgment against an insurer, based on improper...more

Wisconsin Supreme Court Reminds That Duty to Defend is Broader Than Duty to Indemnify

A liability insurance policy generally imposes two duties on the insurer: (1) a duty to indemnify the insured against claims that are covered by the policy, up to the policy limits; and (2) a duty to defend the insured...more

Defence & Indemnity - February 2016: A passenger who grabs the steering wheel is involved in the “use” or “operation” of the...

Felix v. Insurance Corporation of British Columbia, 2015 BCCA 394, per Bennett J., Saunders J. and Stromberg-Stein J. - I. FACTS AND ISSUES - The plaintiff (“Felix”) was driving her car with her intoxicated...more

Defence & Indemnity - February 2016: Insurance Issues: Portage LaPrairie Mutual Insurance Company v. Sabean, 2015 NSCA 53, per...

Future CPP benefits fall under the definition of “any policy of insurance” and are therefore deductible from amounts payable by SEF 44 insurers - Portage LaPrairie Mutual Insurance Company v. Sabean, 2015 NSCA 53, per...more

Insurance Coverage – Equitable Subrogation – Doctrine of Superior Equities

Amco Insurance Company, et al. v All Solutions Insurance Agency, LLC - Court of Appeal, Fifth Appellate District (February 8, 2016) - Equitable subrogation is most commonly employed when an insurer pays its...more

Claims Bar Date Creates Trap for Unwary in Reliance Insurance Company Liquidation

The Commonwealth Court of Pennsylvania has established March 31, 2016, as the Claims Bar Date in the Reliance Insurance Company Liquidation. Policyholders and claimants may think that if they file a claim on March 31, 2016,...more

Penalty Declined – Party Escapes Summary Judgment Despite Evasive Discovery Responses

On February 17, 2016, the Court of Appeal for the Fourth Appellate District in People ex rel. Government Employees Insurance Company (“GEICO”) v. Cruz (Court of Appeal D067061, Superior Court Case 37-2013-00029878),...more

Prevent the Itch! Hospitality Industry Tips to Avoid or Manage the Risk of Bed Bugs

It’s hard not to love travel. The Dalai Lama suggests “Once a year, go somewhere you have never been before,” and Audrey Hepburn proclaimed that “Paris is always a good idea.” But with bed bugs on the rise, travelers may be...more

Murray v. Farmers Insurance Company

Murray v. Farmers Insurance Company Arizona Court of Appeals, Division Two, January 19, 2016 - Court of Appeals Addresses Insurance Agent Negligence Claim; Plaintiff May Claim Emotional Damages - For years, the...more

Recoupment of Defense Costs: An Ohio Court Weighs in on the Debate

An Ohio appellate court recently addressed the much-debated issue of recoupment of defense costs, holding in a 2–1 decision, and on very narrow grounds, that an insurer could recoup nearly $12 million it expended on the...more

New York Rescission Law Strikes Again: Lessons Learned From the Voiding of Heinz’s Product Contamination Insurance Policy

An increasingly popular tool in the insurer’s toolset is attempted rescission of the policy. This tool is particularly sharp if the law applicable to the construction of the policy is that of New York. Earlier this week, the...more

Property Insurance Diminution in Value Class Action: Georgia Federal Court Dismisses Declaratory Judgment Claim

A while back, I wrote about a Georgia Supreme Court decision, Royal Capital Development LLC v. Maryland Casualty Co., that held that diminution in value of real property is potentially covered under a property insurance...more

Court of Appeals Addresses Insurance Agent Negligence Claim; Plaintiff May Claim Emotional Damages

For years, the Murrays bought minimum limits vehicle insurance, including minimum UM/UIM from agent Jones. Then they gradually began increasing their limits. They testified that when they discussed UM/UIM coverage with Jones,...more

Pennsylvania: Public policy prevents punitive damages from being recoverable as compensable damages in bad faith or breach of...

In an issue of first impression, the Third Circuit Court of Appeals held that punitive damages awarded against an insured in a prior personal injury suit are not recoverable as compensable damages in a later breach of...more

“Insanity Defense” Fails To Preserve Coverage For Insured’s Arson

Missouri resident James Roller set fire to his garage in an attempt to commit suicide. When smoke and fumes surrounded him he changed his mind, fled the garage, and alerted his wife of the fire. Mrs. Roller called 911. A...more

Medical Malpractice and Healthcare Quarterly - Winter 2015-2016

DELAWARE MOVES TO MAKE TELEMEDICINE MORE ACCESSIBLE - On July 7, 2015, Governor Jack Markell signed into law House Bill No. 69 (DE LEGIS 80 (2015), 2015 Delaware Laws Ch. 80 (H.B. 69)), which amends various provisions of...more

Appellate Court Notes

SC19309 - Staton v. Commissioner of Correction - SC19195 - Campos v. Coleman - SC19195 Dissent - Campos v. Coleman - In a 4-3 split decision the Court insured that the cost of living will be going up in...more

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