Civil Remedies Insurance Business Torts

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Texas Insurers: Don’t Forget ‘Excessive Demand Doctrine’

With the onslaught of recent hail and other weather related litigation, insurance carriers routinely see excessive and unreasonable settlement demands in statutorily required presuit notice letters. The “excessive demand...more

California’s “Independent” Cumis Counsel Regime Faces A Novel Challenge

On May 5, the California Supreme Court will hear argument in a case that has the potential to profoundly change the relationship between the insurer, its insured and the insured’s independent defense counsel under Civil Code...more

Illinois Court Holds No Duty to Defend Malicious Prosecution Suit

In Indian Harbor Ins. Co. v. City of Waukegan, 2015 IL App (2d) 140293 (Ill. App. Ct. 2d Dist. 2015) the Appellate Court of Illinois, Second District, had occasion to consider when coverage for a malicious prosecution claim...more

En Banc Sixth Circuit Rules Against Disgorgement Remedy in Benefits Case

In Rochow v. Life Insurance Company of North America, No. 12-2074 (6th Cir. March 5, 2015), the U.S. Court of Appeals for the Sixth Circuit, sitting en banc, ruled that an insurance company that wrongfully denied benefits to...more

Disgorgement of Profits Not Available for Arbitrary and Capricious Benefits Denial – This Time

Wrongful denial of employee benefits will not expose plan fiduciaries to equitable remedies – such as disgorgement of profits – where restoration of benefits is adequate to make the claimant whole, says the Sixth Circuit in...more

ERISA: 6th Circuit — Plop Plop, Fizz Fizz: Oh What A RELIEF It Is: No Disgorgement For Arbitrary Denial Of Benefits

Does an arbitrary and capricious denial of ERISA governed disability benefits create a right to disgorgement of profits? NO....more

Revisiting Rochow: The Sixth Circuit Rejects Earlier $3.8 Million Equitable Award in Recent En Banc Decision

Just over a year ago, a panel decision by the Sixth Circuit Court of Appeals in Rochow v. Life Insurance Company of North America, 737 F.3d 415 made big news when the court upheld the district court’s award of $3.8 million in...more

Sixth Circuit Overturns the Lower Court’s Award of $3.8 Million in Alleged Profits Arising From a Denial of Benefits

The U. S. Court of Appeals for the Sixth Circuit, sitting en banc, has overturned the decision of a divided three-judge Sixth Circuit panel which had affirmed the district court’s award of $3.8 million of “disgorged” profits,...more

Court of Appeals of New Mexico Reverses Bad Faith Judgment for Insured and Remands for New Trial on Bad Faith Claim

Progressive Casualty Ins. Co. v. Vigil, No. 32,171 (N.M. Ct. App. Jan. 21, 2015). Court of Appeals of New Mexico rules that district court abused its discretion in excluding evidence of previous coverage ruling in...more

ERISA Fiduciaries Have a Duty to Inform

SUMMARY: In this case, the court found that the employer, serving as plan administrator of a group life insurance plan providing basic and supplemental coverage, may be liable for monetary damages for breach of its fiduciary...more

If You Are a Third-Party Beneficiary, Make Sure the Contract Is Crystal Clear!

In Be Clear if You Want to Have a “Third-Party Beneficiary” in Your Contract, I discussed that if in-house counsel wanted to ensure that a person or entity achieved the status of a third-party beneficiary, it was critical to...more

No Private Right to Recoup Funds Based on Corporate Practice of Medicine Violation

The United States District Court for the Western District of Washington ruled recently that the state’s corporate practice of medicine doctrine does not provide a private right of action, either express or implied, and...more

Is That Covered? Hail Damage

Back in May, 2014, parts of Berks and Lancaster counties were hit with a freak hail storm. With hail as large as tennis balls reported, homes and cars suffered significant damage. Hail damage is generally covered under auto...more

Missouri Court Allows Insured to Pursue Breach of Fiduciary Duty Claim Against Excess Insurer

In its recent decision in SSM Health Care Corp. v. Repwest Ins. Co., 2014 U.S. Dist. LEXIS 158164 (E.D. Mo. Nov. 7, 2014), the United States District Court for the Eastern District of Missouri had occasion to consider whether...more

Catch Me If You Can: Fake Doctor’s Application Voids Coverage for Himself But Not for Innocent Co-Insureds

Written like a blockbuster Hollywood film, the U.S. District Court in South Carolina, in Evanston Insurance Company v. Agape Senior Primary Care, et al., 2014 WL 5365679, issued a ruling October 21, 2014, in which it held...more

Bad Faith Sentinel - October 2014

In This Issue: - Florida District Court of Appeal: A Prematurely Filed Bad Faith Claim Does Not Compel Dismissal - Florida District Court of Appeal: Insurer’s Liability For Breach Of Contract Need Not Be...more

Missouri Court of Appeals Rejects Insurers’ Appeal of Jury Verdict on Bad Faith Failure to Settle, but Remands for New Trial on...

Advantage Bldgs. & Exteriors, Inc. v. Mid-Continent Cas. Co., No. WD76880, 2014 WL 4290814 (Mo. Ct. App. Sept. 2, 2014), reh’g and/or transfer denied (Sept. 30, 2014). Missouri Court of Appeals affirms sufficiency of...more

Missouri Court of Appeals Affirms Award of Compensatory Damages Against Insurer Based Upon Bad Faith Failure to Settle and Overall...

The Missouri Court of Appeals recently affirmed an award of compensatory damages against an insurer based upon bad faith in Advantage Bldgs. & Exteriors, Inc. v. Mid-Continent Cas. Co., 2014 Mo. App. LEXIS 975 (Missouri Court...more

AMJ Investments May Not Alter Texas Claims Landscape

Section 541 of the Texas Insurance Code authorizes a private cause of action through which an insured can recover the “actual damages” caused by its insurer’s violation of the statute’s fair-claims handling provisions. And,...more

Eleventh Circuit Rejects Excess Insurers Bad Faith Claim Against Primary Insurer Due to Lack of Damages Causation

The Eleventh Circuit Court of Appeals reversed a Florida district court’s award of damages to the excess insurer on the ground that the excess insurer failed to prove the primary insurer’s alleged bad faith had caused the...more

Bad Faith Sentinel - June 2014

In This Issue: - Court of Appeals of the State of Washington: Bad Faith Damages May Exceed the Amount of a Reasonable Covenant - Southern District of Mississippi: Insurer Providing Coverage Opinion to Insured...more

Court of Appeals of the State of Washington: Bad Faith Damages May Exceed the Amount of a Reasonable Covenant Judgment

Miller v. Kenny, No. 68594-5-I, 2014 WL 1672946 (Wash. Ct. App. Apr. 28, 2014) - The Court of Appeals of the State of Washington held that a reasonable covenant judgment, consisting of the total liability of the...more

Equitable Surcharge Awarded to Life Insurance Plan Beneficiary

A federal district court in California awarded relief in the form of surcharge to a life insurance plan beneficiary who claimed that a plan administrator failed to provide complete and accurate information in response to...more

Illinois Court Outlines Elements to Consider for Good Faith Analysis of Settlement Demand

To settle or not to settle: that is the question for liability insurers. If you are pondering whether you must accept a plaintiff’s settlement offer, read on. A recent Illinois case, Huang v. Brenson, 7 N.E.3d 729 (Ill. App....more

Gotham Insurance V. Warren E&P Answers Age-Old Question

In Gotham Insurance Co. v. Warren E&P Inc., the Texas Supreme Court recently addressed an age-old and often-asked question: Can an insurer recoup money paid to its insured when it later learns it overpaid? The answer:...more

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