General Business Insurance Civil Remedies

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States Take Aim At Health Insurance Providers Fee In New Litigation

Three states—Kansas, Louisiana and Texas—filed a complaint in federal court on October 22, 2015 challenging the constitutionality and legality of the Affordable Care Act’s health insurance providers fee. The health...more

Seventh Circuit Reverses Injunctive Relief for Chiropractic Association

On October 1, 2015, the United States Court of Appeals for the Seventh Circuit reversed what was previously regarded as a victory for the Pennsylvania Chiropractic Association. The case, Pennsylvania Chiropractic Association...more

UnitedHealthcare Services Denied Injunction Against Out-of-Network Physician Seeking to Bar Balance Billing of the Patient

In UnitedHealthcare Servs., Inc. v Asprinio (2015 NY Slip Op 25298), decided on August 31, 2015, in the Supreme Court of Westchester County, UnitedHealthcare suffered a set-back against attempts to prevent balance billing by...more

Court of Appeals of Wisconsin: Insured Must Be “Made Whole” For Total Loss Before Insurer Can Recover Subrogated Funds

Dufour v. Progressive Classic Ins. Co., No. 2014AP157, 2015 WL 4275292 (Wis. Ct. App. July 16, 2015). The Court of Appeals of Wisconsin reverses the Circuit Court for Dodge County and remands for proceedings on damages...more

California Supreme Court Upholds Limited Right of Carrier to Seek Recovery of Unreasonable Fees Directly from Insured’s...

On August 10, 2015, in Hartford Casualty Insurance Company v. J.R. Marketing, LLC, et al., the California Supreme Court held that in some circumstances insurers may seek reimbursement of payments made to the insured's...more

11th Circuit Finds a Covered “Occurrence” Under CGL Policy For Damages Resulting From Contractor’s Faulty Work and Rejects...

In Pennsylvania National Mutual Insurance Company v. St. Catherine of Siena Parish, 790 F.3d 1173 (11th Cir. 2015), a judgment was obtained by the Parish (a Catholic Church) against Kiker Corporation (“Kiker”), which was...more

One Business Day Delay In Delivering Settlement Check Costs Insurer $1.1 Million

A South Carolina federal district court judge has ordered that Nationwide must pay an accident victim $1.1 million, in excess of the $50,000 Nationwide policy, as a result of Nationwide’s failure to timely respond to a...more

Independent “Cumis” Counsel Now Face Direct Claims for Reimbursement From Insurers

On April 30, 2015, we blogged about Hartford Casualty Insurance Company v. J.R. Marketing, LLC, Case No. S211645, then set for oral argument in the California Supreme Court. [see the prior post: California’s “Independent”...more

California Supreme Court: Insurer Can Directly Sue Independent Counsel for Excess Fees in Limited Circumstances

On August 10, 2015, the California Supreme Court issued a unanimous decision that could have broad implications regarding an insurer’s right to seek reimbursement of unreasonable fees and costs directly from so-called Cumis...more

Third Circuit Court of Appeals Predicts That Pennsylvania Supreme Court Would Prevent an Insured from Recovering Punitive Damages...

Wolfe v. Allstate Prop. & Cas. Ins. Co., No. 12-4450, 2015 WL 3634779 (3d Cir. June 12, 2015). The Third Circuit Court of Appeals holds that evidence of punitive damages award against insured in underlying suit was not...more

Insurance Filed Rate Defense Wins Over the Second Circuit

In a noteworthy embrace of the filed rate doctrine, the Second Circuit recently ruled, in the context of a challenge to so-called lender-placed or “force placed” insurance, that a regulator-approved rate is subject to the...more

Insights from DRI Class Action Seminar 2015 – Part 1

As I’ve done in past years, this post and the next one will summarize some takeaways I gleaned from this year’s DRI Class Action Seminar. Impact of Dart Cherokee: Nowell Berreth, who argued this case in the Supreme...more

Fifth Circuit Finds Erosion in Texas—Because Endorsements Are Transformative

In Amerisure Mut. Ins. Co. v. Arch Specialty Ins Co., No. 14-20239 (5th Cir. April 21, 2015), a case that applied Texas law, the U.S. Court of Appeals for the Fifth Circuit recently held that the word “expenses,” as used in a...more

Tenth Circuit Addresses ERISA Limitations Provision in Class Action Decision

In Fulghum v. Embarq. Corp., 785 F.3d 395 (10th Cir. 2015), the Tenth Circuit Court of Appeals considered the claims of a class of telephone company retirees whose life and health insurance benefits were reduced or eliminated...more

Rules Against Title Insurer on Date of Loss Issue

In the recent decision in First American Title Insurance Co. v. Johnson Bank, 1 CA-CV 14-0190, 2015 WL 3965740 filed June 30, 2015, the Arizona Court of Appeals held that the date for calculating a loss under a lender’s title...more

Maryland District Court Grants Insurer’s Motion to Dismiss Payee’s Counterclaims and Awards Attorney Fees in Interpleader

On July 1, 2015, the United States District Court for the District of Maryland issued an opinion granting Connecticut General Life Insurance Company’s (“CGLIC”) motion to dismiss a payee’s claims for breach of contract and...more

Louisiana Supreme Court Holds That Statute May Confer Broad Duties On Insurers

In Kelly v. State Farm Fire & Casualty Co., the Supreme Court of Louisiana recently held that an insurer can be liable for bad faith failure to settle a claim even if it has not received a firm offer to settle the claim. The...more

Appraisers’ Failure to Perform Assessment of Property’s Existence or Damage is Reversible Error

In Lee v. California Capital Insurance Co. (No. A136280; filed 6/18/15), a California Court of Appeal held that it was error for an appraisal panel to assign loss values to items simply because they were listed in the...more

Third Circuit Holds That Under Pennsylvania Law An Insured Against Whom Punitive Damages Have Been Imposed May Not Recover Those...

As a matter of public policy, Pennsylvania (like a number of other states) prohibits insuring against punitive damages. But what happens if an insurer refuses to settle a case against a policyholder within policy limits and...more

Court Confirms Reinsurance Arbitration Award Without Objection

A federal district court has entered judgment confirming an arbitration award entered in favor of Employers Insurance Company of Wausau against Continental Casualty. The dispute arose out of a certificate of casualty...more

IREG Update

State insurance commissioners take on price optimization - To date, four states—California, Florida, Maryland and Ohio—have issued formal bulletins and memoranda, prohibiting the practice of “price optimization” by...more

Even if You Lose You May Win (Attorneys’ Fees That Is)

In New Jersey, if a policyholder is required to sue its insurance company for coverage, Court Rule R.4:42-9 allows a policyholder to recover attorneys’ fees if it is successful in obtaining coverage. The purpose of this...more

Colorado Supreme Court: Indefinite, Future Assignment of Insurance Proceeds Unenforceable Against Insurer

It is not uncommon for injured persons to assign their rights to insurance proceeds to a third party, and the enforceability of those assignments has been the subject of frequent litigation around the country. In the most...more

Wisconsin Supreme Court Accepts New Cases: Occurrences, 12% Interest, and Donning and Doffing

Last Friday, Wisconsin’s supreme court announced that it had accepted seven new cases. Three of them are of particular interest to Wisconsin businesses. In Wis. Pharmacal Co. v. Nebraska Cultures of Cal.,...more

Minding Your (Policy) Language – Indiana Supreme Court Certifies Pro Rata Allocation Ruling From Lower Court

Courts have struggled between two approaches on how to allocate damages when multiple, consecutive CGL policies have been triggered in situations involving continuous injury or property damage. The majority approach, pro rata...more

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