Conflict of Laws Insurance Civil Procedure

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ERISA Preemption Trumps State Insurance Law Yet Again: Ninth Circuit Declines to Apply California’s Insurance Notice-Prejudice...

In a recent decision, the Ninth Circuit Court of Appeals rejected a Plan participant’s attempt to extend California insurance law’s notice-prejudice rule to self-insured ERISA plans. Zagon v. Am. Airlines, Inc., 2015 BL...more

The Insurance Examination Privilege Just Became Important

When a U.S. insurance regulator investigates market conduct or financial solvency, its work is governed by a state law based on the NAIC Model Law on Examinations. Like the Model Law, all state laws strictly protect the...more

Recent Federal Court Ruling: No ERISA Preemption of Texas Prompt Pay Law Regarding Payment Deadlines; Texas Legislature May Act on...

What's new. A Texas federal district court has ruled that ERISA does not preempt or prohibit application of the Texas Prompt Pay ("TPP") law to Third Party Administrators ("TPAs") of self-funded benefit plans. Judge Lynn...more

California: Service of Suit Endorsement Trumps Forum Selection Clause in Case Involving Product Recall Due to Contamination.

On February 5th in a case involving the recall of over $500,000 worth of oyster products made from Korean shellfish, the Southern District of California held: (1) that the policy’s service of suit clause, which gave the...more

California’s “Third Party Litigation Exception” Not Preempted By The FAA

A California appellate court recently examined that state’s legislative response to the situation where a party moves to compel arbitration and some of the parties to the dispute are not parties to the arbitration agreement....more

Texas Court Enforces Policy’s New York Forum Selection Clause

In Chandler Mgmt. Corp. v. First Specialty Ins. Corp., 2014 Tex. App. LEXIS 13192 (Tex. App. Ct. 5th Dist. 2014), the Appellate Court of Texas, Fifth District, had occasion to consider whether, under Texas law, a surplus...more

Nation’s Highest Court Schedules Oral Arguments in King v. Burwell

A Supreme Court of the United States (SCOTUS) spokesperson announced on December 22, 2014, that the Court will hear oral arguments in King v. Burwell on March 4, 2015. This means that not only could the highest court soon...more

Illinois Supreme Court Agrees to Decide Limits on Self-Insured Car Rental Company's Liability for Customers' Accidents

In the closing days of its November term, the Illinois Supreme Court agreed to decide an issue of considerable importance for Illinois’ car rental industry: can a self-insured car rental company be held liable without...more

Nevada District Court Bars Foreclosure Sale of First Lien HUD-Insured Mortgage

Recently, a federal district court held that a homeowners association (HOA) foreclosure sale is not valid against HUD-insured loans. The District Court noted that the Ninth Circuit has held that federal rather than state law...more

New Jersey Federal Court Examines Claim Dispute Under Standard Flood Insurance Policy

The court in Damiano v. Harleysville Ins. Co., Case No. 13-cv-07293-FLW-LHG, 2014 U.S. Dist. LEXIS 97988 (D.N.J. July 17, 2014) recently addressed the scope of claims that can be asserted against property insurers issuing...more

Fifth Circuit Holds That a TPEE in a CGL Policy Can Exclude Pollution Claims Even in the Face of a UREC

What you need to know: The Fifth Circuit Court of Appeals, applying Texas law, held that a Total Pollution Exclusion Endorsement in a CGL Policy did not irreconcilably conflict with, and therefore was not superseded...more

D.C. Circuit Holds Government False Claims Case Not Precluded By National Mortgage Settlement

On June 10, the U.S. Court of Appeals for the District of Columbia affirmed the district court’s decision not to enjoin the federal government from pursuing alleged False Claims Act violations against a bank that argued such...more

Federal Court Erie Prediction Insufficient to Establish Conflict of Law

In its recent decision in Bridgeview Health Care Ctr. v. State Farm Fire & Cas. Co., 2014 Ill. LEXIS 596 (May, 22, 2014), the Supreme Court of Illinois had occasion to consider whether a federal court’s Erie prediction is...more

Court Rejects Plaintiff’s Attempt to Prevent Plan from Recouping $250,000 Overpayment

A federal district court in the Northern District of California dismissed an equitable estoppel claim brought by a pension-plan participant seeking to prevent the plan from recouping an overpayment. See Groves v. Kaiser...more

Florida, Georgia And Texas Appraisal Update: Is Causation A Coverage Question For The Court Or A Damages Question For The Panel?

In most jurisdictions, underlying coverage issues must be resolved prior to invoking appraisal in a first-party property claim. The question of what constitutes a coverage issue (typically reserved for a court’s judicial...more

State Law Will Not Help Out In All Divorce Situations

Many states, including Florida, automatically terminate former spouses as beneficiaries under life insurance policies, annuities, and other beneficiary-designated accounts upon divorce....more

Attorneys' Fees Reduce ERISA Plan's Recovery From Common Fund

The United States Supreme Court ruled today that absent an express provision to the contrary, the amount an ERISA plan can recover from a plan participant’s lawsuit against a third-party tortfeasor must be reduced...more

California Supreme Court Holds Suits Against Dissolved Foreign Corporations Subject to Survival Statutes of State of Incorporation

Greb v. Diamond International Corp., __ Cal.4th __, __ Cal. Rptr.4th __ (February 21, 2013) In a victory for liability insurers against the asbestos plaintiffs’ bar, the California Supreme Court ruled in Greb v. Diamond...more

Washington Supreme Court: FAA Does Not Preempt State Law Prohibiting Arbitration Agreements in Insurance Contracts

The Washington Supreme Court has ruled that the Federal Arbitration Act (FAA) does not preempt a state statute that prohibits binding arbitration agreements in insurance contracts....more

Seventh Circuit Rules that Medical Necessity Trumps State-Imposed Cap on “Optional” Medicaid Coverage

In a class action lawsuit, the U.S. Court of Appeals for the 7th Circuit recently affirmed a lower court decision granting a preliminary injunction that prevented the state of Indiana from enforcing a $1,000 annual cap on...more

Illinois Supreme Court Refuses to Invalidate Policy Deadline for Uninsured Motorist Claims

Can an insurance policy be rendered unenforceable by Illinois public policy because of a conflict with another state's law? This morning, in an opinion by Justice Lloyd A. Karmeier for a 6-1 majority, the Illinois...more

Fifth Circuit Rejects Expansive Reading of Texas Law Regarding an Insured’s Right to Independent Counsel

Under Texas law, “when the facts to be adjudicated in [a] liability lawsuit are the same facts upon which coverage depends, the conflict of interest will prevent the insurer from conducting the defense.” N. Cnty. Mut. Ins....more

When Are Short Term Disability Claims NOT Governed by ERISA — This Case Explains When State Law Claims Are Not Preempted

When does ERISA govern short term disability payments? Take a look at this recent case, Behjou v. Bank of America et. al, [PDF] __ F.Supp. 3d __ (N.D. California May 1, 2012). FACTS: Behjou brought short term...more

Sedgwick Jury Trial Bad Faith Victory Results in Appellate Court Decision Barring Vicarious Liability

A couple of years ago, Sedgwick authored an amicus brief, which the California Court of Appeal in Watanabe v. California Physicians' Service (2008) 169 Cal.App.4th 56 relied upon to hold that California Health & Safety Code...more

In-Network Provider Has Standing to Pursue ERISA Remedies, But State Law Reimbursement Claim Completely Preempted by ERISA

In Montefiore Medical Center v. Teamsters Local 272, 642 F.3d 321 (2d Cir. 2011), the U.S. Court of Appeals for the Second Circuit held that an in-network provider's state law based reimbursement claim is completely preempted...more

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