Personal Injury Civil Remedies Insurance

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Settling Defendants Beware: Eleventh Circuit Holds Settling Insurer Liable for Failure to Protect Medicare Payments Made by...

Congress created an uproar among personal injury tort defendants and their insurers when it passed the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) less than 10 years ago. The $1,000 per day fine for failure to...more

Insurance Coverage – Equitable Indemnity Claim by Excess Carrier

Ace American Insurance Company v. Fireman’s Fund Insurance Company - Court of Appeal, Second Appellate District (August 5, 2016) - Where an underlying insurer rejects a settlement offer within its policy limits, and...more

Alberta Government Updating 2004 Auto Insurance Reforms

The Alberta government has announced that it is in the process of updating the regulations involved in the 2004 auto insurance reform, namely the Minor Injury Regulation, Alta Reg 123/2004; the Diagnostic and Treatment...more

Subrogation recovery did not violate the made-whole-rule and was not in bad faith per Wisconsin Sup. Ct.

It is highly unusual to find an insurance bad faith case which stems from an insurance company’s subrogation recovery. On July 6th, Wisconsin’s highest court had such a case, reversing the appellate court and holding that...more

Defence & Indemnity - June 2016: I. INSURANCE ISSUES

A. Where a party pleads equitable relief (such as rescission, estoppel or relief from forfeiture) with respect to an insurance policy, the claim cannot be heard by a jury Maynard v. Alberta Motor Assn., 2015 ABQB 564,...more

Eighth Circuit to insurers: Settlement evaluation must constantly adapt to litigation developments

A recent decision of the US Court of Appeals for the Eighth Circuit taught an insurer a costly lesson about trying to avoid extra-contractual liability: Insurers must constantly reevaluate their settlement position throughout...more

The Duty to Follow-up Part II: When The Underlying Litigation Changes

Last month, we discussed the duty to follow-up in the context of an offer to settle made by a tort claimant and how neglect of that duty cost an insurer dearly by converting a claim that could have been settled for $25,000...more

Defence & Indemnity - April 2016: III. QUANTUM/DAMAGES ISSUES

A. TMJ, concussion, depression, PTSD, and chronic pain held not to be “minor injuries” within the meaning of the Minor Injury Regulation. McLean v. Parmar, 2015 ABQB 62, per Eidsvik, J. [4177]...more

Eighth Circuit Holds Insureds’ Miller-Shugart Agreement Breached Policy’s Cooperation Clause

In its recent decision in American Family Mut. Ins. Co. v. Donaldson, 2016 U.S. App. LEXIS 7499 (8th Cir. Apr. 26, 2016), the United States Court of Appeals for the Eighth Circuit, applying Minnesota law, had occasion to...more

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

Supreme Court Limits Plan’s Ability to Recoup Medical Expense Payments

In Montanile v. Board of Trustees of the National Elevator Industry Health Benefit Plan, the US Supreme Court held that when an ERISA plan participant completely dissipates a settlement from a third party on items that are...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

Obamacare in the Courtroom: In the Matter of Double Recovery

The Patient Protection and Affordable Care Act (ACA), a/k/a Obamacare, was drafted to make health care and health insurance more affordable and more available to more Americans as well as to relieve some of the burden on...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

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

Who is Florida’s Attorney General trying to protect?

In Florida, do we citizens who live here comprise “the State”? The attorney general in Florida has launched another one of her battles; which I would guess she characterizes as “defending the best interests of Florida,...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

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

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

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

California Court of Appeals Holds Liability Insurer May Obtain Equitable Subrogation Against its Insured’s Contractual Indemnitor...

In Valley Crest Landscape, Inc. v. Mission Pools of Escondido, Inc., 238 Cal.App.4th 468 (2015), the California Court of Appeals held that an insurer could successfully recover on a claim for equitable subrogation against the...more

Pennsylvania Supreme Court Holds That Insured May Settle Tort Claim Without Insurer Consent Under “Fair and Reasonable” Standard

In Babcock & Wilcox Co. v. American Nuclear Insurers, a divided Supreme Court of Pennsylvania, deciding an issue of first impression under Pennsylvania law, recently held that when an insurer defends its insured subject to a...more

Proper Measure of Medical Damages, Admissibility Of Evidence, and Sufficiency of Evidence in Tort Cases Involving an Uninsured...

Omar Bermudez v. Faith Ciolek - Court of Appeal, Fourth Appellate District (June 22, 2015) - Issues that remained unanswered after the Howell and Corenbaum decisions included: (1) what is the proper measure of...more

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