Insurance Civil Remedies

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Insurance Coverage – Cancellation of Policy and Bad Faith

Trent Mills v. AAA Northern California, Nevada & Utah Ins. Exchange - Court of Appeal, Third District (September 20, 2016) - Under Insurance Code § 1861.03(c)(1), an insurer has a statutory right to cancel an...more

How Appraisal Protects Against Texas Insurance Code Abuse

Insurance practice in Texas has become somewhat rote. Typically, a petition is filed against both an insurance company (that is often not based or incorporated in Texas) and a local adjuster. In addition to a breach of...more

UK Supreme Court: Fraud Trumps the Finality of Settlements

In a recent decision that can have equal application in the United States, the UK Supreme Court ruled that fraud trumps the public policy arguments of finality and encouragement of settlements....more

Massachusetts AG Settles With Insurance Company Over Allegedly Improper Force-Placed Insurance

On September 7, 2016, the Massachusetts Attorney General announced a settlement with an insurance company requiring “refunds for Massachusetts homeowners whose mortgage lenders wrongly force-placed the consumers with [the...more

Insurance – Bad Faith Refusal to Settle

Barickman v. Mercury Casualty Company, et al. - Court of Appeal, Second Appellate District (July 25, 2016) - Where a carrier refuses to accept a settlement demand within policy limits, it risks the chance of being...more

Missouri Federal Court Identifies Roadblocks For An Excess Carriers’ Claim For Attorney Fees Against Primary Carrier

The court’s decision in Axis Specialty Insurance Company v. New Hampshire Insurance Company highlights the scope of recovery available for an excess carrier seeking to recover against a primary carrier. Emboldened by the...more

Arbitration Clause Contained Only In “Side” Agreements To Insurance Policies, Enforced In Dispute Over “Retrospective Premiums”

A U.S. District Court for the Southern District of New York recently enjoined Advanced Micro Devices (AMD), from proceeding with litigation in California against National Union Fire Insurance Company (NUFIC), related to a...more

5 Wishes for Securities Litigation Defense: Early Damages Analysis and Discovery

The fifth of my “5 Wishes for Securities Litigation Defense” (April 30, 2016 post) is to move securities class action damages expert reports and discovery ahead of fact discovery. This simple change would allow the...more

Ohio Court Holds No Coverage for Misrepresentation Claims

In its recent decision in Lakeside Terrace Home Sales, Ltd. v. Arrowood Indem. Co., 2016 U.S. Dist. LEXIS 114828 (N.D. Ohio Aug. 26, 2016), the United States District Court for the Northern District of Ohio, had occasion to...more

Expanding When Liability is “Reasonably Clear”: Massachusetts Court Chips Away at Bad Faith Counterarguments

Earlier this month, a Massachusetts Appellate Court affirmed a trial court’s award of bad faith damages in a case where it found the insurer’s approach to a claim to be “at best inattentive, if not incompetent.” Although the...more

Eleventh Circuit Finds Insurer Liable for Medicare Lien Notwithstanding Insurer's Efforts to Satisfy the Lien in Settlement, also...

In a case with far-reaching implications, the Eleventh Circuit Court of Appeals issued an opinion concluding that the Medicare Secondary Payer Act (MSP) permits a private insurance company/PART C Medicare Advantage...more

11th Circuit Awards Humana Double Damages Under Medicare Secondary Payer Act

Humana Medical Plan, Inc. v. Western Heritage Insurance Co., case number 15-11436. Liability insurers beware, as the 11th Circuit held that Medicare Advantage Organizations (MAO) are entitled to the same rights...more

New Jersey Supreme Court Affirms General Contractor’s Insurance Coverage for Consequential Damages Caused by a Subcontractor’s...

In an important recent decision, New Jersey joined a growing number of states holding that Insurance Services Office’s (ISO) 1986 comprehensive general liability (CGL) policy extends coverage to a property developer faced...more

Eleventh Circuit affirms ruling of no coverage based on insured’s failure to cooperate

As a condition to coverage under standard liability policies, the insured is required to cooperate with its insurer. The provision, termed the “cooperation clause,” typically requires the insured to assist with and...more

STOLI Policies Cancelled, Insurers Retain Premium

Two federal appellate courts have affirmed, on different grounds, the cancellation of large life insurance policies that were alleged to be stranger originated life insurance (STOLI), permitting the issuing insurers to retain...more

Health Plan Case Managers Entitled to Overtime Pay

Managed care companies help insurers and government programs coordinate healthcare plans by making coverage determinations for participants. In many situations, case managers conduct utilization reviews to determine the...more

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

Where Does a Third Party “Stand” on Liens?

Dion v. William Robert Batten, Sr. (8/2/16) Facts and Procedural History: Plaintiff was employed by Neuwirth as a servicing agent. In the course and scope of his employment with Neuwirth, he was involved in a car...more

Florida’s Fifth District Allows Evidence of Prior Sinkhole Insurance Settlement in Subsequent Sinkhole Trial

In Tower Hill Signature Ins. v. Speck, 2016 Fla. App. LEXIS 12167 (Fla. Dist. Ct. App. 5th Dist. Aug. 12, 2016), the Fifth District found the trial court abused its discretion by not admitting into evidence the amount of a...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

Summary Judgment May Be Appropriate When Insured Fails to Take Reasonable Measures to Prevent Property Damage

Many first party property insurance policies exclude claims for water damage that occurs when the insured premises is left vacant or unoccupied, unless the insured has used reasonable care to prevent such losses. In...more

Delaware Chancery Court Finds That Anti-Suit Injunction Bars Trustee Under Reinsurance Trust Agreement From Pursuing Third-Party...

Freestone Insurance Company is a Delaware-domiciled insurer that has been placed in liquidation. U.S. Bank National Association served as the trustee under a reinsurance trust agreement (the “Trust Agreement”) between...more

Eleventh Circuit’s Liberal Reading of Bonner Mall a Game Changer for Class Actions?

An Eleventh Circuit panel recently vacated two district court orders after sending the parties to mediation, and after the parties’ conditioned settlement on vacatur of the orders. In Hartford Casualty Insurance Company v....more

DOJ Sues to Block Health Plan Mergers

The U.S. Department of Justice (DOJ), joined by attorneys general from several states, filed a lawsuit last Thursday in the U.S. District Court for the District of Columbia seeking to block two major mergers between health...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

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