Insurers

News & Analysis as of

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

Mergers & Acquisitions Insurance - The growing use of rep and warranty protection in M&A transactions

The good news is that you can insure almost anything! In M&A transactions, buyers and sellers spend a great deal of time allocating risk relating to known and unknown pre-closing liabilities. The buyer’s view of the...more

Class Action Against State Auto Concerning Homeowners’ Policy Limits Is One Worth Watching

Insurers typically adjust (or propose to adjust) the policy limits on a homeowners’ policy every year to take into account changes in the cost of construction. This is intended to help insureds make sure that sufficient...more

Bad Faith Sentinel - September 2014

In This Issue: - Southern District of New York: It is Unlawful for an Insurer to Withhold Payment When Some Portion on an Insured’s Entitlement is Undisputed - Eastern District of Pennsylvania: State Farm...more

Pennsylvania Supreme Court Denies Review of Faulty Workmanship Decision

Last week, the Pennsylvania Supreme Court let stand the appellate decision in Indalex, Inc. v. National Union Fire Insurance Co. of Pittsburgh, Pa., which held that mold related health problems and property damage allegedly...more

McLennan v Insurance Australia Ltd [2014] NSWCA 300

In its recent decision of McLennan v Insurance Australia Ltd [2014] NSWCA 300, the NSW Court of Appeal confirmed that a provision in an insurance policy that limits or qualifies cover is an exclusion, regardless of where or...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

Nebraska Appellate Court Gets Down to Earth to Hold That Faulty Workmanship Standing Alone Is Not An “Occurrence”

The insurance and construction industries have disagreed about coverage claims involving faulty workmanship for many years. Contractors believe their CGL insurance policies should always cover property damage caused by...more

Oklahoma Court Excludes Evidence of Loss Reserves

Asap v. Starnet Ins. Co., No. CIV-12-461-D, 2014 U.S. Dist. LEXIS 128609 (W.D. Okla. Sept. 15, 2014) is a decision involving multiple motions in limine in connection with a trial of a breach of contract claim brought against...more

Eastern District of Pennsylvania: State Farm Cannot Refuse Appraisal of Superstorm Sandy Damage

Currie v. State Farm Fire & Cas. Co., No. CIV.A. 13-6713, 2014 WL 4081051 (E.D. Pa. Aug. 19, 2014). After Superstorm Sandy damaged the insureds’ house, they and their insurer came to markedly different assessments of...more

Legislation Reforms California’s Insurance Community Investment Program

On September 17, California Governor Jerry Brown signed into law legislation intended to reform the California Organized Investment Network (COIN) program. The COIN program is a partnership among the California Department of...more

Claims Handlers: It’s Time to Adjust Our Claims!

Many insurers have a longstanding practice of paying claims adjusters a set weekly salary, regardless of the number of hours they actually work. The practice has support in federal labor regulations; the regulations...more

Southern District of New York: It is Unlawful for an Insurer to Withhold Payment When Some Portion on an Insured’s Entitlement is...

Lexington Ins. Co. v. MGA Entm’t, No. 12-cv-3677 (SAS), 2014 WL 3955205 (S.D.N.Y. Aug. 12, 2014). The Southern District of New York denies an insurer’s motion to dismiss an insured’s claim that the insurer breached its...more

Excess Insurance Triggered Despite Policyholder’s Settlement with Primary Insurers for Less than Policy Limits

When faced with a catastrophic loss triggering multiple layers of coverage and recalcitrant insurers at the primary layer, a policyholder has strong incentives to settle with the first-layer carriers for less than the full...more

Court Rules on Applicability of Make-Whole Premiums Upon Debt Acceleration

In the context of make-whole premiums, court decisions suggest that the applicability of the premium upon a refinancing in bankruptcy will be governed by the wording of the debt documents, and that if an automatic...more

Leap of Bad Faith: TPAs May Be Sued for Aiding Their Own Actions

Insurers have a duty to process claims in good faith, but sometimes they farm the job out to third-party administrators (TPAs). If the TPA fouls up, many states hold that the insurer is still liable—for its own breach of...more

District Court Dismisses Passenger’s Direct Action Against Airline’s Insurer

Earlier this month, a U.S. District Court in Pennsylvania dismissed a “direct action” personal injury claim against the liability insurer of U.S. Airways in Gonzalez-Marcano v. U.S. Airways, Inc., 2014 WL 4375666 (E.D. Pa....more

Setting Up a Successful Negotiation Regarding “2860 Rates”

“The insurer’s obligation to pay fees to the independent counsel selected by the insured is limited to the rates which are actually paid by the insurer to attorneys retained by it in the ordinary course of business in the...more

When Does an Insurance Co. Waive Atty-Client Privilege?

If an insurance company alleges it lawfully denied a claim, is that an implied waiver of the attorney-client privilege as to its consultation with coverage counsel? When a policyholder sues an insurer for bad faith,...more

Pennsylvania Court Addresses What Is a Coverage Dispute for Appraisal Purposes

Last month, a Pennsylvania federal court rejected the notion that a dispute over whether an admittedly covered occurrence necessitated repair of certain discrete portions of the damaged structure was a coverage dispute,...more

Business Interruption Insurance: Clearing up the Confusion

In Eurokey Recycling Ltd v Giles Insurance Brokers Ltd [2014] EWHC 2989 (Comm), the English Commercial Court has confirmed the nature of an insurance broker’s duties to its clients when obtaining Business Interruption...more

Big Data in Health Care

The use of big data is now widespread in the U.S. health care system. At major industry conferences and in leading publications, big data has become a watchword for clinical care providers, private insurers, pharmaceutical...more

The Scope of Commercial General Liability Policies Continues to Shrink

Watch out for those Employment Practice Liability “EPL” exclusions. The courts have routinely upheld these exclusions now explicitly added to both the Coverage A (bodily injury and property damage) and the Coverage B...more

Illinois Court Holds Insurer Improperly Delayed Declaratory Judgment Action

In FCCI Ins. Co. v. Westfield Ins. Co., 2014 Ill. App. Unpub. LEXIS 1421 (Ill. App. June 27, 2014), the Appellate Court of Illinois had occasion to consider whether an insurer was estopped from asserting policy defenses to...more

Insurers, Be Ready To Pay Twice In Texas

Often, an insurance carrier will issue a check to two joint payees — the named insured and either a public adjuster or a mortgagee. What happens when the one payee cashes the check without first obtaining a signature from the...more

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