Loss Coverage

News & Analysis as of

California Court: Appraisers Cannot be Directed to Assign Loss Values to Undamaged or Non-Existent Items in the Insured’s Scope

It is axiomatic that the appraisers’ task is solely to determine the amount of loss, as opposed to coverage or liability. In Li-Lin Sung v. California Capital Ins. Co., 2015 WL 3797827, 2015 Cal. App. LEXIS 530 (Jun. 18,...more

Bank Bond Covers Third-Party Losses Arising out of Bank Employee’s Fraud, Eighth Circuit Holds

Fidelity bonds are purchased primarily to protect against loss to the policyholder’s own assets, from things like employee theft or embezzlement. In Avon State Bank v. BancInsure, Inc., however, the Eighth Circuit interpreted...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

A House of a Different Color: The Changing Role of Appraisal Panels

Minnesota’s severe weather season is here. With that season comes the possibility of hail, heavy rain, lightning, and other weather-related threats that can quickly result in serious property damage to residential and...more

Court Denies Summary Judgment Motions Despite An Express Agreement To Arbitrate

A New York federal district judge denied Plaintiffs McKenna Long & Aldridge, LLP (“McKenna”) and Vincent W. Sedmak (“Sedmak”) motions for summary judgment which sought to stop an arbitration action from Ironshore Specialty...more

Florida’s Second District Reverses Summary Judgment for Insurer Based on Material Misrepresentation on Homeowner’s Application

In Mora v. Tower Hill Prime Ins. Co., 2015 Fla. App. LEXIS 812 (Fla. Dist. Ct. App. 2d Dist. Jan. 23, 2015), the Second District reversed a Hillsborough County trial court’s grant of summary judgment in favor of the insurer....more

New Jersey Federal Court Gives “Direct Physical Loss” Expansive Meaning Under A Commercial Property Policy.

In Gregory Packaging, Inc. v. Travelers Prop. Cas. Co. of Am., 2014 U.S. Dist. LEXIS 165232 (D. N.J. Nov. 25, 2014), the district court concluded that a release of ammonia rendering a factory uninhabitable for several days...more

Insurance Recovery Law -- December 2014 #2

Ammonia Release Constitutes “Direct Physical Loss” Under Policy - Why it matters: A New York federal court recently ruled that the discharge of ammonia at a manufacturing plant – causing a facility shutdown for...more

Florida’s Fifth District Holds Method of Repair is within the Scope of Appraisal and a Party’s Attorney may not Serve as a...

In Florida Insurance Guaranty Assoc., v. Branco, 39 Fla. L. Weekly D2020a (Fla. Dist. Ct. App. 5th Dist. Sept. 19, 2014), the Fifth District affirmed in part and reversed in part a Hernando County trial court’s order...more

Eastern District of Pennsylvania Denies Bad Faith Claim in Homeowner’s Policy Dispute

White v. Metro. Direct Prop. and Cas. Ins. Co., Civ. A. No. 13-434 (E.D. Pa. July 29, 2014) - Eastern District of Pennsylvania enters summary judgment for the insurer on statutory bad faith claim in coverage dispute...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

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

From the Transportation Archives: The Perfect Storm: The Parameters of a Successful “Act Of God” Defense in Freight Claims

Federal and state law have long established that a shipper cannot prevail in a freight claim against a carrier if an “Act of God” caused the freight damage, loss, or delay in question. This “Act of God” defense is available...more

NY Joins Texas In The Broad Use Of Appraisal

Virtually all property insurance policies include an appraisal provision to resolve disputes over the “amount of loss” for a covered claim. Historically, the phrase “amount of loss” was interpreted to limit appraisal to those...more

Northern District of Ohio: No Reasonable Jury Could Conclude That Insurer’s Denial of Coverage For Two Arsons Was Not Justified

Givens v. West Bend Mut. Ins. Co., No. 4:13 CV 1287, 2014 WL 2946672 (N.D. Ohio Jul. 1, 2014) - The Northern District of Ohio concludes that insurer was justified in denying claim for two fires that were undisputedly...more

Northern District of Texas Dismisses Bad Faith Claims in Well-Control Policy Dispute

Eagle Oil & Gas Co. v. Travelers Prop. Cas. Co. of Am., No. 7:12-cv-00133-O (N.D. Tex. Jul. 14, 2014) - Northern District of Texas dismisses bad faith claims against insurer and adjuster in dispute over coverage for...more

Louisiana Court Upholds Proof Of Loss Requirement Of Standard Flood Insurance Policy

n Villemarette v. FEMA et al., 2014 U.S. Dist. LEXIS 113667 (E.D. La.), the court analyzed whether plaintiffs were entitled to unpaid proceeds of a Standard Flood Insurance Policy (SFIP). Plaintiffs’ policy had coverage...more

New Jersey Court Holds that Six-Month Delay in Providing Notice to Carrier Bars Coverage under Claims-Made Policy

Policyholders often are cautioned to provide notice of a claim to their insurance carrier as soon as possible to avoid the risk that the carrier will deny coverage due to late notice. A recent court decision in New Jersey...more

Insurance and Reinsurance Alert: Follow the Settlements Clauses revisited.

In autumn 2011, Thailand suffered severe floods. Among the properties damaged were shops and distribution centres owed by a subsidiary of Tesco. Tesco was insured against property damage and BI losses in Thailand under a...more

Looking for Illinois Insurance Case Law? One-Stop Shopping

If you are not using the Insurance Case Law Index regularly to check on Illinois insurance cases, you are missing out on a great resource. Now summarizing over 1,890 Illinois state and federal case citations, holdings and...more

New York Court: All Sandy Losses, Including “Downstream” Financial Ones, Capped By Annual Aggregate Limit For Flood

Superstorm Sandy jurisprudence is starting to shed light on some unresolved issues in the effected states. In El-Ad 250 West LLC v. Zurich American Ins. Co., — N.Y.S.2d —, 2014 WL 2931058 (N.Y.Cty., June 27, 2014), a New...more

California Court: An Insurance Claim for Feng Shui Is Not Harmonious Qi

Feng shui is a Chinese philosophical system that supposedly orients buildings and their contents in an auspicious manner. Last month in Patel v. American Economy Ins. Co., — F.Supp.2d —, 2014 WL 1862211 (N.D. Cal., May 8,...more

Connecticut Holds that When a Lapsed Policy is Reinstated, Coverage is Only Restored Prospectively

In a case of first impression in the Nutmeg State, an intermediate level court in Connecticut recently held that reinstatement of coverage after a lapse for non-payment of premiums does not operate to restore coverage...more

Is That Covered?

If the long-term predictions prove to be true and we have a snowy Winter in 2013-14, policyholders may be faced with the issue of whether insurance covers damage to a business facility or home due to a roof collapse from the...more

Perils of the seas needn’t be too perilous

When the cargo vessel “Irene EM” grounded on 30 October 2009 in the Gulf of Khambhat, underwriters declined cover as the loss was not caused by a peril of the sea. The term “perils of the seas” refers only to...more

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