This month’s Friday Five explores decisions from around the country discussing differences between LTD and LWOP policies, the breadth of discretion available to claims administrators and the always important topic of timely...more
This month’s Friday Five explores decisions regarding the timeliness of appeals, the support necessary to sustain an LTD termination decision, a court’s discretion to credit and discredit expert opinions, the circumstances...more
This month’s Friday Five explores recent decisions that reflect the precise nature of rules and definitions in the context of ERISA claims. For example, effective dates of CFR code provisions and contractually defined...more
This month’s Friday Five explores recent decisions that elucidate the difference between disputes that call upon the discretion and judgment of a court compared to disputes where the court is called upon to follow...more
This month’s Friday Five discusses cases that focus on what information properly constitutes the administrative record before the court on which a decision must be based. One case explores the ERISA Records Rule which limits...more
The Consolidated Appropriations Act of 2021, enacted at the end of 2020 includes the No Surprises Act (“Act”), amending the Employee Retirement Income Security Act of 1974, the Internal Revenue Code of 1986, and the Public...more
This month’s Friday Five discusses cases that explore some fundamental principles of disability benefit litigation. While players and fans return to the favorite fall pastime of football, albeit in the “new normal” under...more
On August 25, 2020, the Pennsylvania Supreme Court split 3-3, with one Justice recused, on an appeal from a trial court’s insurance bad faith decision imposing $18 million in punitive damages and $3 million in attorney’s fees...more
This month’s Friday Five discusses cases that explore the bounds of claims administrators’ discretion. Several cases highlight the divergent outcomes possible in light of the deferential arbitrary and capricious standard of...more
From the COVID-19 threat, disrupted supply chains and economic fluctuations to the dichotomy in shifting state and federal policies, regulations, ongoing litigation, compliance issues, and cyber threats, the energy and...more
This month's Friday Five discusses cases that probe the issue of what is appropriately considered in litigation regarding LTD benefits. Some cases seem to state the obvious, for example when a court issues an order directing...more
An insurer successfully defeated a plaintiff’s attempt to keep a bad faith action in state court by “manipulating” federal diversity jurisdiction by naming an individual claims adjuster as a defendant....more
Rejecting insurance bad faith claims based on an insurer’s handling of settlement discussions, the Georgia Supreme Court has ruled that "an insurer’s duty to settle arises only when the injured party presents a valid offer to...more
This month's Friday Five covers three cases that address issues that can be critical for LTD insurers litigating matters in federal court, specifically issues related to injunctions, statutes of limitations and ERISA...more
Mitchell v. State Farm Fire and Casualty Company, No. 3:17cv00170-M, 2018 WL 4572664 (N.D. Miss. Sept. 24, 2018) -
Lorine Mitchell submitted a claim to State Farm for damage to her property from a storm. Under the terms of...more
This month’s Friday Five covers cases that explore a variety of situations where courts consider what level of deference, if any, they must provide in reviewing decisions made by ERISA fiduciaries....more
The Pennsylvania Superior Court recently held that a trial court’s decision to impose $18 million in punitive damages and $3 million in attorneys’ fees for violations of Pennsylvania’s Insurance Bad Faith Statute, 42 Pa....more
Earlier today, the Pennsylvania Department of Health (DOH), Office of Medical Marijuana (OMM), which oversees the Commonwealth’s medical marijuana program, initiated phase II of its licensing process. OMM is now accepting...more
A federal judge in Arizona refused an insurer’s effort eight days before trial to supplement the underlying claim file in a bad faith litigation. The insurer sought to add approximately 60 pages of documents from the...more
Plaintiff Bernie Clemens was injured in a motor vehicle accident in August 2009. Clemens’ attorney helped him recover $25,000 in a supplementary underinsured motorist (SUM) claim, and then sued Clemens’ insurer under...more
The Texas Supreme Court has announced five rules which the Court believes will “provide clarity regarding the relationship between claims for an insurance policy breach and Insurance Code violations.” USAA Texas Lloyds Co. v....more
In Pennsylvania, an insurance bad faith claim requires an insured to show by clear and convincing evidence that the insurer 1) lacked a reasonable basis for denying benefits under the policy, and 2) knew or recklessly...more
Kennedy v. Allstate, No. 15-2221 (E.D. Pa. July 8, 2015).
District Court recognizes possibility that insurance adjusters owe a duty of care to insureds that would be breached by failing to conduct a reasonable...more
9/21/2015
/ Allstate ,
Appeals ,
Arbitration ,
Bad Faith ,
Car Accident ,
Chapter 11 ,
Commercial Bankruptcy ,
Denial of Insurance Coverage ,
Duty of Care ,
E&O Policies ,
Insurance Industry ,
Motorcycle Accidents ,
Negligence ,
PA Supreme Court ,
Punitive Damages ,
Summary Judgment ,
Travelers Property Casualty Co. ,
Unfair or Deceptive Trade Practices
Eighth Circuit: No Bad Faith Where Insured Failed to Make a Sufficient Demand and Insurer Refused to Entertain Settlement Offer Prior to Completing Investigation -
Purscell v. Tico Ins. Co., No. 13-2362, 2015 WL 3855253...more
8/13/2015
/ Allstate ,
Bad Faith ,
Breach of Contract ,
Car Accident ,
Claim Denial Letters ,
DUI ,
Insurance Industry ,
PA Supreme Court ,
Punitive Damages ,
State Farm ,
Wrongful Death
A federal district judge has ruled that Pennsylvania law may permit an insured to sue an insurer’s employee-adjusters for negligence and violations of Pennsylvania’s Unfair Trade Practices and Consumer Protection Law...more