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Denial of Insurance Coverage Appeals

Marshall Dennehey

Pennsylvania Superior Court Finds Appellants’ Position Unreasonable

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In Hespen v. Erie Insurance Company, Levy Insurance Company, LLC and Thomas Levy, 332 A.3d 1229 (Pa. Super. 2024), the Pennsylvania Superior Court rejected the appellants’ assertion of the applicability of the doctrine of...more

Wiley Rein LLP

New York Court Deems Subsequent Sexual Harassment Lawsuit “Related” to Prior Suits

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A New York intermediate appellate court, applying New York law, has held that an insurer had no coverage obligation for a third lawsuit filed against its insured that was deemed related to two earlier lawsuits that were filed...more

Cozen O'Connor

Insurer’s Use of Conflicting Reports Not Bad Faith, Says Court

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In El Dueno, LLC v. Mid-Century Insurance Company (2025 WL 1540329) (10th Cir. 2025)), the Tenth Circuit Court of Appeals affirmed summary judgement on behalf of the insurer on the basis that the insurer did not act in bad...more

Miller Nash LLP

Oregon Supreme Court Reverses Insurance Coverage Denial for Contractor in Twigg v. Admiral Ins. Co.

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In a long-awaited decision that helps contractors obtain coverage for construction defects, the Oregon Supreme Court in Twigg v. Admiral Ins. Co. 371 Or. 308 (2025) ruled that coverage under a commercial general liability...more

Carlton Fields

Third Circuit Holds Harassment Exclusion Bars Coverage for Sexual Assault Suit Under Pennsylvania Law

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In Rice Enterprises LLC v. RSUI Indemnity Co., the Third Circuit Court of Appeals affirmed the district court’s finding that the insured was not entitled to coverage from its employer’s liability insurer or its umbrella...more

Zelle  LLP

Calif. Smoke Claim Ruling Gives Insurers Support On Denials

Zelle LLP on

In their recent Law360 guest article titled "Reconciling 2 Smoke Coverage Cases From California," the authors described a California appellate court's Feb. 7 opinion in Gharibian v. Wawanesa General Insurance Co. as an...more

Carlton Fields

Divided Ninth Circuit Finds Claimant’s Failure to Provide Medical Records Insulates Insurer From Bad Faith Failure to Settle

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If at first you don’t succeed, try, try again. An age-old adage that now provides critical guidance for insurers seeking to protect themselves in the face of bad faith failure to settle claims....more

Carlton Fields

Litigation Under Construction: Recent Life Insurance and Long-Term Care Developments

Carlton Fields on

In Potovsky v. Lincoln Benefit Life Co., the Ninth Circuit Court of Appeals affirmed the dismissal of the insureds’ complaint for failure to sufficiently allege damages regarding the denial of a long-term care claim....more

Marshall Dennehey

Court Denies UIM Coverage to Woman, Claiming ‘Family Member’ Status Through Daughter

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Miller v. USAA General Indemnity Company, No. 23-1934 (3d Cir. Jan. 7, 2025) - The plaintiff, who resided with her daughter in the home of her daughter’s paternal grandmother, sought UIM benefits under an auto insurance...more

Carlton Fields

Eighth Circuit Finds No Coverage Under “Ensuing Loss” Provision Under Arkansas Law

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“Ensuing loss” provisions have long been the subject of nuanced arguments in insurance litigation. The provisions, which sometimes afford coverage for a “covered loss” stemming from an expressly excluded peril, serve as...more

Carlton Fields

Texas Appeals Court Finds Project Owner Excluded From Coverage as Claimants’ Statutory Employer

Carlton Fields on

On April 3, 2025, a Texas state appeals court reversed a trial court order awarding Exxon Mobil $25 million under an umbrella insurance policy issued by Lexington Insurance Co. to Brock Services Ltd. The appeals court found...more

Wiley Rein LLP

Third Circuit: Changes in Exposure Provision Bars Coverage for Pre-Merger Liabilities

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In a win for Wiley’s client, the United States Court of Appeals for the Third Circuit, applying Pennsylvania law, affirmed judgment on the pleadings in favor of a group of insurers on the ground that a Changes in Exposure...more

Marshall Dennehey

Third District Court of Appeal Rules Affidavit Lacks Evidence Linking Damage to Tropical Storm Eta

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Thomas A. Bouchard, Jr. v. Citizens Prop. Ins. Corp., Fla. 3d DCA, No. 3D12-2202, February 19, 2025 - Thomas Bouchard, the appellant, appealed a final summary judgment order entered in favor of Citizens Property Insurance...more

Marshall Dennehey

Fourth District Court of Appeal: Noncompliance with Post-Loss Requirements Is a Contract Breach, No Prejudice to Insurer Needed

Marshall Dennehey on

Alton Forbes v. People’s Trust Ins. Co., Fla. 4th DCA, No. 4D2023-2375, January 8, 2025 - The Fourth District Court of Appeals ruled that the final judgment against the appellant stands because the appellant failed to comply...more

Rivkin Radler LLP

March 2025 New York Insurance Coverage Law Update

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The owners of a warehouse leased it to a commercial tenant to operate a photography studio. The lease required the tenant to procure insurance for the owners and to indemnify them for the negligent acts of the tenant’s...more

Marshall Dennehey

Court Reverses Summary Judgment, Finding Insurer Failed to Prove Policy Exclusion

Marshall Dennehey on

Ronald and Lovelie Belizaire v. Citizens Prop. Ins. Corp., Fla. 4th DCA, No. 4D2023-2488, February 12, 2025 - The Fourth District Court of Appeal reversed the trial court’s order granting summary judgment in favor of the...more

Zelle  LLP

Balancing Discovery and Protecting the Attorney-Client Privilege In the Insurance Coverage Context

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A recent case out of Colorado highlights the continued attack on the attorney-client privilege during the claim adjustment process. In In re: Hill Hotel Owner, LLC v. Hanover Insurance Company, 557 P.3d 798 (Colo. Oct. 29,...more

Quarles & Brady LLP

2024 Wisconsin Insurance Case Law Update

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Every year, Quarles & Brady LLP's Insurance Recovery Team compiles a list of important decisions by Wisconsin state and federal courts addressing insurance issues. Our goal is to keep you informed of developments and help you...more

Goldberg Segalla

Fraud Doesn’t Pay in New York – February 2025 Update

Goldberg Segalla on

As a part of our Quarterly Practice Group Update, we are pleased to produce another installment with examples of our continued success in the area of fraud litigation. The New York State Workers’ Compensation Board has...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

Ninth Circuit Affirms ERISA Plan Administrator’s Decision, Validates Use of Industry Guidelines and Medical Evidence

On March 5, 2019, Magistrate Judge Joseph C. Spero of the U.S. District Court for the Northern District of California issued his opinion in Wit v. United Behavioral Health, in which he attempted to significantly change how...more

Conn Kavanaugh

First Circuit Rules on Important Coverage Issue for Contractors.

Conn Kavanaugh on

First Circuit Court of Appeals Rules That Standard Commercial General Liability Policy Excludes Coverage for Downstream Property Damage When General Contractor’s Scope of Work Covers Entire Building - It is well-accepted...more

Marshall Dennehey

The Sixth District Court of Appeals Rules in Favor of the Insurance Carrier, Finding That Ensuing Water Damage is Not Covered...

Marshall Dennehey on

State Farm Florida Ins. Co. v. Feltes, Fla. 6th DCA, No. 6D2023-0991, November 27, 2024 - This case arose out of the policyholder’s ongoing plumbing issues in her home. The insured property was built in the early 1960s, and...more

Zelle  LLP

Homeowners Did Not Substantially Meet Policy’s Condition Precedent to Recover Replacement Cost Value

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Property Insurance/Replacement Cost - Homeowners Did Not Substantially Meet Policy’s Condition Precedent to Recover Replacement Cost Value - Insurer Did Not Waive Conditions - Henderson v. State Farm Fire and...more

Freiberger Haber LLP

New York Court of Appeals Examines the Enforceability of a Contract’s Two-Year Suit Limitation Period

Freiberger Haber LLP on

In Farage v. Associated Ins. Mgt. Corp., 2024 N.Y. Slip Op. 05875 (Nov. 26, 2024) (here), the New York Court of Appeals examined the enforceability of an insurance contract’s two-year suit limitation period. In a 4-3...more

Wiley Rein LLP

Second Circuit Finds Pre-Suit Letter Was a “Claim” and Remands for Determination of Whether Notice of Claim Was Timely

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The United States Court of Appeals for the Second Circuit, applying New York law, has held that a pre-suit letter sent to an insured constituted a “Claim” under a liability policy. Match Group, LLC v. Beazley Underwriting...more

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