News & Analysis as of

Denial of Insurance Coverage Policy Exclusions Appeals

Marshall Dennehey

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

Marshall Dennehey on

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

Carlton Fields on

“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

Fisher Phillips

Appeals Court Hands Victory to Transgender Employee Seeking Health Benefits: Key Takeaways and 3 Steps Employers Can Take Now

Fisher Phillips on

A federal appeals court recently held that an employer’s health insurance plan wrongly excluded coverage for gender-affirming care in violation of federal civil rights law – offering a warning to employers across the country...more

Sheppard Mullin Richter & Hampton LLP

The Commercial Division Rejects Yet Another Insured’s Claim for Coverage for Covid-Related Revenues Losses

Does the business harm caused by COVID-19 qualify as “direct physical loss” for insurance purposes? In Spirit Airlines, Inc. v. American Home Assurance Company, Index No. 655755/2021, Commercial Division Justice Robert R....more

Hinshaw & Culbertson - Insights for Insurers

Appellate Court Rules Insurers Have Duty to Defend Illinois Biometric Privacy Claim

An Illinois state appellate court recently ruled that a customer's biometric privacy class action claims against an insured tanning salon potentially fell within two insurer's personal injury coverage. See, West Bend Mutual...more

Mitchell, Williams, Selig, Gates & Woodyard,...

Absolute Pollution Exclusion/Quarry Operations: Federal Appellate Court Addresses Coverage for Unplanned Discharge of Rock Fines

The United States Court of Appeals for the Fifth Circuit (“Court”) addressed in a January 17th opinion a company’s umbrella insurance policy’s absolute pollution exclusion. See Eastern Concrete Materials, Inc., v. Ace...more

Bradley Arant Boult Cummings LLP

Fifth Circuit Decision Excluding Coverage under Pollution Exclusion for Damage to Stream Caused by Rock Fines

In a sweeping decision, the U.S. Court of Appeals for the Fifth Circuit extended the absolute pollution exclusion to the unplanned discharge of “rock fines,” pellets produced during quarry operations, and denied coverage for...more

Carlton Fields

Is Your “Securities Claim” Actually Covered Under Your D&O Policy? A Review of In Re Verizon Insurance Coverage Appeals

Carlton Fields on

The question of what constitutes a “securities claim” in the context of public company D&O policies is often debated in insurance coverage disputes, and the answer to this question can have significant effects on the scope of...more

Carlton Fields

Look No Further Than the Insuring Clause: Ill-Gotten Gains Do Not Constitute Covered “Loss”

Carlton Fields on

On August 26, 2019, the Eleventh Circuit Court of Appeals, applying Florida Law, held that ill-gotten gains do not constitute covered “loss” within the meaning of a D&O policy. In Philadelphia Indemnity Insurance Co. v. Sabal...more

Carlton Fields

Autoerotic Asphyxiation Ruling Brews Circuit Split on Coverage

Carlton Fields on

In Tran v. Minnesota Life Insurance Co., the U.S. Court of Appeals for the Seventh Circuit ruled that an insured’s death from autoerotic asphyxiation fell under the policy exclusion for deaths resulting from “intentionally...more

Payne & Fears

Pizza Hut Delivers a Win for Employers: Reimbursement Claims are Not Automatically Excluded from Coverage by a Policy's "Wage &...

Payne & Fears on

The California Court of Appeal recently ruled that a "wage and hour" exclusion in an employment practices liability insurance ("EPLI") policy must be narrowly interpreted to extend coverage for reimbursement claims brought...more

Neal, Gerber & Eisenberg LLP

Seventh Circuit Holds Overbroad Breach of Contract Exclusion Renders E&O Coverage Illusory

On September 23, 2019, the Seventh Circuit acknowledged a common problem with Errors & Omissions (“E&O”) insurance for professional services by finding that an overbroad breach of contract exclusion rendered coverage...more

McDermott Will & Emery

Dental Company’s Indemnification Claim “Bites”

McDermott Will & Emery on

The US Court of Appeals for the First Circuit affirmed the dismissal of a dental product manufacturer’s suit against its insurer, holding that the IP exclusion in the policy expressly excluded the trademark claims over which...more

Sheppard Mullin Richter & Hampton LLP

Court Finds That “Care, Custody Or Control” Exclusion Did Not Negate Coverage For General Contractor Who Shared Jobsite...

McMillin Homes Constr., Inc. v. National Fire & Marine Ins. Co., 35 Cal.App.5th 1042 (2019); Fourth Appellate District Court of Appeal, Division One, Case No. D074219 (June 5, 2019). McMillin Homes Construction, Inc....more

White and Williams LLP

Eleventh Circuit Defers to Insurer’s Definition of Professional Services

Does an Errors & Omissions (E&O) insurer have a duty to defend its insured mental healthcare provider when the policyholder was not licensed to provide such mental health counseling services? The Eleventh Circuit recently...more

Farella Braun + Martel LLP

“That Particular Part” – Yet More

Massachusetts Appeals Court Gets It Right – Mostly - Hot on the heels of the Federal Tenth Circuit Court of Appeals’ decision in MTI, Inc. v. Employers Insurance Company of Wausau, __ F.3d __, 2019 WL 321423 (10th Cir....more

Farella Braun + Martel LLP

Evicting Tenants Over “Illegal” Cannabis Operation Comes Back to Bite Landlords in Coverage Dispute

A 6th Circuit case decided earlier this year demonstrates how positions taken by insureds in prior litigation can impact or foreclose coverage in subsequent disputes with insurers. See K.V.G. Properties, Inc. v. Westfield...more

Carlton Fields

Clearing The Air: Tenth Circuit Strikes Down An Indoor Air Quality Exclusion, Citing Ambiguity

Carlton Fields on

Ambiguity strikes again. While the heavily litigated pollution exclusion is well-known in the insurance world, its progeny—the indoor air exclusion—only recently has started making its way around the block. ...more

Carlton Fields

Sixth Circuit Weighs In On Coverage For Marijuana-Related Property Loss

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The Sixth Circuit Court of Appeals issued a colorful opinion in a property insurance coverage dispute affirming a denial of coverage for loss arising out of an illicit marijuana growing operation in Michigan. The case is...more

Ballard Spahr LLP

Ninth Circuit to Decide Key TCPA Insurance Issue

Ballard Spahr LLP on

The Ninth Circuit Court of Appeals recently heard oral argument in Los Angeles Lakers, Inc. v. Federal Insurance Company, a case raising the issue of whether an exclusion for invasion of privacy claims in a directors and...more

Carlton Fields

Florida Supreme Court Decides that Concurrent Causes Equal Coverage

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It’s said that “defeat is an orphan,” but insurable losses often have multiple, concurrent causes. In some cases, one or more of those causes might be outside the scope of coverage, either by omission or exclusion. In Sebo v....more

Cozen O'Connor

“Context Matters” – Tenth Circuit Holds Mudslide Not an Explosion Under Property Policy

Cozen O'Connor on

On August 29, 2016, the U.S. Court of Appeals for the Tenth Circuit affirmed a Colorado district court ruling that the sudden obliteration of a building in a 2013 mudslide did not constitute an “explosion” under a commercial...more

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