News & Analysis as of

Denial of Insurance Coverage Policy Terms Appeals

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

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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

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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

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

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

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

Zelle LLP on

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

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

BCLP

English Court Decides COVID-19 is a “Catastrophe”

BCLP on

The English Court has, for the first time, considered the meaning of a “catastrophe”, as well as how Hours Clauses work in the context of non-damage business interruption losses claimed under two Property Catastrophe Excess...more

Ervin Cohen & Jessup LLP

Ninth Circuit Deals Another Blow to Restaurants in COVID-19 Insurance Coverage Case

On June 26, 2023, a panel of judges for the United States Court of Appeals for the Ninth Circuit affirmed an insurance company’s win over a restaurant group seeking insurance coverage for pandemic-related claims in Team 44...more

Steptoe & Johnson PLLC

Fourth Circuit Upholds Dismissal of Insurance Claim for Pandemic Related Business Losses

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In a published decision filed March 7, 2022, the U.S. Court of Appeals for the Fourth Circuit in Uncork and Create LLC v. The Cincinnati Insurance Company, affirmed the U.S. District Court for the Southern District of West...more

Butler Snow LLP

The Fifth Circuit Court of Appeals Just Slammed the Door on Texas Businesses Seeking Insurance Coverage for Lost Revenue Due to...

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In a pair of opinions issued last month, the Fifth Circuit Court of Appeals held that Texas businesses’ COVID-19 related income loss was not covered by standard business income and extra expense (“BI/EE”) endorsement in...more

Bricker Graydon LLP

8th Circuit denies COVID-related business income claim in first federal appellate ruling

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In a relatively concise ruling, the 8th Circuit U.S. Court of Appeals issued the first U.S. Appellate Court decision on insurance coverage for COVID-19 related claims. The 8th Circuit ruling affirmed that the insurance policy...more

Gould + Ratner LLP

Suburb's Citizens Out of Luck Against Contractor's Insurer for Contaminated Water

Gould + Ratner LLP on

Under established Illinois law, an insurer must defend a legal action filed against its insured unless it is clear from the face of the underlying complaint that the allegations fail to state facts which bring the case...more

Carlton Fields

The Three “Musts” for a Competent Affidavit or Declaration

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Florida’s Second District Court of Appeal recently issued a decision that serves as a reminder not to take for granted a proposition that most practicing attorneys regularly encounter: a motion for summary judgment must be...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

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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

Pillsbury - Policyholder Pulse blog

A Recent “Event” in Wisconsin: Appellate Court Rules That a Commonly Used London Market “Occurrence” Definition Is Ambiguous

In recent years, Wisconsin generally has been a pro-policyholder jurisdiction when it comes to long-tail environmental coverage cases. That trend continues with a decision by a Wisconsin appellate court in a case involving...more

Robins Kaplan LLP

Empire State of Mind: New York Bad Faith Update

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WHILE THERE REMAINS NO BAD FAITH CAUSE OF ACTION IN NEW YORK, A RECENT APPELLATE DIVISION CASE OUT OF THE FIRST DEPARTMENT MAKES PLAIN THAT AN INSURED NEED NOT MEET A HEIGHTENED PLEADING STANDARD WITH RESPECT TO CONSEQUENTIAL...more

Carlton Fields

Eleventh Circuit Rejects Insurer-Defended Policyholder’s Bid to Expand Florida’s Bad Faith “Excess Judgment Rule” to Include...

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In Cawthorn v. Auto-Owners Insurance Co., No. 18-12067 (11th Cir. Oct. 25, 2019), the Eleventh Circuit affirmed the U.S. District Court for the Middle District of Florida’s grant of summary judgment in favor of Auto-Owners...more

Carlton Fields

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

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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

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