News & Analysis as of

Denial of Insurance Coverage Policy Terms Policy Exclusions

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

No Coverage for Lawsuit Where “Claim” First Made at Time of Pre-Inception Tolling Agreement

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In a win for Wiley’s client, a New York intermediate appellate court, applying New York law, has affirmed that no coverage is available for a legal malpractice lawsuit because the “claim” was first made before the policy’s...more

Morris, Manning & Martin, LLP

Policyholder Concerns after Georgia Federal Court Takes Broad Reading of Pollution Exclusion

In Citizens Ins. Co. of Am., et al. v. Augusta Chiller Service, Inc., et al., the Southern District of Georgia granted insurers' motions for summary judgment in part on their duty to defend under a primary and excess policy...more

Lathrop GPM

California Courts Continue to Grapple with What Constitutes Wildfire “Direct Physical Loss or Damage”

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In Gharibian et al., v. Wawanesa General Insurance Company, the California Second District Court of Appeal found that, under California law, the insureds failed to prove smoke, soot, ash and fire debris on covered property...more

Carlton Fields

Recent Denial of Business Interruption Coverage to Cannabis Manufacturer Highlights Importance of Diving Into the Weeds of...

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In Theraplant LLC v. National Fire & Marine Insurance Co., the U.S. District Court for the District of Connecticut denied the insured cannabis cultivator’s claim for business interruption coverage because the insured failed...more

Carlton Fields

A Bridge Too Far: Pennsylvania Federal Court Declines to Extend Coverage Beyond Policy’s Plain and Unambiguous Terms

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It’s apt to name a blog post after one of history’s great action movies when the case involves a “conceptual artillery duel” that “ends in a draw,” and that is exactly how U.S. District Judge Gerald Austin McHugh Jr. of the...more

Marshall Dennehey

Adequate Notice Requires More Than Delivery of a Policy

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A December 31, 2024, decision from the Supreme Court of Idaho found that adequate notice to an insured required more than the delivery of a policy and, due to the insurer’s failure to do so, coverage under a pre-existing...more

Segal McCambridge

New York Appellate Court Clarifies Insurer Obligations Under the Child Victims Act

Segal McCambridge on

The New York Appellate Division Fourth Department recently issued a decision affirming in part and reversing in part summary judgment motions against GuideOne Mutual Insurance Company (“GuideOne”) in a case brought by The...more

Bradley Arant Boult Cummings LLP

North Carolina Supreme Court: Government-ordered business closures during COVID-19 lockdowns constitute 'direct physical loss'...

Steven Hix and G. Benjamin Milam of Bradley discuss a pair of recent North Carolina Supreme Court rulings on coverage for pandemic-related losses, one of which gave policyholders a rare win. On December 13, the North...more

Rivkin Radler LLP

January 2025 New York Insurance Coverage Law Update

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The insured owned premises located in Huntington Station, NY. The Claimant was allegedly injured when she slipped and fell at the premises. The Claimant sued the insured and the insured sought coverage under her homeowners...more

Rivkin Radler LLP

New York Insurance Coverage Law Update — Compilation 2024

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An owner, general contractor (GC) and subcontractor (Sub) were sued by injured workers at a construction site, and they were defended by the Sub’s insurer, U.S. Specialty Insurance Company. U.S. Specialty tendered their...more

Kilpatrick

COVID All-Risk Policies

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In a ruling that bucked the national trend, the North Carolina Supreme Court recently held that restaurants’ business interruption losses caused by the COVID shutdown were covered under an all-risk property policy. North...more

Houston Harbaugh, P.C.

Supreme Court Of North Carolina Holds That Losses Caused By The COVID-19 Shutdown Orders Are Direct Physical Loss Covered By...

On December 13, 2024, the Supreme Court of North Carolina broke with the nationwide trend, holding that, absent a virus exclusion, commercial property insurance policies cover losses covered by the shutdown orders issued in...more

Lowenstein Sandler LLP

Taking the Right Steps To Navigate the Consent To Settle Provision in an Insurance Policy and Maintaining the Right to Coverage...

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Insurers often try to withhold, or at least minimize, coverage by taking the position that a policyholder has failed to keep the insurer sufficiently informed throughout the defense of an underlying matter or has failed to...more

Zelle  LLP

Is Your War Exclusion Fit for Purpose?

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As global threats evolve, so does the question of what constitutes a ‘war’ risk under a standard property insurance policy, and how this might impact coverage. Historically, a war was a physical conflict between two or...more

Zelle  LLP

The Zelle Lonestar Lowdown Issue 20 - December 2024

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Welcome to The Zelle Lonestar Lowdown, our monthly newsletter bringing you relevant and up-to-date news concerning Texas first-party property insurance law. Inside this Issue: - Todd Tippett’s Top Ten Consultants an...more

Sheppard Mullin Richter & Hampton LLP

An Insurer is not Vicariously Liable for Actions by an Agent That Are Outside the Scope of the Agency Relationship and Were...

In December 2020, Plaintiff Erin Hughes applied for homeowners coverage for her Malibu home with her Farmers’ insurance agent. Hughes obtained a fire policy through the California FAIR Plan and a homeowners policy through...more

Wiley Rein LLP

Tenth Circuit Deems D&O Policy Ambiguous Based on Interplay of Coverage Grant with Managed Care Exclusion

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The United States Court of Appeals for the Tenth Circuit, applying Kansas law, has held that a D&O insurer was obligated to reimburse defense costs where a policy expressly covered antitrust claims but excluded coverage for...more

Marshall Dennehey

Fourth District Court of Appeal Reversed and Remanded a Final Judgment in Favor of the Insureds Where Prompt Notice Was Not...

Marshall Dennehey on

Security First Insurance Company v. Linda Visca and Silvio Visca, No. 4D2023-0961, June 5, 2024 - On February 20, 2020, the defendant was notified of the plaintiffs’ September 10, 2017, Hurricane Irma claim. The policy stated...more

Morris, Manning & Martin, LLP

Insurer Must Defend Hotel from Allegations of Sex Trafficking, Northern District of Georgia Rules

In a recent opinion, the District Court for the Northern District of Georgia has ordered an insurer to defend an insured hotel from allegations that it negligently or intentionally permitted a minor to be trafficked for sex...more

Cozen O'Connor

The Importance of Experts J&S Welding, Inc. v. Liberty Mutual Insurance Company

Cozen O'Connor on

In J&S Welding, Inc. v. Liberty Mutual Insurance Company, the U.S. Court of Appeals reviewed a summary judgment ruling in favor of co-defendant West American Insurance Company (“West American”), issued by the U.S. District...more

Lowenstein Sandler LLP

Best Practices for Negotiating Manuscript Exclusions

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Today on "In the Know,” Eric Jesse discusses best practices for negotiating manuscript endorsements to an insurance policy: in other words, revisions that are specifically negotiated and added by the parties. Because...more

Marshall Dennehey

Denial of Insurer’s Petition for Limited Intervention in Trial Court Action Against Insured to Determine Whether Coverage...

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Key Points: Trial court’s denial of insurer’s petition for limited intervention to determine whether coverage exclusion applied was immediately appealable pursuant to Pa. R.A.P. 313(b)....more

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