News & Analysis as of

Fraud Insurance Litigation

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
Marshall Dennehey

Appellate Court Affirms Ruling a Sworn Proof of Loss and Estimate Related to Later Claim Was Inadmissible as Hearsay and...

Marshall Dennehey on

Universal Property & Casualty Insurance Company v. Luis Nacimiento, Fla. 3rd DCA, 3D23-0301, Apr. 3, 2024 - The insured reported a claim to Universal Casualty & Property Insurance Company in February 2016 for water damage...more

Faegre Drinker Biddle & Reath LLP

Court Sides with Long-Term Care Insurer Over Claim Denial and Potential Fraud

A judge from the District of Colorado recently issued an opinion that might leave the door open for long-term care insurers to void policies after the contestability period expires if an insured commits fraud. See Meyer v....more

Wiley Rein LLP

Dishonesty Exclusion Bars Coverage For Claim Based On Actions Of Contractor Authorized To Conduct Operations On Behalf Of Insured

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Applying California law, a California state appeals court has held that a policy exclusion barring coverage for “any [c]laim . . . [b]ased upon or arising out of any . . . act or omission . . . which is . . . dishonest,...more

Wiley Rein LLP

Fraud Exclusion, California Insurance Code Section 533 Preclude Coverage for Arbitration Award

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A California federal court, applying California law, has held that an employment liability policy does not provide coverage for a judgment against the insured following an arbitrator’s finding of fraud....more

Ervin Cohen & Jessup LLP

Companies That Pay Hackers May Be Able to Recoup Their Losses

Where companies are victimized by ransomware or email scams, their losses arise from payments made by an officer or employee of the company. In the case of ransomware, a company’s files are held hostage pending payment...more

Bennett Jones LLP

Court of Appeal Endorses Draconian Deterrent to Insurance Fraud

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In Abbas v Esurance Insurance Company of Canada, 2023 ABCA 36 [Abbas], the Alberta Court of Appeal endorsed what it described as draconian consequences for insurance fraud as consistent with the Insurance Act, RSA 2000 c I-3...more

Carlton Fields

Expect Focus - Volume I, January 2023

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More than 25 years have elapsed since the SEC adopted Exchange Act Rule 17a-4(f) governing electronic recordkeeping by broker-dealers. In an effort to update the rule to reflect “technology neutral” concepts, the SEC adopted...more

Rivkin Radler LLP

The Title Reporter — Winter 2023

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Here is what we cover in this issue of The Title Reporter: A Legal Update for the Title Insurance Industry •A federal district court in New York granted summary judgment in favor of a title insurance company and its...more

Wiley Rein LLP

Lawsuit Deemed Related to Notice of Circumstances Submitted During Prior Claims-Made Policy Period Under Florida’s “Sufficient...

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The United States District Court for the Western District of Louisiana, applying Florida law, has held that an investor’s lawsuit against an attorney related back to a notice of a potential claim submitted during the earlier...more

Carlton Fields

Federal Court Rejects Computer Fraud Coverage for Social Engineering Loss

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In SJ Computers LLC v. Travelers Casualty and Surety Company of America, the U.S. District Court for the District of Minnesota recently addressed the scope of insurance available for a phishing scheme under the terms of a...more

White and Williams LLP

To Be or To Be On Behalf Of: That Is the Question

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On August 10, 2022, the U.S. District Court for the Middle District of Florida held, on a motion to dismiss, that losses allegedly caused by fraudulent payment requests by persons purporting to be the insured qualified for...more

Ervin Cohen & Jessup LLP

Third-Party Email Fraud Covered By Insurance Policies

In Medidata Solutions, Inc. v. Federal Insurance Company, 268 F. Supp. 3d 471 (S. D. N. Y. 2017), aff’d, 729 Fed. Appx. 117 (2nd Circuit 2018), the Court found that there was insurance coverage where a company had been...more

Wiley Rein LLP

No Coverage for Loss in Consequence of Social Engineering Fraud

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Applying North Carolina law, a federal district court has held that an E&O insurance policy does not provide coverage for loss arising from social engineering fraud despite the fact that the insured’s negligence also...more

Wiley Rein LLP

Insured Cannot Bring Bad Faith Allegation When Coverage “Fairly Debatable”

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The United States District Court for Minnesota, applying Minnesota law, has affirmed a magistrate judge’s decision denying an insured’s motion to amend its complaint to add a claim for bad faith....more

Carlton Fields

Annuity Litigation Roundup

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Court Emphasizes Disclosure Substance Over Form - A recent decision in Nofsinger v. Jackson National Life Insurance Co. shut down a putative class action in which the plaintiff alleged she surrendered her annuity contract...more

Carlton Fields

Recent Trends and Defense Strategies in Agent Sales Practice Suits

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Allegations of misconduct by agents and brokers are a consistent feature of lawsuits aimed at insurance companies. Several recent court decisions illustrate the types of claims insurers have faced and which defense strategies...more

Carlton Fields

Texas Federal Court Finds No Coverage Under Crime Policy for Phishing Scheme Because Insured Did Not “Hold” Diverted Funds and...

Carlton Fields on

RealPage was the victim of a phishing scheme that resulted in the diversion of its client funds from the bank account of a third-party payment processer, Stripe Inc. In the ensuing insurance coverage litigation styled...more

Wiley Rein LLP

Texas Court Holds Late Notice Bars Coverage

Wiley Rein LLP on

The United States District Court for the Northern District of Texas, applying Texas law, has held that an insured’s late notice of a claim bars coverage, rejecting arguments that (i) the initial complaint did not constitute a...more

Payne & Fears

Ninth Circuit Rejects Excess Insurer's Attempt to Dispute Exhaustion of Underlying Insurance

Payne & Fears on

This week, in AXIS Reinsurance Co. v. Northrop Grumman Corp., ____ F.3d ____, 2020 WL 5509743 (9th Cir. Sept. 14, 2020), the Ninth Circuit addressed an important question of first impression: When can an excess insurer...more

Greenberg Glusker LLP

Ninth Circuit Court of Appeal Rules that Excess Insurer Cannot Challenge Exhaustion of Underlying Insurance on Coverage Grounds

Greenberg Glusker LLP on

In Axis Reinsurance Co. v. Northrop Grumman Corporation, 2020 DJDAR 10114 (9th Cir. Sept. 14, 2020), a case of first impression under California law, the Ninth Circuit held that an excess insurer may not dispute exhaustion of...more

Cozen O'Connor

Texas Supreme Court Crafts “Undisputed Evidence of Collusive Fraud” Exception to Eight-Corners Rule

Cozen O'Connor on

In Texas, and as a general rule, only the four corners of the policy and the four corners of the petition against the insured are relevant in deciding whether the duty to defend applies. Richards v. State Farm Lloyds,...more

Carlton Fields

2019 Year-End Class Action Roundup

Carlton Fields on

Life insurers bid farewell to a fairly moderate year of class action litigation. Although several class actions were filed against life insurers in the last quarter of 2019, the filings were reflective of the litigation...more

Jones Day

Insurance Coverage for Social Engineering Crimes—How to Avoid Being Victimized Twice

Jones Day on

The Situation: Businesses are increasingly at risk of social engineering crimes, and often their commercial insurance policies do not provide the full protection that they expected. The Result: Three recent decisions...more

White and Williams LLP

Delaware Chancery Court Provides Guidance on Prior Material Breach and Set-Offs

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The Delaware Chancery Court recently reaffirmed several important contract interpretation principles in Post Holdings, Inc. v. NPE Seller Rep LLC, Civil Action No. 2017-0772-AGB. The case highlights the fact that a party...more

Farella Braun + Martel LLP

Social Engineering Scam Covered By Cyber Insurance

The Sixth Circuit recently entered a ruling in American Tooling Center, Inc. v. Travelers Casualty and Surety Co. of America, 2018 WL 3404708 (6th Cir. July 13, 2018), soundly rejecting a cyber carrier’s extremely narrow...more

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