News & Analysis as of

Insurance Claims Appeals

Sheppard Mullin Richter & Hampton LLP

John’s Grill, Inc. v. Hartford Financial Services, Group, Inc.: Illusory Coverage, Unambiguous Policy Language, and the...

In its latest Covid-era coverage case, John’s Grill, Inc. v. Hartford Financial Services, Group, Inc., the California Supreme Court held that an insured cannot use the “illusory coverage doctrine to transform the policy’s...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

Steptoe & Johnson PLLC

Fourth Circuit Reaffirms Necessary Prerequisites for Claiming Hayseeds Damages and Offers Guidance on Admissibility of Experts

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On June 5, the United States Circuit Court of Appeals for the Fourth Circuit issued an unpublished opinion that provides a blueprint to insurance companies for handling bad faith claims. The Fourth Circuit held in Sellman v....more

Snell & Wilmer

A Few Days Late, and Many Dollars Short: Utah Court Of Appeals Reminds That Statutory Deadlines Matter, and Provides Clarity On...

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Utah's lien statute is intricate, unique, and oft amended by the legislature. And how Utah courts have interpreted the definitions and deadlines in the lien statute are frequent subjects of trial court best efforts and,...more

BCLP

English Court Decides COVID-19 is a “Catastrophe”

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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

Payne & Fears

VIZIO’s Multi-Million-Dollar Insurance Claim Denied Over Communication Issue

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It’s been said that in business, silence isn’t golden, it’s deadly. The same holds true for insurance, where communication with your insurer (or the lack thereof) can be the difference between coverage or a denial....more

Bradley Arant Boult Cummings LLP

The Haunting in the Cornfield: Relators’ Qui Tam Claim Confirmed Dead by the Eighth Circuit

The Eighth Circuit Court of Appeals recently affirmed judgment against relators in a case alleging that a group of dairy farmers growing corn violated the False Claims Act by filing false insurance claims paid by the Federal...more

Houston Harbaugh, P.C.

Third Circuit: Assault on a school bus did not have sufficient connection to use of the bus to trigger auto coverage

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On September 22, 2023, the U.S. Court of Appeals for the Third Circuit held in a non-precedential opinion that an insurer had no duty to defend a school bus transportation company under an auto policy for an alleged assault...more

Carlton Fields

Alabama Federal Court Finds No Duty to Defend Lawsuit Alleging Concealment of Defects in Sale of Home

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In Nationwide Mutual Fire Insurance Co. v. Carmichael, the U.S. District Court for the Northern District of Alabama, applying Alabama law, entered summary judgment ruling that Nationwide Fire Insurance Co. had no duty to...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

Chartwell Law

Sixth District Court of Appeal Addresses the Scope of Appraisal

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In a June 9, 2023 decision, the Sixth District Court of Appeal (“DCA”) explained the role of an umpire during the appraisal process. The First Acceptance Ins. Co., Inc. v. At Home Auto Glass, LLC a/a/o Petra James trial court...more

Chartwell Law

Fourth District Court of Appeal Determines that Fla. Stat. § 627.70152’s Pre-Suit Notice Requirement Applies Retroactively,...

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Earlier this month, Florida’s Fourth District Court of Appeal held that Fla. Stat. § 627.70152’s pre-suit notice requirement applies retroactively to insurance policies issued before the statute’s effective date. The holding...more

Skadden, Arps, Slate, Meagher & Flom LLP

Inside the Courts – An Update From Skadden Securities Litigators - May 2023

Supreme Court Hears Argument on Traceability Requirement in Circuit-Split Slack v. Pirani - Key Points - - Before the end of June, the U.S. Supreme Court is expected to issue a decision in a high-profile securities case...more

Sheppard Mullin Richter & Hampton LLP

Ninth Circuit Affirms Summary Judgment for Allstate in Bad Faith Claim

In an issue of first impression, the Ninth Circuit Court of Appeals affirmed summary judgment for Allstate and held that the two-year statute of limitations for bad faith claims arising out of an uninsured/underinsured...more

Bressler, Amery & Ross, P.C.

Insurer’s Counsel Wins One of the First Sixth District Court of Appeals Decisions in Insurance Defense Case

Fort Lauderdale, FL (March 2023) – Bressler, Amery & Ross, P.C. attorneys Hope C. Zelinger and Lilian Rodriguez-Baz successfully represented United Property & Casualty Insurance Company in an insurance defense appeal. This...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

Conn Kavanaugh

No Case is Too Big to Notify a Claims-Made Insurer

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A headline-grabbing case regarding race in the college admissions process at an elite university, appealed all the way to the United States Supreme Court, is the type of nightmare scenario that might inspire an educational...more

Bradley Arant Boult Cummings LLP

Construction Dust is Pollution?

A recent insurance coverage decision from the United States District Court for the Northern District of Georgia highlights the difficulties of court interpretation of insurance policies and serves as a warning for contractors...more

Sheppard Mullin Richter & Hampton LLP

Negligence is Not Enough/Set-Up Tactics are Disfavored

Over the past 10 years, policy limit settlement demands with myriad conditions have become the norm. In many instances, the conditions are imposed in the hope that the insurer will falter in its efforts to comply. Unless...more

White and Williams LLP

Hurricane Ian: Discussing Wind-Water Disputes

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Most of the Florida homes in the path of Hurricane Ian lack flood insurance, posing a major challenge to rebuilding efforts, new data show. In the counties whose residents were told to evacuate, just 18.5 percent of homes...more

White and Williams LLP

Insurers Can Look To Extrinsic Evidence To Deny a Defense

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Last week, the New Jersey Supreme Court decided Norman International, Inc. v. Admiral Insurance Company, No. 086155 (N.J. Aug. 11, 2022). At issue was coverage for a work-site injury and the interpretation of a policy...more

Lowndes

Are Economic Losses Caused by COVID Shutdowns Recoverable Under Commercial Property Insurance Policies

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As we have previously written, whether economic losses caused by COVID shutdowns can be recovered under commercial property insurance policies is a hotly-contested issue. (Past articles include, ‘Will Your Business...more

Butler Weihmuller Katz Craig LLP

Indiana Rejects Subrogation Waiver Argument Where Contractor Performed Work At The Request Of Another

In U.S. Automatic Sprinkler Corp. v. Erie Insurance Exchange, 21A-CT-580, 2022 WL 906142 (Ind. Ct. App. Mar. 29, 2022), the Indiana Court of Appeals held that a subrogation waiver in an insured’s maintenance contract did not...more

Jones Day

Policyholders Receive Needed Guidance on Use of Extrinsic Evidence in Texas When Enforcing an Insurer's Duty to Defend

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The U.S. Court of Appeals for the Fifth Circuit recently applied the newly adopted Texas Supreme Court decision outlining those circumstances in which extrinsic evidence may be used to determine an insurer's duty to defend...more

Proskauer - Employee Benefits & Executive...

Ninth Circuit Defers to Plan Design and Administrative Discretion on Bounds of Mental Health Coverage

A recent decision by the U.S. Court of Appeals for the Ninth Circuit (Wit et al. v. United Behavioral Health and Alexander et al. v. United Behavioral Health) exemplifies the challenge in balancing a desire to cover evolving...more

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