News & Analysis as of

Policy Terms Denial of Insurance Coverage

Wiley Rein LLP

New York Court Deems Subsequent Sexual Harassment Lawsuit “Related” to Prior Suits

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A New York intermediate appellate court, applying New York law, has held that an insurer had no coverage obligation for a third lawsuit filed against its insured that was deemed related to two earlier lawsuits that were filed...more

Butler Weihmuller Katz Craig LLP

North State Deli: A New Outbreak of COVID-19 Litigation?

Civil-authority “stay-at-home” orders issued in the wake of the COVID-19 pandemic were just one layer of the outbreak’s sweeping impact on people and businesses worldwide. The pandemic has resurfaced in North Carolina in...more

Miller Nash LLP

Oregon Supreme Court Reverses Insurance Coverage Denial for Contractor in Twigg v. Admiral Ins. Co.

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In a long-awaited decision that helps contractors obtain coverage for construction defects, the Oregon Supreme Court in Twigg v. Admiral Ins. Co. 371 Or. 308 (2025) ruled that coverage under a commercial general liability...more

Cozen O'Connor

Noncompliance With Policy’s “Duties After Loss” Provision Leads to Denial of Fire Loss Claim

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In Caribe D. Billie v. Plymouth Rock Assurance Corp. et al, the U.S. District Court for the District of Connecticut granted Plymouth Rock Assurance Corp.’s (“Insurer”) motion for summary judgment, holding that the Insurer was...more

Stark & Stark

A Simple Guide: What if My Life Insurance Claim Is Denied?

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How does the life insurance claims process work? Industry surveys contend that life insurance claims are denied less than 5% of the time, while others more skeptical of the life insurance industry believe the denial rate is...more

Ballard Spahr LLP

WA State Court: No COVID-19 Coverage in Tulalip Tribes v. Lexington

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In a recent COVID-19 Washington State insurance bad faith case, Tulalip Tribes of Washington v. Lexington Ins. Co., Division I of the Washington Court of Appeals affirmed Washington’s stance holding lost physical use of...more

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

Notice Prejudice Rule Applies to Claim Not Reported “As Soon As Practicable” But Within Policy Period

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The United States District Court for the District of Kansas, applying Kansas law, has held that an insurer must show prejudice to deny coverage when an insured provided notice of a claim within the policy’s three-year policy...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

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

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”

Lathrop GPM on

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

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

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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

Katten Muchin Rosenman LLP

Are You Really Covered as an Additional Insured?

For your next construction project in New York, securing commercial general liability coverage as an additional insured may not be as simple as it would appear. Recent court rulings have interpreted the terms of insurance...more

Marshall Dennehey

Fourth District Court of Appeal Rules Policy Endorsement Prevails Over Main Policy in Case of Conflict

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Colony Insurance Company v. Titan Restoration Construction, Inc., Fla. 4th DCA, No. 4D2023-2908, January 8, 2025 - Colony Insurance Company’s insurance policy with the general contracting company, Titan Restoration...more

Maynard Nexsen

Lessons in Limitation – Contractual Limitations Provisions as a Basis for Summary Judgment

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In recent weeks, our firm obtained summary judgment under a contractual limitations provision that the plaintiff-insured argued had been equitably tolled due to the insurance carrier’s conduct. Although the good guys won, the...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

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

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

Cozen O'Connor

Jackson v. Spinnaker: Court Rules a Thorough Investigation is Just Good Business, Not Bad Faith

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In Jackson v. Spinnaker Insurance Company, the United States District Court for the Western District of Pennsylvania considered a homeowners insurance coverage dispute, ultimately finding that questions of residency and...more

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