Insurance Law
[11/19]
Martco Ltd. Pshp. v. Wellons Inc.
In an action against an insurer seeking coverage for an underlying lawsuit regarding defects in a heating system installed by plaintiff, summary judgment for defendant is reversed where: 1) defendant had a duty to defend the underlying suit in light of the language of the policy and the allegations of the underlying complaint; and 2) the "work product" exclusion in the policy did not preclude recovery.
[11/13]
Kim Seng Co. v. Great Am. Ins. Co. of New York
In a dispute over whether plaintiff's insurer had a duty to defend and indemnify plaintiff in a trademark infringement action under an "advertising injury" policy, summary judgment for insurance company is affirmed as the prior publication exclusion in the policy bars coverage for trademark infringement in this case.
[11/13]
Kovach v. Zurich American Ins. Co.
In plaintiff's ERISA suit against an insurance company for denying his claim for dismemberment benefits arising from a drunk-driving motorcycle accident, summary judgment for defendant-plan administrator is reversed and remanded for entry of judgment in favor of the plaintiffs where: 1) defendant's decision to deny benefits to the plaintiffs was contrary to the everyday meaning of the word "accidental" as it would be understood by a typical policyholder, and was based almost entirely on a body of largely distinguishable district court cases; 2) plaintiff's injuries were not "highly likely to occur" as a result of his intoxication, in contrast to the injuries that were highly likely to occur under the facts in Lennon; 3) defendant's interpretation of the Plan's provisions amounts to an additional, unwritten exclusion for all drunk-driving injuries, which is not permitted under even the most deferential standard of review; and 4) defendant's denial of coverage based on plaintiff's injuries being non-accidental was unreasonable, arbitrary and capricious.
[11/12]
Berry & Murphy, P.C. v. Carolina Cas. Ins. Co.
In an action for insurance coverage for a malpractice lawsuit, summary judgment for defendant is affirmed where: 1) the alleged acts of malpractice in a letter sent to the malpractice defendant and the lawsuit were "connected by an inevitable or predictable interrelation or sequence of events" for purposes of the policy; 2) the insurance policy treated as one claim all "related wrongful acts"; and 3) because defendant had no legally cognizable duty to defend or indemnify a claim, plaintiffs' bad faith claim could not survive.
[11/10]
Safety Nat'l. Cas. Corp. v. Certain Underwriters at Lloyd's
In an appeal from the denial of a motion to compel arbitration of a contractual dispute among insurers, the order is reversed where the McCarran–Ferguson Act does not authorize state law to reverse-preempt the Convention on the Recognition and Enforcement of Foreign Arbitral Awards or its implementing legislation.
[11/10]
Payless ShoeSource, Inc. v. Travelers Cos., Inc.
In an action against an insurer for coverage of a settlement in a wage and hour lawsuit, summary judgment for defendant is affirmed where, by operation of the plain terms of the agreement, plaintiff had no claim for coverage against defendant.
[11/05]
General Star Nat. Ins. Co. v. Universal Fabricators, Inc.
In an action claiming that defendant insurer was bound by the terms of an excess insurance policy it had issued to contribute to the satisfaction of a state-court judgment of liability in a personal injury action against two entities for whom the insured had been a contractor, summary judgment for plaintiffs is reversed where the district court erred in deciding that the state-court judgment established legal liability against the insured.
[10/30]
World Harvest Church, Inc. v. GuideOne Mut. Ins. Co.
In an action against an insurer claiming that the insurer was estopped from contesting that a judgment against plaintiff was covered by the policy, the court of appeals certified the following questions to the Georgia Supreme Court: 1) does an insurer effectively reserve its right to deny coverage if it informs the insured that it does "not see coverage," after the insured had received a written reservation of rights from the insurer's sister company in a similar lawsuit in another jurisdiction, or is a written or more unequivocal reservation of rights required?; 2) when an insurer assumes and conducts an initial defense without notifying the insured that it is doing so with a reservation of rights, is the insurer estopped from asserting the defense of noncoverage only if the insured can show prejudice, or is prejudice conclusively presumed?; and 3) if the insured must show prejudice, do the facts and circumstances of this case show it?
[10/29]
Zhang v. Sup. Ct.
In plaintiff's action against her insurer over disputes arising from a fire of her commercial premises, district court's ruling sustaining defendant's demurrer to a cause of action under the Unfair Competition Law (UCL), Business and Professions Code section 17200, is vacated and remanded with directions to reinstate the cause of action as an insurer connected with conduct that would violate Insurance Code section 790.03 can also give rise to a private civil cause of action under the UCL.
[10/29]
Guillemaro-Ginorio v. Contreras-Gomez
In plaintiffs' case against the Office of the Insurance Commissioner of Puerto Rico and two consecutive Insurance Commissioners claiming that they were investigated and sanctioned for Insurance Code violations solely because of their political affiliations, district court's judgment in favor of the plaintiffs in the amount of $4.7 million and a permanent injunction is affirmed as all of defendants' grounds for relief are without merit.
[10/29]
Cox v. Standard Ins. Co.
In plaintiff's ERISA case, district court's judgment on the administrative record approving defendant's discontinuance of plaintiff's long-term disability benefits is affirmed as, taking the record as a whole and applying the highly deferential arbitrary and capricious standard, defendant's decision appears to have been based on a principled and deliberative reasoning process.
[10/28]
Standard Ins. Co. v. Morrison
In an action claiming that a state's practice of disapproving insurance policies with clauses vesting discretion in insurers violated the Employee Retirement Income Security Act (ERISA), summary judgment for defendant-state insurance commissioner is affirmed where: 1) the state's bar on discretionary clauses addresses an insurance-specific problem, because discretionary clauses generally do not exist outside of insurance plans; and 2) the commissioner's practice merely alters the terms by which the presence or absence of the insured contingency is determined; and 3) thus, the state regulatory scheme was saved from preemption under 29 U.S.C. section 1144(a) by the savings clause in section 1144(b).
[10/28]
Westchester Fire Ins. Co. v. Mendez
In an action by an insurer seeking a declaration that it had no obligation to defend or indemnify defendant against a certain claim because he failed to give proper notice of the claim to insurer, default judgment for plaintiffs is reversed where intervenor-Northwest Airlines should have been permitted to defend the declaratory relief action on its own.
[10/28]
James River Ins. Co. v. Kemper Cas. Ins. Co.
In plaintiff-insurer's case seeking a declaration that it had no duty to defend or indemnify two lawyers who were sued for malpractice, district court's grant of summary judgment in favor of defendant-insurer is reversed with instructions to enter the declaratory judgment requested by plaintiff as its policy does not apply since it excludes coverage of conduct covered by a prior insurer, and all the wrongful acts alleged in the malpractice suit arose from events that took place in defendant's policy period.
[10/26]
G-I Holdings v. Reliance Ins. Co.
In plaintiff's action involving coverage under a directors and officers insurance policy brought against defendant Hartford, who had taken over claims administration for defendant-Reliance (liquidated insurer) and assumed some of its liabilities, district court's grant of summary judgment in favor of Hartford is affirmed where: 1) the Hartford policy period does not include the amended Reliance policy period, and there is no basis to conclude that plaintiff could have reasonably expected its policy with Hartford to cover the Reliance policy; 2) the interrelated wrongful acts provision applies to bar coverage for the CCR and Claimants Committee actions under the Hartford policy; 3) other agreements do not make Hartford directly liable for fraudulent conveyance actions; and 4) judicial estoppel does not apply to Hartford's invoking of the interrelated wrongful acts provision.
[10/26]
Kaldenbach v. Mut. of Omaha Life Ins. Co.
In plaintiff's consumer protection and fraud suit against defendant-insurance company concerning the sale of a so-called "vanishing premium" life insurance policy, denial of plaintiff's motion for certification of the action as a class action is affirmed as the court did not err in concluding that he had not demonstrated any of the requisites for class certification.
[10/22]
College of Dental Surgeons of Puerto Rico v. Connecticut Gen. Life Ins. Co.
In plaintiffs' class action lawsuit against defendants, judgment of the district court remanding the case is vacated and remanded as the court determined prematurely that it lacked Class Action Fairness Act (CAFA) jurisdiction on the ground that the complaint does not specifically define a proposed class.
[10/22]
In Re: Safeco Ins. Co. of America
In plaintiffs' class action lawsuit against defendant-automobile insurance providers, defendant's petition for permission to appeal is granted and the judgment of the district court granting plaintiff's motion to remand the action to the state court is affirmed where the new claims added by the class certification order relate back to the relevant transaction or occurrence.
[10/19]
Mega Life & Health Ins. Co. v. Pieniozek
In an action seeking rescission of defendant's life insurance policy, judgment for defendant is affirmed where: 1) the district court properly determined that no timely jury demand was filed and served by either party with respect to the only issue before it on remand; and 2) the district court did not err in concluding the term "annual income" in the policy was ambiguous.
[10/15]
Executive Risk Indemn. Inc. v. Pepper Hamilton LLP
In an action by insurers seeking a declaration that the policy at issue did not cover certain legal malpractice claims, the appellate division's order denying summary judgment is affirmed in part where one plaintiff was not entitled to judgment on the basis of rescission. However, the order is modified in part where the prior knowledge exclusion did not require the known act, error, omission or circumstance to be "wrongful conduct on the part of the insured."
Back to Main Menu
