LexisNexis® Legal Newsroom
    Mealey's Insurance - Judge Finds Homeowner's Water Damage Claims Are Excluded Under Policy

    COVINGTON, Ky. - A Kentucky federal judge on March 3 granted summary judgment for an insurer, finding that a homeowner's claims that a hole in his water meter caused damage and mold growth were excluded under his insurance policy (Richard Geiman v. Northern Kentucky Water District, et al., No. 2:13-cv-177, E.D. Ky.; 2014 U.S. Dist. LEXIS 26700).

    Mealey's Insurance - 6th Circuit Affirms Denial Of Benefits In Medicare Coverage Case

    CINCINNATI - In an unpublished opinion, a panel of the Sixth Circuit U.S. Court of Appeals on Feb. 27 affirmed a denial of benefits, saying Medicare did not provide coverage for the equipment sought (Mary K. Woodfill v. Secretary of Health and Human Services, No. 13-3729, 6th Cir.; 2014 U.S. App. LEXIS 3874).

    Mealey's Insurance - Appeals Court: Provider Costs Need Not Be Considered In Setting Payment Rates

    SAN FRANCISCO - In a Medicaid reimbursement case, a California appeals court on Feb. 28 affirmed a demurrer in favor of the defendant, saying that based on changes in law, states are not required to consider provider costs in setting reimbursement rates (Tim Keffeler, et al. v. Partnership Healthplan of California, No. A135536, Calif. App., 1st. Dist., Div.1; 2014 Cal. App. LEXIS 200).

    Mealey's Insurance - Judge Refuses To Issue Preliminary Injunction In Directors, Officers Coverage Suit

    PADUCAH, Ky. - A Kentucky federal judge on Feb. 28 denied insureds' motion for preliminary injunction in their lawsuit seeking coverage for two underlying actions claiming that the insureds participated in a scheme to improperly market international textbooks (C.A. Jones Management Group, et al. v. Scottsdale Indemnity Co., No. 5:13-CV-00173, W.D. Ky.; 2014 U.S. Dist. LEXIS 25931).

    Mealey's Insurance - Federal Judge: Negligence, Breach Of Contract Claims Fail Against Insurance Agent

    DETROIT - A widow has failed to assert negligence and breach of contract claims against an insurance agent regarding the procurement of insurance for a baseball stadium where her husband suffered injuries and later died, a Michigan federal judge held Feb. 28 (Kimberly Johnson, as executrix of the estate of Douglas Johnson, deceased v. Doodson Insurance Brokerage of Texas LLC d/b/a CSI Special Event Insurance d/b/a CSI Insurance Group, No. 13-10198, E.D. Mich.; 2014 U.S. Dist. LEXIS 25822).

    Mealey's Insurance - Failure To Pay Premiums Doomed Trustee's Claims, Texas Appeals Panel Rules

    HOUSTON - Concluding that a life insurance policy had lapsed due to nonpayment of premiums prior to the death of its insured, a Texas appeals panel on Feb. 27 affirmed dismissal of claims brought by the insured's wife related to the payment of benefits to three beneficiary trusts (Pamela Lombana, et al. v. AIG American General Life Insurance Co., No. 01-12-00168-CV, Texas App., 1st Dist.; 2014 Tex. App. LEXIS 2302).

    Mealey's Insurance - Additional Discovery Needed In Contamination Coverage Dispute, Federal Judge Says

    SACRAMENTO, Calif. - A California federal judge on Feb. 28 denied an insured's motion for partial summary judgment after determining that additional discovery is warranted to determine whether the insured knew of the contamination at issue prior to the inception of the environmental liability insurance policy (Lennar Mare Island LLC v. Steadfast Insurance Co. et al., No. 12-2182, E.D. Calif.; 2014 U.S. Dist. LEXIS 26405).

    Mealey's Insurance - Magistrate Grants Partial Quash Of Subpoenas Issued Against Insurance Agents

    DALLAS - A Texas federal magistrate judge on Feb. 27 granted in part an insurance agent and his employer's motion to quash subpoenas that seek the production of materials concerning their alleged breach of the confidentiality and noncompete agreements because the materials may disclose trade secrets or other confidential information (Orchestrate HR Inc. v. Anthony L. Trombetta, et al., No. 13-2110, N.D. Texas; 2014 U.S. Dist. LEXIS 24995).

    Mealey's Insurance - Faulty Workmanship Is Not An 'Occurrence'; Insurer Has No Duty To Defend, Judge Says

    BOWLING GREEN, Ky. - Faulty workmanship on its own is not an "occurrence" under a commercial general liability insurance policy, a Kentucky federal judge ruled Feb. 28, finding that the insurer has no duty to defend an insured in an underlying breach of contract action (State Auto Property and Casualty Insurance Co. v. Daniel Bragg d/b/a Bragg Septic & Electric, No. 13-100, W.D. Ky.; 2014 U.S. Dist. LEXIS 25659).

    Mealey's Insurance - 9th Circuit Finds Extrinsic Facts In Assault And Battery Case Triggered Coverage

    PASADENA, Calif. - Extrinsic witness statements related to an alleged assault and battery case indicated that a claimant's "injuries might have been caused by events that would not fall under" an insurance policy's exception, a Ninth Circuit U.S. Court of Appeals panel majority held March 3, concluding, therefore, that the insurer's duty to defend was triggered because of the "possibility that the claim may be covered by the policy" (The Burlington Insurance Co. v. CHWC Inc. d/b/a Crazy Horse Restaurant and Nightclub, et al., No. 12-55285, 9th Cir.; 2014 U.S. App. LEXIS 3941).

    Mealey's Insurance - N.Y. Justice: Insurers Cannot Rely On Dishonest Acts, Public Policy Exclusions

    NEW YORK - A New York justice on Feb. 28 severed and dismissed professional liability insurers' affirmative defenses based upon dishonest acts and public policy exclusions in a dispute seeking coverage for an insured's monetary settlement of underlying administrative proceedings by the Securities and Exchange Commission and New York Stock Exchange (NYSE) arising from claims of illegal mutual-fund-trading practices (J.P. Morgan Securities Inc., et al. v. Vigilant Insurance Co., et al., No. 600979/09, N.Y. Sup., New York Co.; 2014 N.Y. Misc. LEXIS 796).

    Mealey's Insurance - 8th Circuit Urged To Affirm Denial Of Injunction In Birth Control Case

    ST. LOUIS - The federal government on Feb. 27 filed a brief with the Eighth Circuit U.S. Court of Appeals, urging the court to affirm the denial of a preliminary injunction in a case brought by a Missouri family challenging the birth control mandate contained in the Patient Protection and Affordable Care Act (PPACA) (Paul Wieland, et al. v. U.S. Department of Health and Human Services, No. 13-3528, 8th Cir.).

    Mealey's Insurance - Texas Federal Judge Remands Reimbursement Suit To State Court

    DALLAS - A Texas federal judge on Feb. 27 remanded a health care reimbursement suit between a health care provider and insurer to state court, saying the claims were not preempted (Texas Center for Obesity Surgery v. UnitedHealthCare of Texas Inc., et al., No. 13-922, N.D. Texas; 2014 U.S. Dist. LEXIS 24996).

    Mealey's Insurance - New Jersey Federal Judge Grants Defendant Partial Judgment In Reimbursement Suit

    NEWARK, N.J. - A New Jersey federal judge on Feb. 27 granted partial summary judgment in favor of an insurer in a health care benefits reimbursement dispute, dismissing the claims asserted by the plaintiff but denying the defendant's motion for recovery for its counterclaim and request for attorney fees (New Jersey Back Institute ASO Juan Rodriguez v. Horizon Blue Cross Blue Shield Insurance Co., No. 12-4985, D. N.J.; 2014 U.S. Dist. LEXIS 25639).

    Mealey's Insurance - Missouri Federal Judge Grants Transfer Of Drug Rebate Case

    ST. LOUIS - A Missouri federal judge on Feb. 27 denied defendants' motion to dismiss a dispute over prescription drug rebates but granted a motion to transfer the case to another federal court (Express Scripts Inc. v. Jefferson Health System Inc., et al., No. 13-379, E.D. Mo.; 2014 U.S. Dist. LEXIS 25057).

    Mealey's Insurance - Policy Doesn't Cover FDIC's Claims Against Bank Executives, Judge Finds

    KANSAS CITY, Kan. - BancInsure Inc. does not have to cover a suit the Federal Deposit Insurance Corp. filed against former directors of Columbian Bank and Trust Co. because coverage of the FDIC's underlying claims is excluded from the bank's policy, a federal judge in Kansas ruled Feb. 27 (BancInsure Inc. v. Carl L. McCaffree, et al., No. 12-2110, D. Kan.; 2014 U.S. Dist. LEXIS 24941).

    Mealey's Insurance - No Construction Defect Claim Was Timely Reported Under Insurance Policy, Panel Says

    SANTA ANA, Calif. - No construction defect claim was reported timely under a claims-made-and-reported insurance policy, a California appeals panel ruled Feb. 27, affirming the entry of summary judgment in favor of an insurer on an assignee's insurance bad faith claim (Bann-Shiang Liza Yu v. Century Surety Co., No. G048427, Calif. App., 4th Dist., Div. 3; 2014 Cal. App. Unpub. LEXIS 1411).

    Mealey's Insurance - Judge Denies Reconsideration Of Stay In Case Over Insurer's Duty To Indemnify Faulty Work

    ABINGDON, Va. - A Virginia federal judge on Feb. 26 refused to reconsider an order that in part stayed an insurer's coverage action with regard to whether there is a duty to indemnify an insured's alleged faulty work that caused damage to other property (Nautilus Insurance Co. v. Strongwell Corp., No. 12-00038, W.D. Va.; 2014 U.S. Dist. LEXIS 24608).

    Mealey's Insurance - Judge Dismisses Breach Of Contract, Negligence Claims Against Insurance Agent

    LOUISVILLE, Ky. - An insured failed to assert claims against an insurance agent for breach of contract, negligence, bad faith, and violation of the Kentucky Unfair Claims Settlement Practices Act, Kentucky Revised Statutes Section 304.12-230 (UCSPA), a Kentucky federal judge ruled Feb. 27 (Chicago Motors LLC d/b/a Speed Auto Sales v. Apex Insurance Agency International Inc. and State National Insurance Company Inc., No. 13-00356, W.D. Ky.; 2014 U.S. Dist. LEXIS 25441).

    Mealey's Insurance - Judge Finds For Retrocessionally Reinsured In Payment Dispute

    TRENTON, N.J. - A federal judge in New York found Feb. 27 that a party to a retrocession reinsurance agreement is entitled to payment of claims that were properly and timely brought to its retrocessional reinsurer (Munich Reinsurance America, Inc. v. American National Insurance Company, No. 09-cv-06435, D. N.J.; 2014 U.S. Dist. LEXIS 25078).

    Mealey's Insurance - Claims Against Manufacturer Constituted 'Advertising Injury,' Panel Says, Reverses

    ANNAPOLIS, Md. - The Court of Special Appeals of Maryland on Feb. 28 found that underlying claims against a light designer and manufacturer insured triggered the "advertising injury" coverage under two of its commercial general liability insurance policies, reversing and remanding a lower court's ruling in favor of the insurers (Blackstone International LTD., et al. v. Maryland Casualty Co., et al., No. 2302, September Term, 2012, Md. App.; 2014 Md. App. LEXIS 17).

    Mealey's Insurance - Building Co-Owner Had No Coverage For Roof Collapse, Ohio Appeals Panel Rules

    CLEVELAND - Because a plaintiff was not a named insured on the property coverages section of a policy covering an apartment building, he was not entitled to coverage for damage related to a roof collapse, an Ohio appellate panel determined Feb. 27, affirming a lower court's grant of summary judgment to the insurer (Michael A. Priore v. State Farm Fire & Casualty Co., et al., No. 99692, Ohio App., 8th Dist.; 2014 Ohio App. LEXIS 681).

    Mealey's Insurance - Reinsurer: No Controversy Exists Between Parties Regarding Arbitration Award

    NEW YORK - A reinsurer argued against confirmation of an arbitration award in a federal court in New York on Feb. 27, saying it had already complied with the award (American Home Assurance Company v. Employers Insurance Company of Wausau, No. 13-cv-05169, S.D. N.Y.).

    Mealey's Insurance - 8th Circuit: Student Cheerleader Injured During 'Practice Session' Under Policy

    OMAHA, Neb. - The Eighth Circuit U.S. Court of Appeals on Feb. 28 concluded that a student cheerleader was injured during a "practice session" under the terms of a university's insurance policy, affirming a lower federal court's ruling that coverage was owed for the injury (Wesley Patterson v. Mutual of Omaha Insurance Co., a Nebraska Corporation, No. 12-3838, 8th Cir.; 2014 U.S. App. LEXIS 3813).

    Mealey's Insurance - Insured Did Not Trigger Policy's Contractual Liability Exclusion, 5th Circuit Finds

    NEW ORLEANS - Relying on answers provided by the Texas Supreme Court, the Fifth Circuit U.S. Court of Appeals on Feb. 26 vacated an entry of summary judgment to an insurer regarding denial of coverage based upon a contractual liability exclusion and remanded the case for further proceedings, reserving to the parties any claims, defenses and arguments other than those related to the contractual liability exclusion (Ewing Construction Company Inc. v. Amerisure Insurance Co., No. 11-40512, 5th Cir.; 2014 U.S. App. LEXIS 3688).