LexisNexis® Legal Newsroom
    Mealey's Insurance - Panel Upholds Dismissal Of Negligent Misrepresentation Claim Against Insurance Agent

    ST. LOUIS - Claimants failed to allege negligent failure to procure insurance and negligent misrepresentation claims against an insurance agent regarding an insurance policy under which the claimants seek coverage for fire damage, a Missouri appeals panel held Jan. 28, affirming dismissal of the claims (Biri M. Blevins, et al. v. American Family Mutual Insurance Co. and Janey Foust, No. ED99852, Mo. App., Eastern Dist.; 2014 Mo. App. LEXIS 76).

    Mealey's Insurance - 5th Circuit Panel Finds 30-Month Delay In Claim Payment May Show Bad Faith

    NEW ORLEANS - Although an insurer has demonstrated legitimate justifications for portions of the 30-month period between its insured's accident and its ultimate payment of uninsured motorist (UM) benefits, a Fifth Circuit U.S. Court of Appeals panel majority on Jan. 28 found that the insured sufficiently raised fact issues regarding some of the time periods when the insurer was not actively investigating the claim (Faith James, et al. v. State Farm Mutual Automobile Insurance Co., No. 11-60458, 5th Cir.; 2014 U.S. App. LEXIS 1741).

    Mealey's Insurance - Alabama High Court: Networks Do Not Have To Contract With Health Care Provider

    MONTGOMERY, Ala. - A divided Alabama Supreme Court on Jan. 24 held that a trial court erred in submitting a claim for intentional interference with business relationship to a jury in a health care network dispute, saying the defendants had no obligation to do business with the plaintiff health care provider (Alabama Psychiatric Services, et al. v. A Center for Eating Disorders, No. 1110703, Ala. Sup.; 2014 Ala. LEXIS 9).

    Mealey's Insurance - Arizona Appeals Court Affirms Denial Of Prescription Drug Coverage

    PHOENIX - An Arizona state appeals court in a Jan. 23 unpublished opinion affirmed that a health insurance company properly denied benefits for a prescription drug because the plan and state law expressly prohibited coverage for drugs not included in the plan's formulary (Deanna M. Cancino v. Arizona Health Cost Containment Administration, et al., No. 13-130, Ariz. App., Div. 1; 2014 Ariz. App. Unpub. LEXIS 84).

    Mealey's Insurance - Wash. Federal Judge Grants Injunction, Class Status In Denial Of Benefits Case

    SEATTLE - A Washington federal judge on Jan. 24 granted a preliminary injunction and class certification in a case challenging the denial of benefits for the treatment of autism (K.M., et al. v. Regence BlueShield, et al., No. 13-1214, W.D. Wash.; 2014 U.S. Dist. LEXIS 9156).

    Mealey's Insurance - Ky. Appeals Court: Arbitration Provision Not Applicable In Reimbursement Suit

    FRANKFORT, Ky. - A Kentucky appeals court in a Jan. 24 unpublished opinion affirmed an order denying a motion to compel arbitration between a Medicaid managed care organization (MCO) and a health care provider (Kentucky Spirit Health Plan Inc., et al. v. PremierTox Inc., et al., No. 2012-CA-001457-MR, Ky. App.; 2014 Ky. App. Unpub. LEXIS 57).

    Mealey's Insurance - Insurance Policy Precludes Coverage For Contractor's Faulty Work, Judge Finds

    NEW ORLEANS - A contractor's alleged faulty repairs, including faulty short-term mitigation repairs, are subject to an insurance policy's exclusion, a Louisiana federal judge ruled Jan. 27, dismissing an insurer's third-party complaint against the contractor (Cedar Ridge LLC v. Landmark American Insurance Co., et al., No. 13-672, E.D. La.; 2014 U.S. Dist. LEXIS 9617).

    Mealey's Insurance - Excess Policy Was Not Triggered, Panel Rules, Reverses $1.3M Ruling Against Insurer

    ATLANTA - The 11th Circuit U.S. Court of Appeals on Jan. 24 reversed and remanded a lower federal court's $1.3 million judgment against an excess insurer in a Florida property manager's lawsuit seeking excess coverage for Hurricane Wilma damage, finding that Florida's insurable interest statute bars recovery beyond the property manager's revenue stream from the damaged property (Banta Properties Inc. v. Arch Specialty Insurance Co., No. 12-14186, 11th Cir.; 2014 U.S. App. LEXIS 1419).

    Mealey's Insurance - Florida Appeals Panel Allows Bad Faith Suit Against State-Created Insurer

    TALLAHASSEE, Fla. - A Florida appeals panel on Jan. 23 found that although a nonprofit insurer created by the Florida Legislature is generally immune from lawsuits, the insurer's statutory immunity "does not extend to the 'willful tort' of failing to attempt in good faith to settle claims as provided by" the state's bad faith statute (Perdido Sun Condominium Association Inc. v. Citizens Property Insurance Corp., No. 1D13-1951, Fla. App., 1st Dist.; 2014 Fla. App. LEXIS 696).

    Mealey's Insurance - No Coverage Owed For Perchlorate Contamination, Indiana Panel Determines

    INDIANAPOLIS - No coverage is owed for perchlorate contamination caused by an insured's manufacturing of highway safety flares because the policies' pollution exclusions are applicable under Maryland law and bar coverage for the claims, the Indiana Court of Appeals said Jan. 23 (Chubb Custom Insurance Co. et al., v. Standard Fusee Corp., No. 49A02-1301-PL-91, Ind. App.; 2014 Ind. App. LEXIS 15).

    Mealey's Insurance - Insurer Has No Duty To Defend, Indemnify Accounting Firm, Federal Judge Rules

    BOSTON - Professional liability coverage for underlying claims against an accounting firm insured and one of its principals is barred by the policy's "securities practice" exclusion, a Massachusetts federal judge ruled Jan. 23, granting the insurer's motion for summary judgment (Robert S. Salomon, et al. v. Philadelphia Insurance Companies, No. 13-10378-DPW, D. Mass.; 2014 U.S. Dist. LEXIS 8334).

    Mealey's Insurance - Federal Judge Transfers Motion To Compel To Georgia Federal Court

    NEW YORK - A federal judge in New York on Jan. 23 transferred to a federal court in Georgia the Federal Deposit Insurance Corp.'s motion to compel responses from Everest Reinsurance Holdings Inc. (Everest Re), finding that the issue is better decided by the judge presiding over a similar coverage action Progressive Casualty Insurance Co. filed against the FDIC in the FDIC's capacity as the bank's receiver (Federal Deposit Insurance Corp. v. Everest Reinsurance Holdings Inc., No. 13-0381, S.D. N.Y.; 2014 U.S. Dist. LEXIS 8506).

    Mealey's Insurance - Justice: Insurers Properly Denied Coverage Based On Rational Policy Interpretations

    NEW YORK - A New York justice on Jan. 22 granted five builders risk insurers' motion for summary judgment in an insured's breach of contract and bad faith lawsuit seeking $6,409,029 in additional insurance benefits for loss of income and $140,568 in extra expenditures stemming from water leaks that occurred at its Manhattan luxury condominium complex (W2001Z/15 CPW Realty LLC v. Lexington Insurance Co., et al., No. 650593/2010, N.Y. Sup., New York Co.).

    Mealey's Insurance - Pre-Existing Condition, Job Review Made Settlement Offer Reasonable, Judge Says

    SCRANTON, Pa. - In light of an underinsured motorist (UIM) claimant's medical conditions that pre-existed her auto accident and positive job reviews after the accident, a Pennsylvania federal judge on Jan. 22 held that her insurer's settlement offer and investigation could not be seen as unreasonable, granting summary judgment to the insurer on a bad faith claim against it (Karen and Stanley Miezejewski v. Infinity Auto Insurance Co., No. 3:12-cv-01000, M.D. Pa.; 2014 U.S. Dist. LEXIS 7425)

    Mealey's Insurance - Judge Dismisses Portion Of Insolvent Insurers' Receiver's Breach Of Contract Lawsuit

    OKLAHOMA CITY - An Oklahoma federal judge on Jan. 24 dismissed for lack of standing the portion of a receiver's lawsuit on behalf of two insolvent insurers seeking to recover money owed by a professional employer organization to any of the various state guaranty associations (State of Oklahoma, ex rel. John Doak, insurance commissioner as receiver for Park Avenue Property & Casualty Insurance Co. and Imperial Casualty and Indemnity Co. v. Staffing Concepts International Inc., No. 12-409, W.D. Okla.; 2014 U.S. Dist. LEXIS 8767).

    Mealey's Insurance - Asbestos Exclusions Bar Coverage, Maryland Federal Judge Determines

    BALTIMORE - An insured's claims for coverage of asbestos suits filed during its insurer's 1986 and 1987 policy years are barred from coverage because the policies included asbestos exclusions, a Maryland federal judge said Jan. 24 (AC&R Insulation Co. Inc. v. Pennsylvania Manufacturers' Association Insurance Co., No. 12-3528, D. Md.; 2014 U.S. Dist. LEXIS 9063).

    Mealey's Insurance - Breach Of Contract Claim Over Home's Alleged Mine Subsidence Survives Dismissal

    WHEELING, W.Va. - Even though a state organization has ultimate settlement authority over a couple's insurance claim based on mine subsidence, a West Virginia federal judge on Jan. 22 held that the insureds were still entitled to bring a breach of contract claim against their insurer, denying a motion to dismiss (Mark Bettinazzi, et al. v. State Farm Fire and Casualty Co., No. 5:13-cv-00166, N.D. W.Va.; 2014 U.S. Dist. LEXIS 7835).

    Mealey's Insurance - Reinsured Argues For Reconsideration Of Denial Of Motion For Summary Judgment

    NEW YORK - A foreign reinsured performance bond issuer on Jan. 24 argued in a federal court in New York for reconsideration of the court's recent denial of the bond issuer's motion for summary judgment regarding jurisdiction, based on a recent U.S. Supreme Court opinion (St. Paul Fire & Marine Insurance Company v. Aseguradora De Creditos Y Garantias, S.A., No. 12-cv-4627, S.D. N.Y.).

    Mealey's Insurance - Panel: Insurer Had Duty To Defend Damages From Collapsed Retaining Wall

    MOUNT VERNON, Ill. - A commercial general liability insurer had a duty to defend its insureds' faulty workmanship that caused damages sustained by homeowners from a collapsed retaining wall, an Illinois appeals panel affirmed Jan. 23 (Pekin Insurance Co. v. Kiefer Landscaping LLC, et al., No. 5-12-0588, Ill. App., 5th Dist.; 2014 Ill. App. Unpub. LEXIS 107).

    Mealey's Insurance - Earth Movement Exclusion Bars Coverage For Insured's Water Damage, Panel Finds

    DES MOINES, Iowa - An earth movement exclusion under an apartment owner's insurance policy precludes coverage for an insured's loss from sewage backflow and water infiltration damage to an apartment complex, the Iowa Court of Appeals affirmed Jan. 23 (MGM Apartments LLC v. Mid-Century Insurance Co., No. 3-1022, Iowa App.; 2014 Iowa App. LEXIS 80).

    Panel Rules Trustee Cannot Bring Claims Against Title Insurer Individually

    LOS ANGLES - A California appeals panel on Jan. 21 ruled that because a trustee was not a party to a title insurance policy in his individual capacity, he was able to bring claims against the insurer only in his capacity as a trustee, not individually (Bruce T. Mulhearn, et al. v. Lawyers Title Insurance Co., et al., No. B244893, Calif. App., 2nd Dist.; 2014 Cal. App. Unpub. LEXIS 373).

    Panel: Employer Liability Exclusion Not Subject To Reasonable Expectations Doctrine

    RALEIGH, N.C. - A North Carolina appeals panel on Jan. 21 rejected a subcontractor insured's contention that an employer liability exclusion in its commercial general liability insurance policy is ambiguous, affirming a lower court's summary judgment ruling in favor of the insurer in a coverage dispute stemming from a construction site injury (Naylor Concrete Construction Co. Inc. v. Mid-Continent Casualty Co., No. COA13-83, N.C. App.; 2014 N.C. App. LEXIS 90).

    Excess Insurer's Limits Triggered By Settlement Of Defects Claim, Judge Finds

    PHOENIX - A settlement agreement among a limited partnership, a contractor and the contractor's primary insurer over a construction defects claim triggered the coverage limits of an follow-form excess insurance policy, an Arizona federal judge ruled Jan. 22, finding that the primary insurance policy was exhausted (Lexington Insurance Co. v. Scott Homes Multifamily Inc., et al., No. 12-02119, D. Ariz.; 2014 U.S. Dist. LEXIS 7976).

    6th Circuit Finds No Coverage For Fraud Claims Against Jeweler

    CINCINNATI - Concluding that a jeweler's businessowners policy did not provide coverage for fraud counterclaims against it related to the loss of a diamond, a Sixth Circuit U.S. Court of Appeals panel on Jan. 21 affirmed dismissal of the jeweler's breach of contract and bad faith claims against its insurer (John Stafford, et al. v. Jewelers Mutual Insurance Co., No. 13-3385, 6th Cir.; 2014 U.S. App. LEXIS 1214).

    No Coverage Exists For $483,389 Copper Sheeting Theft, 5th Circuit Affirms

    NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on Jan. 23 affirmed a lower federal court's finding that there is no coverage for the theft of $483,389.20 in copper sheeting under a first-party property insurance policy issued to a warehouse business operated insured (United National Insurance Co. v. Mundell Terminal Services Inc., et al., No. 13-50052, 5th Cir.; 2014 U.S. App. LEXIS 1279).