Mealey's Insurance - Magistrate Judge Recommends Accepting Guilty Plea In Health Care Fraud Suit

MIAMI - A federal magistrate judge in Florida on Feb. 17 recommended accepting a home health care clinic owner's guilty plea in a $13 million Medicare fraud scheme, finding that the defendant was capable and competent in entering an informed plea (United States of America v. Alexander Lara, No. 15...

Mealey's Insurance - Judge: Issues Exist On Whether Insurer Breached Its Contract By Denying Claim

CAMDEN, N.J. - Questions of fact exist as to whether an insurer breached its contract by denying coverage for water damage sustained by homeowners, a New Jersey federal judge ruled Feb. 18; however, the judge granted summary judgment on the homeowners' bad faith claim (Joseph Dooley and Elizabeth...

Mealey's Insurance - Panel Says Subcontractor Was Not Required To Name Additional Insured

ELGIN, Ill. - A subcontractor was not required by written agreement to name a contractor as an additional insured under commercial general liability insurance policy, an Illinois appeals panel held Feb. 17, affirming summary judgment to the insurer (West Bend Mutual Insurance Co. v. Athens Construction...

Mealey's Insurance - Judge Denies Defendants' Motion To Dismiss Insurers' Fraudulent Billing Lawsuit

MINNEAPOLIS - A federal judge in Minnesota on Feb. 13 denied a motion filed by a number of chiropractic centers and their owners, seeking dismissal of a lawsuit brought by numerous insurance companies claiming that the defendants submitted fraudulent bills under Minnesota's No-Fault Automobile Insurance...

Mealey's Insurance - Liquidator Of Insolvent Insurer Asks For Permission To Settle With Reinsurer

HARRISBURG, Pa. - The liquidator of an insolvent insurer asked a Pennsylvania court on Feb. 17 to approve a $6.5 million commutation of a reinsurance agreement (In re: Reliance Insurance Co. in liquidation, No. 1 REL 2001, Pa. Cmwlth.).

Mealey's Insurance - N.J. High Court: Insurer's Rejection Of Arbitration Award 'Fairly Debatable'

TRENTON, N.J. - An insurer's rejection of an arbitration award in an uninsured motorist action was "fairly debatable," barring an insured's claim for insurance bad faith, the New Jersey Supreme Court ruled Feb. 18 (Augustine W. Badiali v. New Jersey Manufacturing Insurance Group, No...

Mealey's Insurance - Judge Rejects Man's Challenge To Legitimacy Of Anti-ACA Bill's Fiscal Note

NASHVILLE, Tenn. - A man lacks standing to pursue a suit accusing a government official of fraudulently concocting a fiscal note to torpedo a Tennessee bill blocking implementation of the Patient Protection and Affordable Care Act (ACA), a federal judge held Feb. 18 (Louie E. Johnston Jr. v. Lucien C...

Mealey's Insurance - New Jersey Top Court: Bad Faith Claim Barred Under Principle Of Res Judicata

TRENTON, N.J. - An insured's bad faith claim against his insurer is barred by the principle of res judicata because a trial court properly litigated in a previous lawsuit, the New Jersey Supreme Court ruled Feb. 18 (Kwabena Wadeer, et al. v. New Jersey Manufacturers Insurance Co., No. A-54 September...

Mealey's Insurance - Judge Denies Dismissal Of Subrogated Insurer's Negligence Claims

RENO, Nev. - A Nevada federal judge refused on Feb. 19 to dismiss a subrogated insurer's strict products liability, negligence, breach of implied warranties and breach of express warranties claims against the manufacturer of an engine that caused a fire (Waterton Global Mining Company LLC and Chubb...

Mealey's Insurance - Judge Says Insurer Owes Partial Duty For Damages Caused By Faulty Work

SALT LAKE CITY - An insurer owes no coverage for an insured's liability for damage to a main deck, a Utah federal judge ruled Feb. 18; however, the judge held that the insurer is liable for damage caused to interior walls and flooring by the insured's defective work on other parts of the building...

Mealey's Insurance - Insurer Had 'Reasonable Justification' For Denying Coverage, Judge Rules

DAYTON, Ohio - A federal judge in Ohio on Feb. 17 granted summary judgment in favor of an insurer in an insurance breach of contract and bad faith lawsuit, ruling that the insurer had "reasonable justification" for denying coverage and canceling the insured's commercial homeowners insurance...

Mealey's Insurance - Administrator Must Consider Medical Evidence When Evaluating Claim, Judge Says

SAN DIEGO - A California federal judge on Feb. 17 remanded a disability claimant's suit to allow an insurer to evaluate the claimant's entitlement to benefits based on the claimant's medical condition after determining that the insurer incorrectly denied benefits because it failed to extend...

Mealey's Insurance - Delaware Judge Denies Woman's Appeal Over Unemployment Insurance Benefits

NEW CASTLE, Del. - A woman's appeal of three decisions by the Unemployment Insurance Appeals Board (UIAB) was denied Feb. 19 by a Delaware Superior Court judge, who ruled that the appeal was untimely because it was filed more than 10 days after the decisions were final (Tiara Hall v. Unemployment...

Mealey's Insurance - Panel Affirms, Modifies Judgment In Insured's Favor In Hurricane Ike Coverage Suit

BEAUMONT, Texas - A Texas appeals panel on Feb. 19 affirmed a lower court's judgment in favor of an insured as modified in a coverage dispute over damage caused by Hurricane Ike (National Lloyds Insurance Co. v. Latosha A. Lewis, No. 09-13-00413-CV, Texas App., 9th Dist.; 2015 Tex. App. LEXIS 1573...

Mealey's Insurance - Judge Dismisses Bad Faith Claim Against Insurer For Defects Coverage

TAMPA, Fla. - A Florida federal judge applied Alabama law on Feb. 20 to dismiss breach of contract and bad faith claims against a commercial liability insurer regarding its duty to indemnify a settlement of an underlying construction defects case (MI Windows & Doors LLC f/k/a MI Windows & Doors...

Mealey's Insurance - Florida Judge Orders Ancillary Receivership Of Nevada Insurer

TALLAHASSEE, Fla. - A Florida judge on Feb. 19 ordered a Nevada-domiciled insurer into an ancillary receivership after the insurer was put into liquidation in its home state (State of Florida, ex rel., the Florida Department of Financial Services v. Sensible Home Warranty, LLC, No. 2015-CA-0273, Fla...

Mealey's Insurance - Florida Panel Reverses Trial Court Ruling Regarding Appraisal In Sinkhole Case

LAKELAND, Fla. - A Florida appellate panel on Feb. 20 reversed and remanded a lower court, holding that ordering the state's insurance guarantor to participate in an appraisal of a home's sinkhole damage is at odds with the guarantor's statutory mandate (Florida Insurance Guaranty Association...

Mealey's Insurance - Subrogated Insurer's Professional Negligence Claim Fails, Judge Says

PITTSBURGH - A Pennsylvania federal judge on Feb. 20 dismissed a subrogated insurer's professional negligence claim against a contractor regarding water damage arising from a fire sprinkler system installed by the contractor (Insurance Company of Greater New York, as subrogee of Five Star Hotels...

Mealey's Insurance - Illinois Majority: Innocent Insured Doctrine Inapplicable; Rescission Was Proper

SPRINGFIELD, Ill. - A majority of the Illinois Supreme Court found Feb. 20 that a professional liability insurance policy was properly rescinded for a material misrepresentation made by an attorney and an appeals court erred when it applied the innocent insured doctrine and partially served the policy...

Mealey's Insurance - U.S. Supreme Court Denies Claimant's Petition In Denial Of Benefits Suit

WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 23 denied a disability claimant's petition for writ of certiorari challenging the 11th Circuit U.S. Court of Appeals' decision that a disability insurer was not required to consider additional documentation the claimant submitted after her appeal...

Mealey's Insurance - High Court Review Denied Of Prejudice Requirement To Deemed-Exhaustion Exception

WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 23 let stand a 10th Circuit U.S. Court of Appeals ruling that even though a disability plan's summary plan description (SPD) did not comply with the notice and disclosure requirements of the Employee Retirement Income Security Act because it described...

Mealey's Insurance - Judge Refuses To Dismiss Insurer's Suit Disputing Coverage For Guar Bean Investor

NEW YORK - A New York federal judge on Feb. 19 denied an insured's motion to dismiss an insurer's lawsuit disputing coverage for legal fees and costs that the insured incurred in an underlying lawsuit arising from its investment in a guar bean company (St. Paul Fire and Marine Insurance Co. v...

Mealey's Insurance - Insolvent Insurer Asks Federal Appeals Court To Lift Stay In Case Against It

SAN FRANCISCO - An insolvent Oklahoma insurer on Feb. 19 asked the Ninth Circuit U.S. Court of Appeals to lift the stay of an appeal in a case against it, noting that the liquidating Oklahoma court had approved of lifting the stay (Federal Deposit Insurance Corporation, as Receiver for Security Pacific...

Mealey's Insurance - Judge Finds Triable Issues Of Coverage, Bad Faith In Construction Defects Dispute

PHOENIX - An Arizona federal judge ruled Feb. 23 that there is an issue regarding the extent of excess coverage toward a settlement in an underlying construction defects case and whether the insurer acted in bad faith regarding the investigation, evaluation and processing of the claim for a trial to...

Mealey's Insurance - Judge Transfers Allstate's Suit Against Former Agency To Florida Federal Court

CHICAGO - Allstate Life Insurance Co.'s breach of contract lawsuit against a former life insurance agent and his agency is better suited to Florida federal court, a federal judge in Illinois ruled Feb. 23, explaining that all of the former agent's allegedly fraudulent conduct occurred in Florida...