Mealey's Insurance - No Coverage Owed For Injuries Caused By Toxic Mold, New Jersey Panel Affirms

TRENTON, N.J. - Insurers owe no coverage for injuries sustained as a result of toxic mold because a fungus exclusion clearly bars coverage for the injuries, the Appellate Division of the New Jersey Superior Court said Dec. 11 (William Hurst, et al. v. American Zurich Insurance Co., et al., No. A-5447...

Mealey's Insurance - Judge Remands Insured's Coverage Suit Regarding Construction Defects Claim

TRENTON, N.J. - A New Jersey federal judge on Dec. 12 remanded an insured's coverage lawsuit against its insurer regarding a claim for defense and indemnification in a construction defects lawsuit because the underlying action involves the same parties and issues (Kane Builders Inc. v. Continental...

Mealey's Insurance - Insurer Has No Duty To Indemnify Water Damage, Judge Says

ORANGEBURG, S.C. - A commercial general liability insurer has no duty to indemnify assignees for alleged water damage sustained to a science building caused by an insured's work, a South Carolina federal judge ruled Dec. 12, declining to alter or amend her judgment (Evanston Insurance Co. v. R&L...

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Mealey's Insurance - Pollution Exclusion Does Not Bar Coverage For Contaminated Oil, Judge Says

DETROIT - A Michigan federal judge on Dec. 11 denied an insurer's motion for summary judgment after determining that a policy's pollution exclusion does not apply to bar coverage for contaminated fuel oil (Secura Insurance Co. v. DTE Gas Services Co., et al., No. 14-10401, E.D. Mich.; 2014 U...

Mealey's Insurance - Judge Finds Reinsurance Arbitration Agreement Valid And Compels Arbitration

SAN JOSE, Calif. - A federal judge in California on Dec. 11 granted a reinsurer's motion to compel arbitration with its reinsured regarding allegations that it overcharged its reinsured after a claim (Randazzo Enterprises, Inc. a California corporation v. Applied Underwriters Captive Risk Assurance...

Mealey's Insurance - Judge Adopts Recommendation To Accept Guilty Plea In Fraud Case

BEAUMONT, Texas - A federal judge in Texas on Dec. 15 adopted a magistrate judge's recommendation to accept a man's guilty plea for aiding and abetting an insurance fraud scheme after the defendant agreed with the evidence presented by the federal government and testified that he was knowingly...

Mealey's Insurance - Mass. Federal Judge Partially Dismisses Celexa/Lexapro Third-Party RICO Cases

BOSTON - A Massachusetts federal judge on Dec. 12 partially dismissed Racketeer Influenced and Corrupt Organizations Act actions filed by two health insurers seeking to represent a class of third-party payers who allegedly paid for fraudulent prescriptions for the antidepressants Lexapro and Celexa but...

Mealey's Insurance - Pa. High Court Allows Claims Against Insurer Related To False Mold Assurances

HARRISBURG, Pa. - The Pennsylvania Supreme Court on Dec. 15 reversed a trial court's ruling dismissing homeowners' claims that their insurer acted negligently when it made false assurances in relation to the toxicity of mold in their house and remanded the case for further proceedings (David...

Mealey's Insurance - Question Of Fact Exists As To Whether Insurer Acted In Bad Faith, Panel Rules

MIAMI - A federal district court erred in granting summary judgment in an insurance coverage dispute because there was at least a question of fact as to whether an insurer acted in bad faith in refusing to settle an underlying claim, an 11th Circuit U.S. Court of Appeals panel ruled Dec. 15 (GEICO General...

Mealey's Insurance - Judge Partially Grants Protective Order In Bad Faith Lawsuit

SEATTLE - A federal judge in Washington on Dec. 15 granted in part and denied in part an insurer's motion for a protective order in a breach of contract and insurance bad faith lawsuit, ruling that the insurer is not required to "produce loss reserve documents that are entitled to work product...

Mealey's Insurance - Judge Stays Insurance Coverage Suit After Insurer Is Placed In Liquidation

HOUSTON - A federal judge in Texas on Dec. 16 stayed a suit against an insolvent insurer, noting that the liquidating court had ordered the end of all litigation against the insolvent insurer (Air Tropiques, S.P.R.L. v. Northern & Western Insurance Company, Ltd., et al., No. 13-cv-01438, S.D. Texas...

Mealey's Insurance - Judge: Government's Loss Of Evidence Warrants Dismissal Of Fraud Indictment

SALT LAKE CITY - The government's loss of computer data from a women's health care clinic operated by a woman accused of defrauding Medicare by coaching illegal aliens to apply for benefits under the Baby Your Baby (BYB) program warrants the dismissal of her indictment, a federal judge in Utah...

Mealey's Insurance - Florida Panel Affirms Order Compelling Appraisal Of Alleged Sinkhole Damage

DAYTONA BEACH, Fla. - A Florida appellate panel on Dec. 12 affirmed a lower court decision compelling appraisal of alleged sinkhole damage to a home insured by an insolvent insurer (Florida Insurance Guaranty Association v. Kenneth Sill, et al., No. 5D13-3363, Fla. App., 5th Dist.; 2014 Fla. App. LEXIS...

Mealey's Insurance - New York Justice Orders Liquidation Of Insurer With Consent Of Insurer's Board

NEW YORK - A New York justice on Dec. 16 granted New York's superintendent of financial services' petition for an order to liquidate an insurer (In the Matter of UHAB Mutual Insurance Company, No. 452618/2014, N.Y. Sup., New York Co.).

Mealey's Insurance - 3rd Circuit: Defendant May Rely On Plaintiff's Statements For Proof Of Numerosity

PHILADELPHIA - The defendant in an insurance breach-of-contract class complaint may rely on statements made by the lead plaintiff regarding the class size to prove numerosity, the Third Circuit U.S. Court of Appeals ruled Dec. 12, partially reversing a District Court's ruling (Francine Judon, et...

Mealey's Insurance - Insurance Policy Bars Coverage For Sinkhole Damage, Panel Rules

LAKELAND, Fla. - A homeowners insurance policy precludes coverage for sinkhole damage sustained by an insured, a Florida appeals panel held Dec. 17, reversing summary judgment entered in favor of the insured (Florida Peninsula Insurance Co. v. Maricela Cespedes, No. 2D12-4575, Fla. App., 2nd Dist.; 2014...

Mealey's Insurance - Federal Judge Refuses Insurer's Request To Amend To Include Fraud Claim

ST. LOUIS - After finding that statements allegedly made by a homeowner in relation to mold and water damage to her property were not admissible, a Missouri federal judge on Dec. 16 denied an insurer's request to amend its counterclaim to include a cause of action for fraudulent misrepresentation...

Mealey's Insurance - Pa. High Court: Insured May Assign Damages To Injured Party In Bad Faith Suit

HARRISBURG, Pa. - In answering a question from the Third Circuit U.S. Court of Appeals, the Pennsylvania Supreme Court on Dec. 15 held that an insured may, under state law, assign the ability to assert damages against an insurer to an injured plaintiff deriving from the insurer's bad faith toward...

Mealey's Insurance - Minnesota High Court Upholds Coverage For Insured's Hail Damage

ST. PAUL, Minn. - An appraisal panel did not err in determining for purposes of insurance coverage that the replacement of an insured's damaged siding panels with siding of comparable material and quality required replacement of all of the siding on the insured's buildings to achieve a reasonable...

Mealey's Insurance - Appeals Court Releases Publication Of Previously Unpublished Opinion

CHICAGO - An Illinois appeals court panel on Dec. 16 released a published version of an opinion previously released as an unpublished opinion in which it affirms a lower court decision that a reinsurer's certificates clearly provide a limit of coverage that includes both losses and expenses (Continental...

Mealey's Insurance - Insured's Negligent Work Is Not 'Property Damage,' Federal Judge Concludes

DENVER - A commercial general liability insurer has no duty to defend a construction defects lawsuit arising from an insured's alleged negligent work in a home, a Colorado federal judge ruled Dec. 17, finding that there was no "property damage" and, alternatively, that the "your work"...

Mealey's Insurance - Judge: Amount In Controversy Does Not Exceed Statutory Limit In Bad Faith Suit

WHEELING, W.Va. - Remand of an insurance bad faith lawsuit to state court is warranted, a federal judge in West Virginia ruled Dec. 16, because an insurer has failed to show that the amount in controversy would exceed statutory limits (James Breen v. Motorists Mutual Insurance Companies, d.b.a. Motorists...

Mealey's Insurance - Religious Retirement Home Company Challenges ACA Birth Control Mandate

TAMPA, Fla. - The Patient Protection and Affordable Care Act (ACA)'s contraceptive mandate infringes on religious beliefs, a Christian retirement community argues in a Dec. 18 reply filed in Florida federal court (Christian and Missionary Alliance Foundation Inc., et al. v. Sylvia Mathews Burwell...

Mealey's Insurance - 4th Circuit Affirms Verdict, Sentencing In Health Care Fraud Case

RICHMOND, Va. - A Fourth Circuit U.S. Court of Appeals panel on Dec. 19 upheld a jury's verdict finding a dermatologist guilty of 13 counts of health care fraud and affirmed a judge's sentencing of the defendant, holding that the evidence presented during the trial supported the jury's decision...