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Mealey's Insurance - Actual Cost Value Applies To Insured's Loss From Damage To Dock, Magistrate Judge Says

TACOMA, Wash. - An insured's dock is not a "building" as that term is used in an insurance policy and, thus, coverage for only actual cost value (ACV) applies, a Washington federal magistrate judge ruled Nov. 30, also finding that the insured failed to show that the insurer improperly calculated...

Mealey's Insurance - South Dakota High Court: Fact Issues Exist On Insurer's 'Your Work' Exclusion

PIERRE, S.D. - Genuine issues of material fact remain to preclude summary judgment on the application of "your work" and "professional services" exclusions in a dispute between an insurer and its insured over coverage for damage to grain bins, the South Dakota Supreme Court held Nov...

Mealey's Insurance - Texas High Court Refuses To Rehear Stowers Action Arising From Wrongful Death

AUSTIN, Texas - The Texas Supreme Court has denied a motion to rehear a lawsuit alleging that insurers failed to act in good faith to settle a liability claim stemming from a wrongful death, according to its orders pronounced Dec. 2 (Roy Seger, et al. v. Yorkshire Insurance Co. Ltd., et al., No. 13-0673...

Mealey's Insurance - California Panel Affirms Attorney Fees Order As Modified, Reduces Award By $9,994

LOS ANGELES - A California appeals panel on Dec. 1 affirmed a lower court's attorney fee award in favor of an insurer except as to $9,994.76 in fees that were not recoverable, reducing the total award to $73,218.29 (Wertheim LLC v. The Bar Plan Mutual Insurance Co., No. B268539, Calif. App., 2nd...

Mealey's Insurance - Termination Of Benefits Was Not Abuse Of Discretion, Federal Judge Says

LOS ANGELES - A California federal judge on Nov. 30 determined that a disability insurer did not abuse its discretion when it terminated a claimant's short-term disability benefits because the insurer's termination was based on reliable evidence (Greg Martin v. Aetna Life Insurance Co. et al...

Mealey's Insurance - Coverage Owed For Vitamin E Supplement Claims, Texas Federal Judge Determines

WICHITA FALLS, Texas - Because an excess liability policy provides coverage for the negligent conduct of an insured arising from the manufacture and distribution of a vitamin E supplement, class plaintiffs are entitled to access $15 million held in the court's registry, a Texas federal judge said...

Mealey's Insurance - Judge: Amount In Controversy Standard In Bad Faith Suit Not Met

LOS ANGELES - Remand of an insurance breach of contract and bad faith lawsuit to state court is proper, a federal judge in California ruled Dec. 1, because an insurer failed to show that the amount in controversy meets the statutory requirements for removal (Jules Kraut, et al. v. Bankers Life and Casualty...

Mealey's Insurance - Illinois Panel: Appeal Seeking Coverage For $8.4M Junk Fax Ads Award Is Untimely

CHICAGO - An Illinois appeals panel held Dec. 5 that it lacks jurisdiction to hear a claimant's appeal in a dispute over insurance coverage for an underlying $8,414,374.50 judgment arising from unsolicited fax advertisements in violation of the Telephone Consumer Protection Act (TCPA), rejecting...

Mealey's Insurance - Insurer Argues It Is Entitled To Reimbursement Of Defense Costs Paid Under Deductible

SAN FRANCISCO - An insurer involved in an environmental contamination coverage dispute claims in a Dec. 1 motion for partial summary judgment filed in California federal court that it is entitled to reimbursement of the deductible it paid on behalf of its insured because the policy at issue specifically...

Mealey's Insurance - Judgment Debtor Tells Court It Is Appealing Order That It Pay Arbitration Award

NEW YORK - A judgment debtor told a federal court in New York on Dec. 2 that it is appealing a $7.8 million judgment against it related to a reinsurance participation agreement that the judgment debtor claimed it was not a party to (AmTrust North America, Inc. and Technology Insurance Company, Inc.,...

Mealey's Insurance - Supreme Court Finds No Dismissal Mandate For False Claims Act Seal Violations

WASHINGTON, D.C. - In a unanimous ruling, the U.S. Supreme Court on Dec. 6 held that the False Claims Act (FCA) "does not enact so harsh a rule" as mandating dismissal of a relator's lawsuit under the act for a violation of the statute's requirement that the relator's complaint...

Mealey's Insurance - Panel: Nurse Employed By Agency Qualifies As 'Employee' Of Hospital Under Policy

RICHMOND, Va. - The Fourth Circuit U.S. Court of Appeals on Dec. 6 held that a nurse who was employed by a staffing agency and assigned to work at a hospital qualifies as a hospital "employee" under its insurance policy, vacating and remanding an equitable contribution lawsuit arising from...

Mealey's Insurance - Court Properly Disregarded Portions Of Expert Witness' Affidavit, 9th Circuit Says

PORTLAND, Ore. - The Ninth Circuit U.S. Court of Appeals on Dec. 5 held that a lower federal court did not err in disregarding the heat-related portions of an affidavit from an expert witness in a dispute over coverage for a building collapse (Tarleton LLC v. State Farm Fire and Casualty Co., No. 14...

Mealey's Insurance - Judge: Insurer's Revision Of Estimate In Insurance Dispute Not In Bad Faith

SCRANTON, Pa. - A federal judge in Pennsylvania on Dec. 5 granted an insurer's motion for summary judgment on an insured's claim for insurance bad faith in a homeowners insurance dispute, ruling that the insured failed to show that the insurer's actions during the investigation and subsequent...

Mealey's Insurance - Trust Did Not Have The Authority To Make Claims Decisions, Kentucky Panel Says

FRANKFORT, Ky. - The Kentucky Court of Appeals on Dec. 2 affirmed the dismissal of two disability claimants' amended complaints after finding that the claimants could not assert their claims against the trust that administered their employer's disability plan because the trust did not possess...

Mealey's Insurance - Insurer Not Required To Complete Independent Medical Exam, Judge Says

LAFAYETTE, La. - A disability insurer did not abuse its discretion in denying a claim for long-term disability benefits because the insurer was not required to complete an independent medical exam of the claimant and was not required to give greater weight to the opinions of the claimant's treating...

Mealey's Insurance - Judge Rejects Insureds' Breach Of Contract Arguments In Bad Faith Suit

LOS ANGELES - Summary judgment is warranted against insureds in an insurance breach of contract and bad faith lawsuit because the insureds have failed to show that their insurer breached its contract in failing to pay their claims for benefits or denied their requests for a defense or indemnification...

Mealey's Insurance - Insured's Bad Faith Claim Lacks Factual Support, Judge Rules

OKLAHOMA CITY - An insured's insurance bad faith counterclaim was dismissed Dec. 5 after a federal judge in Oklahoma ruled that the insured failed to plead its counterclaim with any facts to support it (Employers Mutual Casualty Co. v. W-W Trailer Manufacturers, d/b/a W.W. Trailer Manufacturing,...

Mealey's Insurance - Lack Of Factual Allegations Dooms Bad Faith Claim, Federal Judge Rules

PHILADELPHIA - Dismissal an insured's bad faith claim against his insurer for failure to pay uninsured motorist benefits pursuant to an automobile insurance policy is proper because the insured failed to state any factual allegations to support his bad faith claim, a federal judge in Pennsylvania...

Mealey's Insurance - 11th Circuit Affirms Dismissal Of Federal Conspiracy Claims Against Insurer

ATLANTA - The 11th Circuit U.S. Court of Appeals on Dec. 5 affirmed a lower court's dismissal of an insured's federal conspiracy claims against his homeowners insurer, a claims investigator and a deputy sheriff arising from the insured's claim that $496,641 was stolen from his home (Windham...

Mealey's Insurance - Termination Of Benefits Supported By Evidence, Texas Federal Judge Says

BEAUMONT, Texas - A federal magistrate judge correctly found that a disability insurer's termination of disability benefits was not an abuse of discretion, a Texas federal judge said Dec. 6, noting that the evidence clearly supports the insurer's decision (Troy Arrington v. Unum Life Insurance...

Mealey's Insurance - Mississippi Federal Judge: Transfer Of Oil Spill Suit To Louisiana Is Not Warranted

JACKSON, Miss. - Transfer of a suit filed by the United States seeking damages for oil spill removal costs from Mississippi federal court to Louisiana federal court where an insurance coverage action is pending is not warranted because the United States' suit does not overlap with the coverage suit...

Mealey's Insurance - Judge: Firms' Contingency Fees Were Reasonable, Orders Woman To Pay Restitution

ALBUQUERQUE, N.M. - A federal judge in New Mexico on Dec. 6 ordered a woman who pleaded guilty to disability insurance fraud and wire fraud to pay two beneficiaries of an estate more than $100,000 in restitution, finding that the contingency fees charged by a research firm and a law firm they hired to...

Mealey's Insurance - 1st Circuit Affirms Homeowners Insurer Has No Duty To Defend

BOSTON - The First Circuit U.S. Court of Appeals on Dec. 7 found that a homeowners insurance policy draws a clear distinction between an insurer's duty to defend that applies to suits alone and the insurer's right to investigate that applies to both suits and claims, affirming a lower federal...

Mealey's Insurance - 6 Former Insys Executives Indicted For Paying Kickbacks For Opioid Scripts

BOSTON - Six former executives and managers of drug maker Insys Therapeutics Inc. were indicted Dec. 6 for racketeering, mail fraud and wire fraud conspiracy for allegedly bribing medical practitioners to prescribe Subsys, a fentanyl-containing pain drug, and for defrauding medical insurers, according...