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Mealey's Insurance - Texas Panel Finds Take- Nothing Judgment In Hurricane Ike Coverage Suit Was Proper

HOUSTON - A Texas appeals panel held Feb. 9 that a take-nothing judgment against insureds is proper because a commercial insurer overpaid the actual cash value of Hurricane Ike property damage by more than $1.5 million based on the jury's findings as to actual cash value (Triyar Companies, LLC, et...

Mealey's Insurance - Policy Limits Coverage For Insureds' Water Damage, New York Panel Majority Says

ROCHESTER, N.Y. - Because an insurance policy limits coverage to $25,000 for water damage and an insured property was damaged by water that entered the basement through a broken conduit, a trial court erred in denying the insurer's motion for summary judgment, a Fourth Department New York Supreme...

Mealey's Insurance - California Appeals Panel Says No Additional Coverage Owed For Water Damages

SAN FRANCISCO - An insurer owes no additional coverage for water damages to an insured's condominium, the First District California Court of Appeal, Division Four, said Feb. 10 after determining that substantial evidence supports a jury's verdict in favor of the insurer (Greg Kawai v. State Farm...

Mealey's Insurance - Judge: Breach Of Contract, Bad Faith Claims Not Filed Within Limitations Period

SACRAMENTO, Calif. - An insured's claims for insurance breach of contract and bad faith against his insurer were not timely filed within the contractual limitations period and the insured failed to show that the insurer engaged in any outrageous conduct to support a claim for intentional infliction...

Mealey's Insurance - Mental Health Facility Administrator Found Guilty For Kickback Scheme

SHREVEPORT, La. - A federal jury in Louisiana on Feb. 10 found a mental health care facility administrator guilty of organizing a kickback scheme that resulted in the submission of $6.7 million in fraudulent bills to Medicare, the U.S. Attorney's Office announced (United States of America v. Tom...

Mealey's Insurance - Insured Ordered To File Motion To Remand If It Objects To Removal

SHREVEPORT, La. - A Louisiana federal magistrate judge on Feb. 10 ordered an insured seeking coverage for damages caused by a sewage backup that occurred during the insured's work in a neighborhood to file a motion to remand its suit if it contests the insurer's notice of removal to Louisiana...

Mealey's Insurance - Federal Judge: ERISA Stock Ownership Plan Cannot Seek Recovery Under Crime Policy

HOUSTON - A federal judge in Texas on Feb. 9 held that a third-party holding corporate stock cannot seek coverage under an insurance policy's plain language that limits coverage to "direct" losses when a corporate officer committed fraud that caused the devaluation of the corporation's...

Mealey's Insurance - Judge Rejects Insurers' Motion For Leave To Appeal Temporary Restraining Order

NEW YORK - A federal judge in New York on Feb. 9 denied as moot errors and omissions insurers' motion for leave to appeal a temporary restraining order (TRO) issued in a bankruptcy court in a coverage dispute with their insured MF Global Holdings Ltd. (MFGH) (MF Global Holdings Ltd., et al. v. Allied...

Mealey's Insurance - Judge: Claims Alleging Wrongful Antitrust, Monopolizing Conduct Are Related

ORLANDO, Fla. - Judgment was entered in favor of insurers on Feb. 15, one day after a Florida federal judge found that there is no further coverage owed to insureds for lawsuits alleging that they have intentionally engaged in wrongful antitrust and monopolizing conduct in an effort to dominate the health...

Mealey's Insurance - Insured's Breach Of Contract Is Barred By 2-Year Statute Of Limitations, Judge Says

DENVER - A two-year statute of limitations precludes an insured's breach of contract claim against its insurer for denied coverage for property damage to commercial properties, a Colorado federal judge ruled Feb. 13 (The Pinewood Townhome Association Inc. v. Auto-Owners Insurance Co., No. 15-01604...

Mealey's Insurance - Judge Denies Objection, Says Magistrate Judge's Discovery Order Was Proper

SALT LAKE CITY - A federal judge in Utah on Feb. 13 denied an insolvent insurer's objection to a magistrate judge's order compelling discovery of certain categories of information sought by a group of the insolvent insurer's former directors and officers (Western Insurance Company v. Dick...

Mealey's Insurance - Judge Rules In Insurer's Favor In Suit Arising From Superstorm Sandy Flood Damage

CAMDEN, N.J. - A New Jersey federal judge on Feb. 14 granted a federal flood insurer's motion for summary judgment in a lawsuit brought by insureds seeking a declaration that they are entitled to coverage and compensatory damages stemming from the insurer's purported mishandling of their Superstorm...

Mealey's Insurance - Disability Plan Is Governed By ERISA, California Federal Judge Determines

LOS ANGELES - A California federal judge on Feb. 10 denied a plaintiff's motion to remand a disability suit to state court because the disability plan at issue is not a "church plan" and is governed by the Employee Retirement Income Security Act (Melvyn L. Durham v. The Prudential Insurance...

Mealey's Insurance - Insureds Failed To Comply With Post-Loss Obligations, Florida Panel Says, Reverses

MIAMI - A Florida appeals panel on Feb. 15 reversed a lower court's ruling compelling appraisal against an insurer in a Hurricane Wilma coverage dispute, finding that the insureds failed to comply with their post-loss duties under their insurance policy (State Farm Florida Insurance Co. v. Jose R...

Mealey's Insurance - Insureds Failed To File Suit Within 1-Year Limitation Period, Federal Judge Says

LOS ANGELES - Because insureds seeking coverage for damages to their home caused by a sewage backup did not file their lawsuit against their insurers until well after the policy's one-year limitation period expired, a California federal judge on Feb. 13 granted the insurers' motion for summary...

Mealey's Insurance - Magistrate Judge Recommends Entering Default Against Doctor, Clinics For Fraud

NEW YORK - A federal magistrate judge in New York on Feb. 13 recommended that a federal judge enter default judgment against a doctor and the clinics he owned for common-law fraud and violation of the Racketeer Influenced and Corrupt Organizations Act for his role involving the submission of fraudulent...

Mealey's Insurance - Claimant's Suit Was Timely Filed, California Federal Judge Says

SAN FRANCISCO - A disability claimant's suit alleging wrongful termination of benefits was timely filed, a California federal judge said Feb. 13 after determining that the plan's three-year limitations period did not begin to run until after the 180-day deadline to appeal the termination of benefits...

Mealey's Insurance - Joinder Of Adjuster Was Improper, Federal Judge Rules In Denying Motion To Remand

DALLAS - Finding that an insured improperly joined an insurance adjuster in a dispute over coverage for storm damage, a Texas federal judge on Feb. 14 denied the insured's motion to remand and dismissed the claims against the adjuster without prejudice (Hutchins Warehouse Limited Partners v. American...

Mealey's Insurance - Washington Federal Judge Denies Motion For Summary Judgment On Bad Faith Claims

SEATTLE - A Washington federal judge on Feb. 13 denied an insurer's motion for summary judgment on an insured's claims for bad faith in an environmental coverage dispute because the judge previously found that the insurer breached it duty to defend and any estoppel argument is now irrelevant...

Mealey's Insurance - Texas High Court Refuses To Rehear Ruling On Discovery Order In Hailstorm Dispute

AUSTIN, Texas - The Texas Supreme Court refused to revisit its ruling in a hailstorm coverage dispute that directed a lower court to vacate the part of its discovery order compelling production of management reports and emails and to re-evaluate the issue of sanctions against the insurer, according to...

Mealey's Insurance - 10th Circuit Panel Says No Breach Of Contract For Denying Claim For Damages

DENVER - Because an insured failed to establish that it suffered water damage to "covered property" at a renovation project under a builders risk policy, the 10th Circuit U.S. Court of Appeals on Feb. 16 affirmed a Colorado federal judge's finding that the insurer properly denied coverage...

Mealey's Insurance - Federal Judge Says Claimant Is Residually Disabled, Not Totally Disabled As Required

ATLANTA - A disability claimant is not entitled to benefits under a policy's lifetime sickness rider because the claimant is residually disabled and not totally disabled as required for benefits under the rider, a Georgia federal judge said Feb. 15 (William F. Nefsky v. Unum Life Insurance Company...

Mealey's Insurance - Judge Converts Motion To Dismiss, Orders Further Briefing In Bad Faith Suit

ALBUQUERQUE, N.M. - Unable to determine from the evidence provided whether an insured's disability benefits plan is governed by the Employee Retirement Income Security Act of 1974 (ERISA), a federal judge in New Mexico on Feb. 14 converted the insurer's motion to dismiss to a motion for summary...

Mealey's Insurance - 9th Circuit: Insurance Policy Bars Damage Caused By 'Subsidence'

SAN FRANCISCO - Claims against a mutually insured subcontractor for damage caused by "subsidence" are excluded under an insurance policy, the Ninth Circuit U.S. Court of Appeals ruled Feb. 14, finding that an insurer had no duty to defend and thus was not responsible to share in costs incurred...

Mealey's Insurance - Substantial Evidence Supports Plan Denial Of LTD Benefits, Ohio Federal Judge Says

COLUMBUS, Ohio - The denial of a claim for long-term disability (LTD) benefits was not arbitrary and capricious because the claimant was provided with a fair review procedure and substantial evidence supports the denial of benefits, an Ohio federal judge said Feb. 14 in granting the plan's motion...