LexisNexis® Legal Newsroom
Mealey's Insurance - Claim Denial Supported By Available Medical Evidence, Michigan Federal Judge Says

DETROIT - A federal magistrate judge did not err in recommending that a defendant's motion for summary judgment be granted because the available medical evidence supports the denial of a disability claimant's long-term disability claim, a Michigan federal judge said Sept. 13 in adopting the magistrate...

Mealey's Insurance - Material Misrepresentations On Application Void Coverage, 6th Circuit Affirms

CINCINNATI - The Sixth Circuit U.S. Court of Appeals on Sept. 16 affirmed a lower federal court's ruling that there is no coverage for the Tennessee attorney general's lawsuit against the provider of bio-identical hormone replacement therapy because the insured made material misrepresentations...

Mealey's Insurance - 9th Circuit: Error In Admitting Testimony Does Not Warrant New Trial

PASADENA, Calif. - A Ninth Circuit U.S. Court of Appeals panel on Sept. 14 affirmed the denial of a woman's motion for a new trial, holding that even though a judge erred in allowing testimony that inculpated the defendant, there was sufficient evidence to support her conviction of mail fraud in...

Mealey's Insurance - Majority: Insurer Liable For $3M Judgment In Suit Arising From Teen's Suicide

SEATTLE - A majority of the Ninth Circuit U.S. Court of Appeals on Sept. 16 affirmed a lower federal court's ruling that a commercial general liability insurer had a duty to defend its insured against underlying claims that its misleading marketing, wrongful admission to a behavior modification residential...

Mealey's Insurance - Judge: Rockfall Damage Excluded From Coverage Under Insurance Policy

SALT LAKE CITY - An insurer did not act in bad faith in denying a claim for coverage under a homeowners insurance policy pursuant to the policy's earth movement exclusion for damage caused by a rockfall, a federal judge in Utah ruled Sept. 15, because the policy was not ambiguous and did not provide...

Mealey's Insurance - Judge: Misrepresentations On Ownership, Prior Claims Warrant Voiding Policy

ABERDEEN, Miss. - A federal judge in Mississippi on Sept. 16 awarded summary judgment to Allstate Indemnity Co., ruling that a man's misrepresentations on his policy application regarding the ownership of a property that sustained fire damage and his failure to inform the company of prior insurance...

Mealey's Insurance - 5th Circuit Says Pollution Endorsement Does Not Exclude All Underlying Claims

NEW ORLEANS - A district court erred in granting summary judgment in favor of an insurer based on its policy's pollution endorsement because it is not clear that the endorsement excludes coverage for all of the underlying claims alleged against an insured, the Fifth Circuit U.S. Court of Appeals...

Mealey's Insurance - Policy Clearly Precludes Loss For Roof Damaged By Wet Rot, Michigan Panel Says

TROY, Mich. - No coverage is owed to an insured seeking coverage for a damaged roof because the cause of the damage was wet rot, which is clearly an excluded cause of loss under the applicable policy, the Michigan Court of Appeals said Sept. 15 (Michigan Battery Equipment Inc. v. EMCASCO Insurance Co...

Mealey's Insurance - No Coverage Due To Underlying Plaintiff For Lead Paint Injuries, Federal Judge Says

BALTIMORE - An underlying plaintiff is not entitled to coverage under policies issued to the owner of a rental property where she allegedly sustained damages as a result of lead paint because the underlying plaintiff is not an insured or a beneficiary under the policies at issue and because the policies...

Mealey's Insurance - Insurer Entitled To Rescind Professional Liability Policies, Federal Judge Rules

ROCKFORD, Ill. - An Illinois federal judge on Sept. 19 granted a professional liability insurer's request to rescind three policies because of material misrepresentations that a patent and trademark attorney insured made on his application (Minnesota Lawyers Mutual Insurance Co. v. Jerry A. Schulman...

Mealey's Insurance - Judge Declines Insurer's Dismissal Motion, Rules That Argument Is Vague

DALLAS - A federal judge in Texas on Sept. 15 denied an insurer's motions to dismiss and for summary judgment in an insurance breach of contract and bad faith lawsuit, ruling that the insurer failed to plead, in detail, each of an insured's claims it seeks to dismiss (David Giboney v. Allstate...

Mealey's Insurance - Judge: No Valid Lack Of Reasonable Basis Argument Made In Bad Faith Suit

PHILADELPHIA - A federal judge in Pennsylvania granted an insurer's motion to dismiss claims in an insurance bad faith lawsuit on Sept. 15, ruling that an insured failed to show that the insurer lacked a reasonable basis for denying her claim for underinsured motorists (UIM) benefits (Linda Murphy...

Mealey's Insurance - Judge Resentences Doctor For Insurance Fraud Following Appeal

TYLER, Texas - A federal judge in Texas on Sept. 15 resentenced a doctor to 135 months in prison and ordered him to pay $145,358.23 in restitution to Medicare, Medicaid and Blue Cross Blue Shield of Texas after the Fifth Circuit U.S. Court of Appeals affirmed his conviction (United States of America...

Mealey's Insurance - Insurance Servicer Says Court Lacks Say Over Reinsurance Arbitration Award Case

NEW YORK - An insurance services company sued for allegedly not honoring a reinsurance arbitration award told a federal court in New York on Sept. 19 that the court does not hold jurisdiction over the dispute (AmTrust North America, Inc. and Technology Insurance Company, Inc., as judgment creditors of...

Mealey's Insurance - Special Deputy Receiver Reports Quarterly Status Of Liquidation Estate

AUSTIN, Texas - The special deputy receiver (SDR) of an insolvent insurer reported to a Texas court on Sept. 15 the financial status of the liquidation estate and outlined details of reinsurance recoverables and recoveries (The State of Texas v. San Antonio Indemnity Company, No. D-1-GV-13-001153, Texas...

Mealey's Insurance - DOJ: Skilled Nursing Company, Board Members To Pay $30M Over False Billing

WASHINGTON, D.C. - The U.S. Department of Justice announced Sept. 19 that North America Health Care Inc. (NAHC), its chairman of the board and a senior vice president have agreed to pay a total of $30 million to resolve allegations that they violated the False Claims Act (FCA) by submitting false claims...

Mealey's Insurance - Washington Federal Judge: Additional Briefing Needed On Discretionary Clause

SEATTLE - A Washington federal judge on Sept. 19 ordered parties involved in a disability benefits dispute to submit additional briefing on whether a discretionary clause, included in a disability plan that was issued in the State of Texas, is valid in the State of Washington where the claimant resides...

Mealey's Insurance - Judge: Reinsurers Failed To State A Claim For Relief In Breach Of Contract Suit

WASHINGTON, D.C. - Dismissal of claims in an insurance breach of contract and bad faith lawsuit is proper because reinsurers have failed to state a claim for relief against the Federal Crop Insurance Corp. (FCIC) regarding its modification of the methodology that sets crop premiums, a federal judge in...

Mealey's Insurance - Coverage For Qui Tam Action Limited To $25,000, Federal Judge Rules

LAS VEGAS - A Nevada federal judge on Sept. 19 held that coverage for an underlying qui tam action is available under a professional liability insurance policy's billing errors endorsement up to the $25,000 sublimit of liability, rejecting the insureds' argument that they are owed $2 million...

Mealey's Insurance - Man Says Reinsurance Dispute Does Not Involve Him

ATLANTA - A man purportedly associated with a reinsurer sued for allegedly avoiding payment obligations tells a federal court in Georgia in a Sept. 21 brief that claims against him should be dismissed because the court does not hold personal jurisdiction over him (Canal Insurance Company, et al. v. Golden...

Mealey's Insurance - Reinsurer Says Magistrate Judge's Discovery Orders Are Fundamentally Unfair

SYRACUSE, N.Y. - A reinsurer in a Sept. 19 brief asks a federal court in New York to reconsider its discovery rulings that the reinsurer says require it to produce reserve information while not requiring its reinsured to produce the same category of documentation (Utica Mutual Insurance Company v. Century...

Mealey's Insurance - Insured Did Not Comply With Terms Of Insurance Policy, Federal Judge Rules

HOUSTON - An insured is not entitled to coverage under a one-year casualty insurance policy for losses as the result of a burglary because the insured failed to pay the premium by the required deadline, failed to disclose that he has filed similar claims under the terms of a previous policy and failed...

Mealey's Insurance - Judge: Insureds Conceded They Are Not Entitled To Defense In Insurance Dispute

TULSA, Okla. - An insurer is entitled to judgment on the pleadings on claims that it failed to properly provide a defense for insureds under the terms of a homeowners insurance policy because the insureds conceded that they were not entitled to a defense for the claims made against them, a federal judge...

Mealey's Insurance - Remodelers' Lawsuit Against Federal Flood Insurer Cannot Survive, Judge Rules

NASHVILLE, Tenn. - A Tennessee federal judge on Sept. 20 granted a federal flood insurer's motion to dismiss a breach of contract, unjust enrichment, fraudulent inducement and intentional and negligent misrepresentation lawsuit against it, finding that the claims are preempted by federal law (D&S...

Mealey's Insurance - Reinsurer Counters Motion To Vacate Arbitration Award

NEW YORK - A reinsurer told a federal court in New York on Sept. 22 that an arbitration award should be confirmed because a reinsured has not shown that an arbitration umpire was biased (Yosemite Insurance Company v. Nationwide Insurance Company, No. 16-cv-05290, S.D. N.Y.).