NEW YORK - In vacating a lower court's decision, a panel of the Second Circuit U.S. Court of Appeals on July 31 held that a New York state law related to obtaining reimbursement of medical benefits from plaintiffs' tort settlements is not subject to preemption pursuant to the Employee Retirement Income Security Act, but that federal jurisdiction does exist under the Class Action Fairness Act (CAFA) (Meghan Wurtz, et al. v. Rawlings Co., et al., No. 13-1695, 2nd Cir.; 2014 U.S. App. LEXIS 14877).
ANCHORAGE, Alaska - A trial court abused its discretion by not permitting a plaintiff to conduct discovery into the intent behind a settlement offer in a personal injury case, which both parties seek to enforce per their respective understanding of the funds available under a liability insurance policy, the Alaska Supreme Court ruled July 30 (Brent McCormick v. Chippewa Inc., et al., No. S-15406, Alaska Sup.; 2014 Alas. LEXIS 151).
DALLAS - A Texas federal judge on July 30 granted a health care provider's motion to remand a reimbursement suit to state court, saying the Employee Retirement Income Security Act did not preempt the plaintiff's claims (Methodist Hospitals of Dallas v. Aetna Health, No. 13-4992, N.D. Texas; 2014 U.S. Dist. LEXIS 104291).
KANSAS CITY, Kan. - A Kansas federal judge on July 31 granted a health insurer's motion for summary judgment in a wrongful denial of benefits case, saying the plan excluded coverage for treatments considered experimental or investigative and studies confirmed a lack of support for the treatment involved to treat abdominal cancers (Doug Burton, in his capacity as executor of the Estate of Marsha Burton v. Blue Cross and Blue Shield of Kansas, No. 13-2099, D. Kan.; 2014 U.S. Dist. LEXIS 104328).
PINE BLUFF, Ark. - There is no coverage under a commercial general liability insurance policy for underling claims that a manufacturer insured improperly acquired and sold a lubricant blended with another company's secret formula, an Arkansas federal judge ruled Aug. 1, granting the insurer's motion for summary judgment (Pinnacle Resources Inc. v. Chartis Specialty Insurance Co., No. 5:13CV00240 SWW, E.D. Ark.; 2014 U.S. Dist. LEXIS 105402).
FORT MYERS, Fla. - There is no actual case or controversy regarding an insurer's duty to defend an additional insured in a construction defects case because it has accepted that duty, a Florida federal judge ruled Aug. 1, dismissing the primary insurer's declaratory judgment and equitable contribution claims against the insurer (Amerisure Mutual Insurance Co. and Amerisure Insurance Co. v. Crum & Forster Specialty Insurance Co. and Evanston Insurance Co., No. 12-443, M.D. Fla.; 2014 U.S. Dist. LEXIS 105467).
HARTFORD, Conn. - An insurer had a duty to defend a mutual insured for damages sustained from water intrusion at a law library, the Connecticut Supreme Court affirmed in an opinion to be released Aug. 5, also upholding the allocation of a pro-rata share of the defense costs between insurers (Travelers Casualty and Surety Company of America, et al. v. The Netherlands Insurance Co., et al., No. SC 19089, Conn. Sup.; 2014 Conn. LEXIS 262).
ST LOUIS - The Eighth Circuit U.S. Court of Appeals on July 31 reversed a decision dismissing coverage claims asserted by a homeowner against an insurer, finding that her claims for mold remediation and water damage were not excluded under the policy (Jessica Syfco v. Encompass Indemnity Co., No. 13-2903, 8th Cir.; 2014 U.S. App. LEXIS 14632).
FRESNO, Calif. - Insurers failed to allege an equitable reimbursement claim against an insured regarding the defense of an underlying construction defects case, a California federal judge ruled July 30, dismissing the claim (Travelers Indemnity Company of Connecticut, et al. v. Centex Homes, et al., No. 14-217, E.D. Calif.; 2014 U.S. Dist. LEXIS 105009).
SAN JOSE, Calif. - A California federal magistrate judge on July 29 denied motions for summary judgment filed by the owners of an apartment complex and their insurer, finding that issues of fact exist as to whether the insurer was liable to cover mold-related damage under an insurance policy (Kenneth E. Martz, et al. v. Leading Insurance Group Insurance Co. Ltd., No. 13-03815, N.D. Calif.; 2014 U.S. Dist. LEXIS 104235).
NEW ORLEANS - One day after finding that an insured failed to submit a timely proof of loss for his supplemental claim in a Hurricane Isaac coverage dispute, a Louisiana federal judge on July 31 entered judgment in favor of a federal flood insurer (Robert J. Lusco Jr. v. Allstate Insurance Co., et al., No. 13-6634, E.D. La.; 2014 U.S. Dist. LEXIS 103993).
SAN FRANCISCO - A majority of the Ninth Circuit U.S. Court of Appeals on July 30 found that a policy's assault and battery exclusion excluded coverage for priests and the diocese they worked for, reversing and remanding a lower court's ruling against the insurer in a coverage dispute arising from claims of sexual misconduct (Interstate Fire & Casualty Company Inc. v. The Roman Catholic Church of the Diocese, No. 12-17195, 9th Cir.).
COLUMBIA, S.C. - A professional liability insurer is not entitled to rescind four policies it issued to a law firm insured, and the insurer has a duty to defend a 2012 claim stemming from an alleged motion for sanctions brought against the insured, a South Carolina federal judge ruled July 29, denying the insurer's motion for summary judgment (Darwin National Assurance Co. v. Matthews & Megna LLC, et al., No.: 1:13-cv-01319-TLW, D. S.C.; 2014 U.S. Dist. LEXIS 102888).
WICHITA FALLS, Texas - A federal judge in Texas on July 29 denied a motion for reconsideration filed by an insurer seeking a ruling that the insurance policy it issued to an oil and gas exploration company covered only the cost of redrilling a well lost or damaged as a result of uncontrolled flow, rather than lost due to pressure operations related to a blowout of the hydraulic fracturing well (Eagle Oil & Gas Co. v. Travelers Property Casualty Company of America, No. 12-00133, N.D. Texas; 2014 U.S. Dist. LEXIS 102940).
PHILADELPHIA - A panel of the Third Circuit U.S. Court of Appeals on July 29 held that the Medicare as a Secondary Payer Act (MSP Act) authorizes the government to seek reimbursement from a settlement a plaintiff receives from a tortfeasor because the funds came from a "primary plan" and that the plaintiff cannot invoke a New Jersey state law to avoid her reimbursement obligations (Cecelia A. Taransky v. Secretary of the U.S. Department of Health and Human Services, et al., No. 13-3483, 3rd Cir.; 2014 U.S. App. LEXIS 14408).
SACRAMENTO, Calif. - A California appeals court on July 29 held that a health care provider must actually contract for the right to preserve its right to recover its customary billing rates through a Hospital Lien Act (HLA) lien or it forfeits the right to recover the customary billing rate for emergency room services from third-party tortfeasors (Dameron Hospital Association v. AAA Northern California, et al., No. C070475, Calif. App., 3rd. Dist.; 2014 Cal. App. LEXIS 684).
BOSTON - A Massachusetts federal judge on July 29 found that there is no coverage under a professional liability insurance policy for jury awards against an attorney for $397,000 in actual damages and $20,000 for professional negligence stemming from his participation in the sale of the site of an Indian burial ground (American Guarantee & Liability Insurance Co. v. John F. Lamond, et al., No. 13-13168-RGS, D. Mass.; 2014 U.S. Dist. LEXIS 103117).
MADISON, Wis. - A federal judge in Wisconsin granted in part a motion for summary judgment on July 28 and said a reinsurer owes an insurer nearly $700,000 under a reinsurance agreement (Employers Insurance Company of Wausau v. R&Q Reinsurance Company, No. 13-cv-00709, W.D. Wis.).
JOPLIN, Mo. - A federal judge in Missouri on July 25 dismissed an insured's insurance bad faith claim against his insurers for failure to pay on a long-term disability policy, ruling that Missouri does not recognize a cause of action for bad faith (Eric Millman v. Provident Life & Accident Insurance Co., et al., No. 14-5073, W.D. Mo.; 2014 U.S. Dist. LEXIS 101626).
GREENBELT, Md. - A health insurance company on July 25 sued multiple ambulatory service centers in a Maryland federal court for allegedly conspiring to submit fraudulent bills for services provided to patients covered by the plaintiff (Connecticut General Life Insurance Co., et al. v. Advanced Surgery Center of Bethesda, et al., No. 14-2376, D. Md.).
HANNIBAL, Mo. - The expert witness proffered by the plaintiff in a dispute over insurance coverage for roof and water damage from a hailstorm did not have "sufficient specialized knowledge" regarding the type of roof at issue, a Missouri federal judge found July 25, also concluding that the expert's report was based on an insufficient factual basis and, as such, must be excluded (Phyllis Hannan v. Auto-Owners Insurance Co., No. 2:13-cv-00053, E.D. Mo.; 2014 U.S. Dist. LEXIS 101403).
PEORIA, Ill. - An Illinois federal judge on July 25 dismissed an insurer's suit seeking a declaration regarding an indemnity payment for exposure to an insured's asbestos products because the insurer's suit is duplicative of a suit filed by the injured party against the insured (Arrowood Indemnity Co. v. James Shipley et al., No. 11-1220, C.D. Ill.; 2014 U.S. Dist. LEXIS 101546).
CHICAGO - An Illinois panel on July 28 affirmed a lower court's $84.5 million judgment in favor of an insured in a coverage dispute arising from the Italian government's recall of a prescription drug (Certain Underwriters at Lloyd's London, et al. v. Abbott Laboratories, No. 03 CH 9307, Ill. App., 1st Dist.).
ANN ARBOR, Mich. - A group of insurers told a federal court in Michigan on July 25 that a pair of arbitration awards should be vacated because of the arbitration umpire's evident partiality, among other reasons (Star Insurance Company, et al. v. National Union Fire Insurance Company of Pittsburgh, PA, No. 14-cv-12915, E.D. Mich.).
BALTIMORE - Insurers failed to join all necessary parties to their declaratory judgment lawsuit regarding coverage for a mutual insured in an underlying lawsuit over the insured's alleged failure to install functional radon removal systems, a Maryland federal judge ruled July 28, dismissing the lawsuit (Crum & Forster Specialty Insurance Co. v. Gemcraft Homes Inc., No. 14-542, Nationwide Mutual Insurance Co. v. Gemcraft Homes Inc., No. 14-1464, D. Md.; 2014 U.S. Dist. LEXIS 102447).