MIAMI - A Florida appeals panel on July 26 held that it lacks jurisdiction to hear a homeowners insurer's appeal of a Hurricane Wilma coverage dispute, dismissing the appeal (Gulfstream Property & Casualty Insurance Co. v. David Coley, No. 3D16-885, Fla. App., 3rd Dist., 2017 Fla. App. LEXIS 10651).
NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on July 28 affirmed a lower court's finding that an underlying complaint against an insured failed to allege the use of another's "advertising idea," a trade dress claim or a claim for slogan infringement (Laney Chiropractic and Sports Therapy, P.A. v. Nationwide Mutual Insurance Co., 16-11183, 5th Cir., 2017 U.S. App. LEXIS 13748).
ANNAPOLIS, Md. - A majority of the Maryland Court of Special Appeals on July 27 affirmed a lower court's ruling that a commercial general liability insurer failed to establish that the policy's assault and battery exclusion barred coverage for an underlying shooting that injured a patron of the insured's restaurant, finding, however, that the judgment against the insurer should be reduced from $100,000 to $74,999.99 (White Pine Insurance Co. v. Howard R. Taylor, No. 493, September Term, 2016, Md. Spec. App., 2017 Md. App. LEXIS 758).
HARRISBURG, Pa. - A federal judge in Pennsylvania on July 25 sentenced a woman to 46 months in prison for obtaining $84,500 in compensation from Medicaid for behavioral health services she provided even though she was excluded from the program for previous convictions for health care fraud, the U.S. Department of Justice announced (United States of America v. Tammie Sensenig, No. 17cr0043, M.D. Pa.).
MACON, Ga. - A Georgia federal judge on July 25 denied an insurer's motion for summary judgment on the duty to defend after determining that all of the underlying allegations arising out of exposure to welding fumes are not excluded under the policy at issue (Evanston Insurance Co. v. Sandersville Railroad Co., No. 15-247, M.D. Ga., 2017 U.S. Dist. LEXIS 115686).
HARRISBURG, Pa. - A trial court judge properly denied a man's petition under the Post-Conviction Relief Act (PCRA) seeking reversal of his conviction for insurance fraud, the Pennsylvania Superior Court ruled July 26, holding that the man was ineligible for such relief because he was not incarcerated or under supervised relief at the time the request was filed (Commonwealth v. Robert Carl Bolus, No. 1300 MDA 2016, Pa. Super., 2017 Pa. Super. Unpub. LEXIS 2858).
PHILADELPHIA - The Third Circuit U.S. Court of Appeals on July 26 affirmed a Pennsylvania federal jury's verdict in favor of an insured after the stone facade on her home collapsed, rejecting the insurer's argument that the main cause of the collapse is excluded under the homeowners policy (Ahsaki Gordon, et al. v. Allstate Property and Casualty Insurance Co., No. 16-3671, 3rd Cir., 2017 U.S. App. LEXIS 13507).
BOSTON - A man who was sentenced to 48 months in prison for intentionally setting fire to a diner he and his wife owned for the purposes of obtaining insurance proceeds was ordered by a federal judge in Massachusetts on July 26 to pay the insurer the $15,327.86 it incurred in investigating the incident (United States v. Jeffrey Cordio, No. 16-40012-TSH, D. Mass., 2017 U.S. Dist. LEXIS 116640).
JEFFERSON CITY, Mo. - A Missouri federal judge on July 24 granted in part and denied in part summary judgment motions and amended class definitions in a dispute over whether a homeowners insurer should have applied a deductible to the actual cash value (ACV) payment it issued the insureds for their hail damage loss (David Bond, et al. v. Liberty Insurance Corp., No. 15-04236, W.D. Mo., 2017 U.S. Dist. LEXIS 114778).
TACOMA, Wash. - A Washington federal judge on July 25 denied an insurer's motion to dismiss after determining that the insured's complaint seeking a coverage declaration for an underlying environmental contamination suit has stated a coverage claim against the insurer that is appropriate for resolution in the federal court (USNR LLC v. Hartford Accident & Indemnity Co., et al., No. 16-5879, W.D. Wash., 2017 U.S. Dist. LEXIS 116463).
NEW YORK - A New York federal judge on July 24 adopted a federal magistrate's recommendation to remand a long-term disability claim as it pertained to the claimant's physical disability, but not the claimant's psychiatric disability, because the evidence may support a finding that the claimant is physically disabled according to the terms of the plan (Marie Richter v. Metropolitan Life Insurance Co., No. 15-8266, S.D. N.Y., 2017 U.S. Dist. LEXIS 115119).
TRENTON, N.J. - Umbrella and excess policies must be included when allocating liability for coverage of underlying asbestos claims filed against an insured because the excess and umbrella policies are a type of risk transfer, a New Jersey federal judge said July 26 in granting an insurer's motion for summary judgment (The Travelers Indemnity Co., et. al., v. Thomas & Betts Corp., No. 13-6187, D. N.J., 2017 U.S. Dist. LEXIS 117135).
WAUSAU, Wis. - A Wisconsin appeals panel on July 25 affirmed a lower court's ruling that a legal malpractice claim against a law firm insured was not reported within a professional liability insurance policy's two-year extended reporting period (ERP) (Michael J. Sheffield v. Darwin National Assurance Company, et al., No. 2016AP846, Wis. App., Div. 3, 2017 Wisc. App. LEXIS 554).
DALLAS - A Texas appeals panel on July 24 affirmed a lower court's summary judgment ruling in favor of an insurer in a breach of contract lawsuit arising from a $73,000 appraisal award for the insured's hailstorm damage (Floyd Circle Partners LLC v. Republic Lloyds, No. 05-16-00224, Texas App., 5th Dist., 2017 Tex. App. LEXIS 6906).
HARRISBURG, Pa. - A Pennsylvania judge on July 25 approved a direct payment of reinsurance by a reinsurer to an insured in the liquidation of Reliance Insurance Co. (In re: Reliance Insurance Co. in liquidation, No. 1 REL 2001, Pa. Cmwlth.).
JEFFERSON CITY, Mo. - A Missouri federal judge on July 24 granted an insured's motion to intervene as the representative of a class action alleging that a homeowners insurer committed breach of contract when it unlawfully applied a policy's $1,000 deductible to an actual cash value (ACV) payment in a hailstorm coverage dispute (Eric Lafollette v. Liberty Mutual Fire Insurance Co., No. 14-04147, W.D. Mo.; 2017 U.S. Dist. LEXIS 114779).
SAN FRANCISCO - A California federal judge on July 24 determined that a disability claimant is entitled to long-term disability benefits because the claimant met her burden of proving that she was disabled according to the terms of the plan at issue (Hadar Meiri v. Hartford Life and Accident Insurance Co., No. 16-103, N.D. Calif., 2017 U.S. Dist. LEXIS 115224).
NEW YORK - A firm's loss due to a fraudulent wire transfer scheme constituted computer fraud even though the thief used email spoofing rather than hacking into the company's system, a New York federal judge ruled July 21, finding that coverage for the multimillion dollar loss existed under the computer fraud provision of the company's executive protection insurance policy (Medidata Solutions Inc. v. Federal Insurance Co., No. 1:15-cv-00907, S.D. N.Y.).
TACOMA, Wash. - A Washington federal judge on July 20 partially granted a motion for summary judgment filed by insurers to the extent that it sought declaratory judgment that only property damage to welds was covered under an insurance policy, but found that an underlying complaint could impose liability on a pipe company that may be also covered under the policy (Travelers Property Casualty Company of America, et al. v. Northwest Pipe Company, et al., No. 17-5098, W.D. Wash., 2017 U.S. Dist. LEXIS 113325).
GRAND RAPIDS, Mich. - A Michigan appeals panel on July 20 affirmed a lower court's ruling in favor of an insured in a coverage dispute arising from water damage to the insured's Ann Arbor, Mich., property (Cincinnati Insurance Co. v Thomas Kaeding II, No. 332559, Mich. App., 2017 Mich. App. LEXIS 1185).
FRANKFORT, Ky. - A Kentucky appeals panel on July 21 affirmed a lower court's grant of summary judgment in favor of a professional liability insurer in a lawsuit alleging that the insurer breached its duty to deal in good faith with a third party who sued its doctor insured for medical malpractice (Deborah Lemaster v. Medical Protective Insurance Services, Inc., No. 2016-CA-000826, Ky. App., 2017 Ky. App. Unpub. LEXIS 534).
BALTIMORE - A self-funded, self-administered group health plan failed to allege a claim over which jurisdiction would exist under the Patient Protection and Affordable Care Act's (ACA) "internal revenue tax" or "any sum" provisions, a Maryland federal judge ruled July 21, dismissing the health plan's lawsuit alleging that it was improperly required to pay reinsurance contributions under the ACA (Electrical Welfare Trust Fund v. United States of America, et al., No. 16-2186, D. Md., 2017 U.S. Dist. LEXIS 113687).
GREENBELT, Md. - Following remand from the Fourth Circuit U.S. Court of Appeals, a Maryland federal judge on July 21 entered a $3,591,847.28 judgment plus post-judgment interest in favor of a professional liability insurer in its equitable contribution lawsuit arising from a medical malpractice claim (Interstate Fire and Casualty Co. v. Dimensions Assurance Ltd., No. 13-3908, D. Md., 2017 U.S. Dist. LEXIS 114221).
DETROIT - A Michigan federal judge on July 20 granted a commercial excess insurer's motion for summary judgment in an insured's breach of contract lawsuit seeking to recover $306,808.46 in post-judgment interest that was awarded against the insured in an underlying product liability dispute (Key Safety Systems, Inc. v. AIG Specialty Insurance Co., No. 16-11974, E.D. Mich., 2017 U.S. Dist. LEXIS 112837).
SAN ANTONIO - A Texas federal judge held on July 19 that an insured's state law tort causes of action as to how her federal flood insurer handled her claim are preempted by federal law, further concluding that it is undisputed that the insured failed to file an adequate proof of loss to support her breach of contract claim against the insurer (Patricia Hernandez v. National Lloyds Insurance Co., No. 15-1008, W.D. Texas, 2017 U.S. Dist. LEXIS 112567).