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., No. 15-7355, C.D. Calif.; 2016 U.S. Dist. LEXIS 166120).
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 Dist., Div. 5; 2016 Cal. App. Unpub. LEXIS 8558).
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, Texas Sup.).
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. 30, reversing and remanding an entry of summary judgment to the insurer (Western National Mutual Insurance Co. v. Gateway Building Systems Inc. and Dakota Mill & Grain Inc., Nos. 27841 & 27842, S.D. Sup.; 2016 S.D. LEXIS 148).
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 ACV (Douglas and Tammy Herzog v. Property and Casualty Insurance Company of Hartford, No. 16-05083, W.D. Wash.; 2016 U.S. Dist. LEXIS 166177).
ALBUQUERQUE, N.M. - A cardiologist's proposed testimony about the appropriateness of diagnoses and treatment by a doctor accused of health care fraud is reliable and relevant under Daubert v. Merrell Dow Pharmaceuticals, Inc. (509 U.S. 579, 597 ), a federal judge in New Mexico ruled Dec. 1, finding that the proffered expert's lack of training in holistic medicine does not adversely affect his methodology (United States of America v. Roy Heilbron, No. 15-CR-2030, D. N.M.; 2016 U.S. Dist. LEXIS 166211).
BROOKLYN, N.Y. - A New York federal magistrate judge on Nov. 30 ruled that an insured is entitled to underwriting and claims files for a limited number of its London Market Insurers to determine if nonduplicative documents exists among the policies issued by the London Market Insurers to the insured (Certain Underwriters at Lloyd's, et al., v. National Railroad Passenger Corp., et al., No. 14-4717, E.D. N.Y.; 2016 U.S. Dist. LEXIS 165967).
CINCINNATI - Because six medical experts unanimously agreed that a disability claimant was not disabled from performing any occupation, the disability insurer did not act arbitrarily and capriciously in terminating the claimant's long-term disability (LTD) benefits, the Sixth Circuit U.S. Court of Appeals said Nov. 29 (Dana Leppert v. Liberty Life Assurance Company of Boston, No. 16-3387, 6th Cir.; 2016 U.S. App. LEXIS 21438).
ST. LOUIS - Dismissal of a bad faith claim in an insurance dispute is proper because the state does not recognize a claim for bad faith refusal to pay benefits, but an insured has properly stated his claim for breach of contract against the insurer, a federal judge in Missouri ruled Nov. 29 in granting in part and denying in part the insurer's motion to dismiss (Roger L. Smith v. Zurich American Insurance Co., No. 16-0187, E.D. Mo.; 2016 U.S. Dist. LEXIS 163444).
TALLAHASSEE, Fla. - A majority of the Florida Supreme Court on Dec. 1 held that an appeals court erred in reversing an $8 million judgment against a homeowners insurer in a coverage dispute over alleged property damage caused by construction defects, rain and wind, quashing the lower court's opinion and remanding to apply the concurring cause doctrine (John Robert Sebo v. American Home Assurance Co. Inc., No. 14-897, Fla. Sup.; 2016 Fla. LEXIS 2596).
BALTIMORE - A federal judge in Maryland on Nov. 23 overruled a property owner's argument that an insurance company's lawsuit seeking rescission of a general liability policy due to alleged misrepresentations about lead paint violations on the policy application is untimely, ruling that the owner was unable to provide sufficient evidence to support the argument (CX Reinsurance Company Ltd. v. Leader Realty Company, et al., No. JKB-15-3054, D. Md.; 2016 U.S. Dist. LEXIS 162349).
NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on Nov. 29 denied a petition for rehearing after determining that a refinery owner seeking help with environmental cleanup costs under its parent company's insurance policy should have and could have discovered that it was not named as an insured under the policy simply by looking at the insurance policy sometime within the six years of the policy's issuance (AIG Specialty Insurance Company, f/k/a Chartis Specialty Insurance Company v. Tesoro Corporation, No. 15-50953, 5th Cir.).
SYRACUSE, N.Y. - A reinsurer asked a federal court in New York on Nov. 28 to intervene in a number of discovery disputes with an insurer, notably asking that the court allow it to depose up to 20 current and former employees and agents of the insurer (Utica Mutual Insurance Company v. R&Q Reinsurance Company, No. 15-cv-00270, N.D. N.Y.).
BROOKLYN, N.Y. - A New York federal magistrate judge on Nov. 23 granted an insured's motion to compel the production of documents in an environmental contamination coverage dispute after determining that the insured has shown a need for the requested documents and that the request was not overly burdensome (Certain Underwriters at Lloyd's, et al., v. National Railroad Passenger Corp., et al., No. 16-2778, E.D. N.Y.; 2016 U.S. Dist. LEXIS 162783).
CHICAGO - An Illinois federal judge on Nov. 23 granted an insurer's motion seeking discovery in an asbestos coverage dispute after finding that the effect of an underlying settlement agreement on the insurer's duty to defend must first be determined before a decision can be made on the insurer's duty to defend the insured against a number of other underlying asbestos suits (The Hillshire Brands Co. v. Travelers Casualty and Surety Co., No. 15-06859, N.D. Ill.; 2016 U.S. Dist. LEXIS 162386).
NEW ORLEANS - A Louisiana federal judge on Nov. 23 denied an insurer's motions for summary judgment on the duty to defend and indemnify an insured and an additional insured against two underlying suits filed by neighboring residents of an insured shipyard after determining that the insurer failed to prove that the policy's exclusions for health hazard, silica or pollution bar coverage for the underlying suits (Hanover Insurance Co. v. Superior Labor Services Inc., et al., No. 11-2375 c/w 14-1930, 14-1933, 16-2490, E.D. La.; 2016 U.S. Dist. LEXIS 162480).
HARTFORD, Conn. - A Connecticut appeals court found that an insurer's duty to defend was not barred by a public entity errors and omission liability insurance policy's contract exclusion because an underlying complaint left open the possibility that a negligent misrepresentation claim against the insured did not arise out of a contract, reversing and remanding a lower court in an opinion to be officially released Dec. 6 (Town of Monroe v. Discover Property and Casualty Insurance Co., No. AC 38332, Conn. App.; 2016 Conn. App. LEXIS 443).
OAKLAND, Calif. - An asbestos personal injury liquidating trust properly submitted proposals to an insurer regarding the payment of allowed claims that triggered the insurer's policies and did not violate two debtors' plan of reorganization by allocating to the insurer 100 percent of the liquidated value of each approved unpaid claim, a California federal bankruptcy judge held Nov. 21 (In re CFB Liquidating Corporation, f/k/a Chicago Fire Brick Co., et al., No. 01-45483, [Barry A. Chatz, as Trustee for the CFB/WFB Liquidating Trust v. Continental Casualty Company, No. 15-4136] N.D. Calif. Bkcy.; 2016 Bankr. LEXIS 4034).
RICHMOND, Va. - The Fourth Circuit U.S. Court of Appeals on Nov. 22 affirmed a lower federal court's ruling in favor of an insurer in a lawyer and his consulting firm's lawsuit alleging breach of contract, unjust enrichment, conversion, unauthorized use of name and trademark and copyright infringement (Devil's Advocate LLC, et al. v. Zurich American Insurance Co., No. 15-1048, 4th Cir.; 2016 U.S. App. LEXIS 20952).
TRENTON, N.J. - Insurers' coverage obligations in a mold damages suit can be adjudicated only after the insureds' liability for the damages caused by the mold contamination is resolved, the Appellate Division of the New Jersey Superior Court determined Nov. 21 (Larry Chenault v. Victory Highlands Condominium Association Inc., et al., Nos. A-3626-14T4, A-3627-14T4, A-3628-14T4, N.J. Super., App. Div.; 2016 N.J. Super. Unpub. LEXIS 2500).
NEW YORK - A New York federal judge on Nov. 21 amended a prior ruling entered in favor of an insured to clarify that the insured timely notified the insurer of only one underlying suit pending against it and not two suits pending against it (Olin Corp. v. Insurance Company of North America, et al., No. 84-1968, S.D. N.Y.; 2016 U.S. Dist. LEXIS 161542).
PHILADELPHIA - A federal judge in Pennsylvania on Nov. 21 rejected an insurer's motion to dismiss in an insurance breach of contract and bad faith lawsuit for failure to join an indispensable party, allowing an insured to amend his complaint to add his wife as a plaintiff (William Koepke v. Allstate Vehicle & Property Insurance Co., No. 16-4633, E.D. Pa.; 2016 U.S. Dist. LEXIS 161112).
SEATTLE - A federal judge in Washington on Nov. 18 granted in part and denied in part competing motions for summary judgment in an insurance breach of contract and bad faith lawsuit, ruling that although an insurer breached its contract with its insureds under a homeowners insurance policy, its reading of the policy was reasonable (Noah Baskett, et al. v. Country Mutual Insurance Co., No. 15-1317, W.D. Wash.; 2016 U.S. Dist. LEXIS 160449).
FRESNO, Calif. - An insurer is entitled to summary judgment in an insurance breach of contract and bad faith lawsuit, a federal judge in California ruled Nov. 18, because California law bars insurers from indemnifying their insureds for punitive damages awards (Paul Evert's RV Country Inc., et al. v. Universal Underwriters Insurance Co., et al., No. 15-0124, E.D. Calif.; 2016 U.S. Dist. LEXIS 160519).
ROCHESTER, N.Y. - A New York federal judge in an opinion filed Nov. 18 granted partial summary judgment to a man whose long-term disability claims were denied, saying that the defendants failed to adequately explain all of the reasons for denying the claim in violation of the Employee Retirement Income Security Act (Charles Standish v. Federal Express Corp. Long Term Disability Plan, et al., No. 6:15-cv-6226, W.D. N.Y.; 2016 U.S. Dist. LEXIS 160093).