McALLEN, Texas - A federal judge in Texas on April 13 granted a motion for summary judgment in favor of an insurer and others, ruling that no breach of contract occurred because the insurer complied with the terms of an appraisal provision under a property insurance policy and, thus, the insurer could not have acted in bad faith (Mark Dizdar, et al. v. State Farm Lloyds, et al., No. 14-514, S.D. Texas; 2016 U.S. Dist. LEXIS 49839).
NEW ORLEANS - An insured's failure to promptly give notice of hailstorm damage prejudiced an insurer's investigation, the Fifth Circuit U.S. Court of Appeals ruled April 14, affirming the entry of summary judgment to the insurer on breach of contract claims (Hamilton Properties, et al. v. American Insurance Co., et al., No. 15-10382, 5th Cir.; 2016 U.S. App. LEXIS 6818).
DENVER - The 10th Circuit U.S. Court of Appeals on April 15 found that because an underlying claim alleged only intentional harm by an employer, there is no employers liability coverage for an underlying lawsuit arising from an employee's fatal injury (Cudd Pressure Control Inc. v. New Hampshire Insurance Co., et al., No. 14-6148, 10th Cir.; 2016 U.S. App. LEXIS 6888).
WASHINGTON, D.C. - The U.S. Supreme Court on April 18 denied a disability insurer's petition for writ of certiorari, refusing to review the Sixth Circuit U.S. Court of Appeals' decision that a plan's claim notification deadline can be waived if the claimant's disability prevents the claimant from timely filing a claim for disability benefits (UniCare Life and Health Insurance Co. v. Laura Waskiewicz, No. 15-1116, U.S. Sup.).
DENVER - An insurance expert may not offer opinions that conflict with a federal court's interpretation of an insurance policy's condominium enhancement endorsement in a breach of contract and bad faith lawsuit stemming from the insurer's denial of coverage for water damage, a Colorado federal judge ruled April 13 (Chateau Village North Condominium Association v. American Family Mutual Insurance Co., No. 14-01583, D. Colo.; 2016 U.S. Dist. LEXIS 49665).
HARRISBURG, Pa. - A federal judge in Pennsylvania on April 13 granted in part an insurance agency's motion to lift the stay of its case requesting confirmation of an arbitration award concerning an arbitration with an insolvent insurer (Arrowhead General Insurance Agency, Inc. v. Lincoln General Insurance Company, No. 15-cv-01726, M.D. Pa.; 2016 U.S. Dist. LEXIS 49448).
TRENTON, N.J. - An insurance policy's external insulation and finish system (EIFS) exclusion precludes coverage for construction defect claims, a New Jersey appeals panel affirmed April 13, finding that sufficient expert testimony supported the contention that EIFS was installed in the project as defined in the exclusion (Crum & Forster Insurance Co. and Crum & Forster Specialty Insurance Co. v. The Breese Corp. and Lakeside at North Haledon Condominium Association, Inc., No. A-3880-13T1, N.J. Super. App. Div.; 2016 N.J. Super. Unpub. LEXIS 829).
INDIANAPOLIS - Dismissal of an insured's bad faith denial of coverage claim in an insurance dispute is proper because the insured failed to show that insurers wrongfully denied coverage or mismanaged the claims handling, a federal judge in Indiana ruled April 12 (Telamon Corp. v. The Charter Oak Fire Insurance Co., et al., No. 13-0382, S.D. Ind.; 2016 U.S. Dist. LEXIS 48803).
RICHMOND, Va. - The Fourth Circuit U.S. Court of Appeals held April 14 that internal "corporate screw-ups" provide no basis to excuse an insured's failure to give its professional liability insurer timely notice of an underlying lawsuit after being validly served with process, further finding that the insurer suffered "actual prejudice" from the late notice (St. Paul Mercury Insurance Company v. American Bank Holdings, Inc., No. 15-1559, 4th Cir.; 2016 U.S. App. LEXIS 6793).
NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on April 14 found that the owner of a vacant Dallas hotel failed to provide prompt notice of its claim for hailstorm damage and that its insurer was prejudiced by the late notice (Hamilton Properties, et al. v. The American Insurance Co., et al., No. 15-10382, 5th Cir.; 2016 U.S. App. LEXIS 6818).
WEST PALM BEACH, Fla. - A Florida appeals panel held April 13 that because an insured did not intend to cause an injury or break state law by placing automated solicitation telephone calls, a lower court did not err in finding that the calls constituted an "occurrence" triggering coverage under a general liability insurance policy (Old Dominion Insurance Co. v. Stellar Concepts & Design Inc., et al., No. 4D14-4601, Fla. App., 4th Dist.; 2016 Fla. App. LEXIS 5608).
LAKELAND, Fla. - A Florida appeals panel on April 13 reversed a lower court's final judgment to the extent that it awarded insureds monetary damages for subsurface repairs without requiring them to enter into a contract for those repairs in a sinkhole coverage dispute (Citizens Property Insurance Corp. v. Niurka Simoneau, et al., No. 2D14-4183, Fla. App., 2nd Dist.; 2016 Fla. App. LEXIS 5551).
ORLANDO, Fla. - A federal judge in Florida on April 11 granted in part and denied in part an insurer's motion to dismiss in an insurance breach of contract and bad faith lawsuit, ruling that dismissal of an insured's breach of fiduciary duty claim is proper because it is duplicative of the insured's other bad faith claims (Janis Braddy v. Infinity Assurance Insurance Co., No. 15-119, M.D. Fla.; 2016 U.S. Dist. LEXIS 48565).
WASHINGTON, D.C. - A federal judge in the District of Columbia on April 13 awarded summary judgment to Nationwide Mutual Fire Insurance Co., finding that a property owner's misrepresentation that a business on the site was a delicatessen rather than an entertainment venue that served alcohol was material and warranted voiding the policy (Nationwide Mutual Fire Insurance Co. v. Almco Ltd., et al., No. 13-1009, D. D.C.; 2016 U.S. Dist. LEXIS 49358).
ATLANTA - The 11th Circuit U.S. Court of Appeals on April 12 affirmed a district court's finding that a disability claimant failed to prove that a termination of disability benefits was arbitrary and capricious but reversed the court's award of costs in favor of the plan because the plan was not the prevailing party as it was held liable for a civil penalty for not timely responding to the claimant's request for plan documents (Kathy Emery v. American Airlines Inc., No. 15-10100, 11th Cir.; 2016 U.S. App. LEXIS 6595).
ANN ARBOR, Mich. - An Ohio man pleaded guilty in Michigan federal court on April 11 to one count of conspiracy to commit health care fraud, two counts of health care fraud and five counts of making false statements relating to health care matters for his role in a $6.2 million Medicare fraud scheme (United States of America v. Charles McRae, et al., No. 13cr20348, E.D. Mich.).
GREENBELT, Md. - A federal judge in Maryland sentenced a doctor to more than nine years in prison and ordered him to pay $3.1 million in restitution for his role in an insurance fraud scheme he operated out of a pain clinic he owned with his wife, the U.S. Attorney's Office for the District of Maryland announced April 11 (United States of America v. Paramijt S. Ajrawat, et al., No. 14cr316, D. Md.).
CHICAGO - The liquidator of an insolvent insurer told an Illinois court on April 8 that a school board's $14 million liquidated delay damages claim is not valid because the construction of the schools in question was completed in a timely manner (People of the State of Illinois, ex rel. Andrew Boron, Director of Insurance of the state of Illinois v. Lumbermens Mutual Casualty Co., No. 12-24227, Ill. Cir., Cook Co.).
CHICAGO - A reinsurer told a federal court in Illinois on April 11 that its reinsured did not provide it with prompt notice of asbestos-related claims against an insured and that the reinsured is therefore in breach of certain facultative reinsurance certificates (R&Q Reinsurance Company v. The American Insurance Company, No. 16-cv-04199, N.D. Ill.).
SACRAMENTO, Calif. - An "other insurance" clause cannot be enforced in an equitable contribution action between successive primary insurers, a California appeals panel held April 11, also finding that enforcement of the clause in a primary commercial general liability insurance policy would violate public policy (Certain Underwriters at Lloyds, London v. Arch Specialty Insurance Co., No. C072500, Calif. App., 3rd Dist.; 2016 Cal. App. LEXIS 275).
PHILADELPHIA - A Pennsylvania Superior Court panel on April 11 affirmed a trial court judge's decision to deny a woman's sixth petition for post-conviction relief from a sentence imposed after she was found guilty of insurance fraud, holding that the judge did not abuse his discretion when finding that the woman was provided adequate assistance of counsel (Commonwealth v. Bianca Aura Bucano, No. 2292 EDA 2015, Pa. Super.; 2016 Pa. Super. Unpub. LEXIS 1161).
NEW ORLEANS - A district court did not err in granting summary judgment in favor of a disability insurer because the claimant failed to raise a genuine dispute of material fact that the insurer abused its discretion in denying his claim for long-term disability benefits, the majority of the Fifth Circuit U.S. Court of Appeals said April 11 (Patrick Burell, et al. v. Prudential Insurance Company of America, No. 15-50035, 5th Cir.; 2016 U.S. App. LEXIS 6578).
SPRINGFIELD, Ill. - An Illinois federal judge on April 8 transferred an insurer's coverage lawsuit regarding its duty to defend and indemnify an underlying construction defects case to another Illinois federal court (Hastings Mutual Insurance Co. v. Atlantis Pools, Inc., et al., No. 15-3341, C.D. Ill.; 2016 U.S. Dist. LEXIS 47570).
BOSTON - A company with policies from two insolvent insurers told a federal court in Massachusetts on April 7 that the state's insurance insolvency fund's claims against it must fail because of the court's findings in a previous ruling dismissing an earlier complaint (Massachusetts Insurers Insolvency Fund v. Beacon Roofing Supply, Inc., et al., No. 15-cv-12291, D. Mass.).
NEW ORLEANS - An insurer has no duty to defend its insured against an underlying suit filed by neighboring residents of the insured shipyard because the policies' silica exclusion clearly bars coverage; however, the insurer does have a duty to defend against a second underlying suit because the insurer failed to prove that the policies' pollution exclusion applies to bar coverage, a Louisiana federal judge said April 8 (Hanover Insurance Co. v. Superior Labor Services Inc., et al., No. 11-2375 c/w 14-1930, 14-1933, E.D. La.).