TAMPA, Fla. - Because a disability plan administrator was not served with a claimant's motion seeking an order requiring the plan administrator to reschedule and videotape an independent medical exam (IME), a Florida federal magistrate judge on Oct. 21 denied the claimant's motion without prejudice and allowed the claimant to refile and serve the motion on the plan administrator (Alexander Stratigos v. Prudential Insurance Company of America, No. 16-2780, M.D. Fla.; 2016 U.S. Dist. LEXIS 146094).
SYRACUSE, N.Y. - A reinsurer asked a federal court in New York on Oct. 21 for permission to file a reply to its reinsured's contention that the reinsurer's objections to a pair of discovery orders is untimely (Utica Mutual Insurance Company v. Century Indemnity Company, No. 13-cv-00995, N.D. N.Y.).
FORT MYERS, Fla.- A federal judge in Florida on Oct. 24 dismissed without prejudice a primary and excess insurers' amended complaint seeking a declaration that they have no duty to defend or indemnify their cancer care service provider insured against underlying class action lawsuits stemming from a 2015 data breach, giving the insurers seven days to cure the deficiencies in their petition (The Charter Oak Fire Insurance Co., et al. v. 21st Century Oncology Investments, No. 16-00732, M.D. Fla.).
BOSTON - A U.S. Army veteran filed a class action suit on Oct. 25 in Massachusetts federal court against a disability insurer, alleging that the insurer wrongfully offset disability benefits payable under the insurer's policy by disability benefits received from the U.S. Department of Veterans Affairs because the policy does not list veterans disability benefits as income eligible for an offset under the policy (Marco Martinez v. Sun Life Assurance Company of Canada, No. 16-12154, D. Mass.).
ATLANTA - A district court did not err in granting summary judgment in favor of an employer and a disability insurer because the evidence supported the disability insurer's conclusion that the disability claimant was capable of working in a sedentary position, the 11th Circuit U.S. Court of Appeals said Oct. 21 (Andrew Ramdeen v. Prudential Insurance Company of America, et al., No. 16-11179, 11th Cir.; 2016 U.S. App. LEXIS 18962).
HONOLULU - An insured has failed to show that insurers acted in bad faith in failing to pay the entire amount of a settlement in a patent infringement lawsuit pursuant to the terms of a commercial liability insurance policy, a federal judge in Hawaii ruled Oct. 21 in dismissing the insured's insurance bad faith counterclaim (The Hanover Insurance Co., et al v. Anova Food LLC, No. 14-0281, D. Hawaii; 2016 U.S. Dist. LEXIS 146114).
ATLANTA - A federal judge in Georgia on Oct. 21 granted a pair of insurers' motion to depose certain people to determine if their alleged actions regarding a reinsurer fall under the jurisdiction of the Georgia federal court (Canal Insurance Company, et al. v. Golden Isles Reinsurance Company, Ltd, et al., No. 15-cv-3331, N.D. Ga.).
WASHINGTON, D.C. - The U.S. Department of Justice (DOJ) announced Oct. 24 that a skilled nursing facility and its 83-year-old owner have agreed to pay $145 million to resolve allegations that they submitted fraudulent bills to Medicare and TRICARE, which provides health benefits for U.S. Armed Forces personnel (United States of America v. Life Care Centers of America Inc., et al., No. 16-113, E.D Tenn.).
CONCORD, N.H. - The liquidator of an insolvent insurer asked a New Hampshire court on Oct. 21 to approve his recommendation that the liquidation estate settle certain asbestos bodily injury related claims for $34 million (In the Matter of the Liquidation of The Home Insurance Company, No. 03-E-0106, N.H. Sup., Merrimack Co.).
MONTGOMERY, Ala. - An insurer on Oct. 20 moved for reconsideration or, in the alternative, for certification of interlocutory appeal, arguing that an Alabama federal judge erroneously applied a total pollution exclusion as if it were a qualified pollution exclusion and in doing so, incorrectly determined that the total pollution exclusion cannot be asserted as a bar to coverage for two underlying lawsuits alleging injuries from sewage exposure (Evanston Insurance Co. v. J&J Cable Construction LLC, et al., No. 15-506, M.D. Ala.).
SACRAMENTO, Calif. - The U.S. Department of the Navy on Oct. 19 filed a complaint in intervention in a California federal court, seeking a declaration that an insurer owes coverage for environmental contamination discovered at one of the Navy's California shipyards (Lennar Mare Island LLC v. Steadfast Insurance Co., et al., No. 12-2182, E.D. Calif.).
MONTGOMERY, Ala. - A condominium association's breach of warranty and negligence claims against a contractor, its subcontractor and their surety are subject to mandatory arbitration under the language of the contract between the association and the contractor, the Alabama Supreme Court affirmed Oct. 21 (The Hanover Insurance Co., et al. v. Kiva Lodge Condominium Owners' Association Inc., No. 1141331, Ala. Sup.; 2016 Ala. LEXIS 123).
AUSTIN, Texas - The Texas Supreme Court has refused to revisit a judgment in favor of an insured in a coverage dispute over damage caused by Hurricane Ike, according to its orders pronounced list issued Oct. 21 (National Lloyds Insurance Co. v. Latosha A. Lewis, No. 15-0261, Texas Sup.).
AUSTIN, Texas - The Texas Supreme Court on Oct. 21 denied a motion to rehear its finding that homeowners in the upper White Oak Bayou watershed area of Texas have demonstrated that a fact question exists as to whether government entities were substantially certain that their actions in approving new upstream development without properly mitigating it would cause the homes to flood, according to its orders pronounced list (Harris County Flood Control District and Harris County, Texas v. Edward A. and Norma Kerr, et al., No. 13-0303, Texas Sup.).
TRENTON, N.J. - The entire-controversy doctrine precludes a subrogated insurer from asserting claims on behalf of its insured against an engineering firm for damage to a condominium because the claims were fully resolved in a prior lawsuit filed by the insured, a New Jersey appeals panel ruled Oct. 20 (Franklin Mutual Insurance Co. as subrogee of Sevastyan Ploshchansky v. Castle Restoration and Construction Inc. and Falcon Engineering Company LLC, No. A-5272-14T2, N.J. Super., App. Div.).
PASADENA, Calif. - The Ninth Circuit U.S. Court of Appeals on Oct. 20 found that an underlying lawsuit alleging Lanham Act and unfair competition claims against an insured potentially sought damages that were covered under an insurance policy, reversing a lower court's no coverage ruling (First One Lending Corp., et al. v. The Hartford Casualty Insurance Co., No. 14-56492, 9th Cir.; 2016 U.S. App. LEXIS 18935).
HAMMOND, Ind. - Noting the possibility of inconsistent adjudications, an Indiana federal judge on Oct. 18 denied an insurer's request for a default judgment against insured contractors because homeowners' underlying negligence lawsuit against them has not been resolved by judgment and the homeowners are named in the coverage dispute (Property-Owners Insurance Co. v. Raymond T. Yagelski, et al., No. 14-267, N.D. Ind.; 2016 U.S. Dist. LEXIS 143914).
SALT LAKE CITY - Genuine issues of material fact exist as to whether an insured had actual knowledge of a superior deed of trust on property it acquired, a federal judge in Utah ruled in denying cross-motions for summary judgment in an insurance breach of contract and bad faith lawsuit on Oct. 18 (Johnsen and Allphin Properties LLC v. First American Title Insurance Co., No. 12-740, D. Utah; 2016 U.S. Dist. LEXIS 144429).
CAMDEN, N.J. - Two companies that sell transcutaneous electrical nerve stimulation (TENS) devices and associated accessories to medical professionals and allegedly submitted inflated bills to Aetna Health Inc. and Aetna Life Insurance Co. (collectively, Aetna) cannot face allegations of insurance fraud brought by the insurer, a federal judge in New Jersey rule Oct. 19, explaining that North Carolina law requires that the accused party be criminally convicted of insurance fraud before bringing the claim (Aetna Health Inc., et al. v. Carolina Analgesic Inc., et al., No. 13-7202, D. N.J.; 2016 U.S. Dist. LEXIS 144872).
OKLAHOMA CITY - Dismissal of insurance breach of contract and bad faith claims against an insurer is not proper because an insurance policy's no action clause is inapplicable, a federal judge in Oklahoma said Oct. 19 (Wilbanks Securities Inc., et al. v. Scottsdale Insurance Co., et al., No. 16-294, W.D. Okla.; 2016 U.S. Dist. LEXIS 144761).
PASADENA, Calif. - Although a California federal court did not err in its interpretation of California insurance law, it erred in determining that the insurer failed to show that the insured incurred an economic loss as required to sustain her insurance bad faith claim against a life insurance provider, a Ninth Circuit U.S. Court of Appeals panel ruled Oct. 18 (Beverly Burton v. The Prudential Insurance Company of America, No. 14-56721, 9th Cir.; 2016 U.S. App. LEXIS 18617).
ATLANTA - A federal judge in Florida did not err when finding that a man who pleaded guilty for his role in an insurance fraud scheme that involved fraudulently billing private insurance companies for services that were not provided was accountable for $31 million in intended losses, the 11th Circuit U.S. Court of appeals ruled Oct. 18, holding that the defendant agreed in his plea agreement that his actions resulted in losses between $20 million and $50 million (United States of America v. Alejandro Jesus Cura, No. 15-15259, 11th Cir.; 2016 U.S. App. LEXIS 18638).
PASADENA, Calif. - The Ninth Circuit U.S. Court of Appeals on Oct. 19 affirmed a federal court's finding that a bank's management liability insurance policy's "unrepaid loan carve-out" does not bar coverage for damages sought by the Federal Deposit Insurance Corp. (FDIC) in an underlying lawsuit alleging tortious conduct by the bank's directors and officers (St. Paul Mercury Insurance Co. v. Federal Deposit Insurance Corporation, No. 14-56830, 9th Cir.; 2016 U.S. App. LEXIS 18811).
CHICAGO - A reinsurer on Oct. 19 asked a federal court in Illinois to strike portions of its reinsured's answer to an amended complaint, including a challenge to the court's jurisdiction over the dispute (R&Q Reinsurance Company v. The American Insurance Company, No. 16-cv-04199, N.D. Ill.).
HARRISBURG, Pa. - A disability insurer's termination of a claimant's benefits was not unreasonable because the evidence supports the insurer's conclusion that the claimant was not disabled after her discharge from an inpatient program at a mental health facility, a Pennsylvania federal judge said Oct. 17 (Cheryl Gailey v. Life Insurance Company of North America, No. 15-564, M.D. Pa.; 2016 U.S. Dist. LEXIS 143110).