PORTLAND, Ore. - An Oregon federal judge on Jan. 27 dismissed an insured's breach of contract counterclaim against its umbrella insurer regarding coverage for an underlying construction defects case (Chartis Specialty Insurance Co. f/k/a American International Specialty Lines Insurance Co. v. American Contractors Insurance Company Risk Retention Group, et al., No. 13-01669, D. Ore.; 2015 U.S. Dist. LEXIS 8906).
NASHVILLE, Tenn. - A Tennessee federal judge on Jan. 23 dismissed a Medicare False Claims Act case, saying the plaintiff failed to plead the claims with the specificity required (Kathleen McFeeters v. Northwest Hospital, et al., No. 13-467, M.D. Tenn.; 2015 U.S. Dist. LEXIS 8523).
WASHINGTON, D.C. - The House of Representatives lacks standing to challenge implementation of the Patient Protection and Affordable Care Act (ACA)'s employer mandate in court, the U.S. Department of Health and Human Services (HHS) told a federal judge in the District of Columbia on Jan. 26 (United States House of Representatives v. Sylvia Mathews Burwell, et al., No. 14-1967, D. D.C.).
NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on Jan. 26 found that it is apparent that the net income described in calculating a coinsurance penalty in a commercial property insurance policy is not actual net income but projected net income and, therefore, a lower federal court erred in finding that the policy's coinsurance provision was ambiguous (Mt. Hawley Insurance Co. v. Advance Products & Systems, Inc., No. 14- 30068, 5th Cir.; 2015 U.S. App. LEXIS 1173).
NEW YORK - A group of London market insurers filed suit on Jan. 22 in the New York County Supreme Court, seeking a declaration that no coverage is owed for two environmental contamination suits filed against the insured and separate, personal injury suits arising out of chemical exposure to a butter flavoring ingredient filed against the insured's successor (Accident & Casualty Insurance Company of Winterthur et al. v. Chemtura Corp. et al., No. 650204/2015, N.Y. Sup., New York Co.).
MINNEAPOLIS - A Minnesota appeals panel on Jan. 26 affirmed an appraisal award regarding an insured's damages suffered from storms because the insured did not elect to waive an insurer's appraisal right and failed to present evidence to show that appraisers conducted the appraisal hearing in a way to result in prejudice of the insured's rights (Bjorklund Companies LLC v. Auto-Owners Insurance Co., No. A14-1175, Minn. App.; 2015 Minn. App. Unpub. LEXIS 90).
CHICAGO - The Seventh Circuit U.S. Court of Appeals on Jan. 23 affirmed a federal judge's ruling that a pollution exclusion precluded coverage for groundwater contamination caused by trichloroethylene (TCE) and other chemicals (Visteon Corporation, et al. v. National Union Fire Insurance Co. of Pittsburgh, No. 14-2725, 7th Cir.; 2015 U.S. App. LEXIS 1064).
WASHINGTON, D.C. - The U.S. Supreme Court on Jan. 26 denied a petition from the State of Oklahoma seeking a writ of certiorari before judgment in its challenge to the availability of subsidies in Patient Protection and Affordable Care Act (ACA) insurance exchanges (State of Oklahoma, ex rel. Scott Pruitt v. Sylvia Mathews Burwell, et al., No. 14-586, U.S. Sup.).
WEST DES MOINES, Iowa - The Iowa insurance commissioner will liquidate CoOportunity Health Inc., a consumer-owned health insurance company started with $146 million in Patient Protection and Affordable Care Act (ACA) funds, it announced Jan. 23 (State of Iowa, et al. v. CoOpportunity Health Inc., No. N/A, Iowa Dist., Polk Co.).
CHICAGO - The First District Illinois Appellate Court on Jan. 21 affirmed a trial court's ruling that insurers have no duty to indemnify an insured for environmental investigation costs because environmental investigation costs are not considered damages under Florida law (Premark International LLC v. Continental Casualty Co., et al., No. 1-13-2760, Ill. App., 1st Dist.; 3rd Div.; 2015 Ill. App. Unpub. LEXIS 93).
CENTRAL ISLIP, N.Y. - All of the injuries alleged in three underlying lawsuits arise out of a pre-workout energy supplement's failure to conform with an insured's statements and, therefore, coverage for the actions is barred by the policy's failure-to-conform exclusion, a New York federal judge ruled Jan. 23 (General Star Indemnity Co. v. Driven Sports Inc., No 14-3579, E.D. N.Y.; 2015 U.S. Dist. LEXIS 7966).
JACKSON, Miss. - A majority of the Mississippi Supreme Court on Jan. 22 granted a petition for writ of certiorari filed by an insured seeking to reverse an appeals court's rejection of her bad faith and negligence lawsuit arising from her alleged loss caused by a casino barge that collided with her home during Hurricane Katrina (Cherri R. Porter v. Grand Casino of Mississippi Inc., et al., No 2010-CT-00307-SCT, Miss Sup.).
MONTPELIER, Vt. - The Vermont Supreme Court on Jan. 23 reversed a trial court's establishment of a final bar date because an insurer's liquidation estate has ample assets and the final bar date would be unfair to insureds and others with long-tail asbestos-related claims (In re Ambassador Insurance Company, Inc., No. 2013-184, Vt. Sup.).
LAFAYETTE, La. - A Louisiana federal judge held Jan. 22 that a "claim" was made against an insured during its third-party administrator and technology professional liability, network security liability and business interruption insurance policy period, further finding that the insured provided timely notice of the claim (HealthSmart Benefit Solutions, Inc. versus Principia Underwriting, et al., No. 14-00776, W.D. La.; 2015 U.S. Dist. LEXIS 8134).
MILWAUKEE - An insured is not entitled to attorney fees from proceeds in a settlement of an underlying lawsuit regarding a construction project, a Wisconsin federal judge ruled Jan. 22 (Edward E. Gillen Co. v. The Insurance Company of the State of Pennsylvania, No. 10-564, E.D. Wis.; 2015 U.S. Dist. LEXIS 7870).
NEW YORK - A New York federal magistrate judge on Jan. 20 granted a disability claimant's motion to compel discovery on the limited issue of determining whether procedural irregularities or conflicts affected the insurer's denial of a long-term disability claim (Liyan He v. Cigna Life Insurance Company of New York, No. 14-2180, S.D. N.Y.; 2015 U.S. Dist. LEXIS 6652).
NEW YORK - A New York appeals panel on Jan. 22 found that there is a fact issue regarding whether an employee's diversion of checks that were required to be deposited with his employer to a condominium developer manifests an intent to harm the employer within the meaning of a fidelity bond (Keybank National Association, et al. v National Union Fire Insurance Company of Pittsburgh, PA, et al., No. 13799, 104125/10, N.Y. Sup., App. Div., 1st Dept.; 2015 N.Y. App. Div. LEXIS 615).
BIRMINGHAM, Ala. - Because a disability insurer cannot prove than a disability plan was part of an employee welfare benefit package, the insurer's argument that the state law claims are preempted by the Employee Retirement Income Security Act fails, an Alabama federal judge said Jan. 21 in denying the insurer's motion for summary judgment (Lawrence Rosen M.D. v. Provident Life and Accident Insurance Co., No. 14-0922, N.D. Ala.; 2015 U.S. Dist. LEXIS 6586).
ATLANTA - The 11th Circuit U.S. Court of Appeals on Jan. 22 affirmed a lower court's ruling that a workers' compensation exclusion bars coverage for a $9.5 million wrongful death judgment against an insured after the Florida Supreme Court answered three certified questions in the affirmative (Leticia Morales, et al. v. Zenith Insurance Co., No. 12-11755, 11th Cir.; 2015 U.S. App. LEXIS 930).
CHICAGO - An Illinois judge on Jan. 20 ordered an insurance company into rehabilitation and appointed the state's acting director of insurance as rehabilitator (People of the State of Illinois, ex rel. James A. Stephens, Acting Director of Insurance of the State of Illinois v. Millers Classified Insurance Company, an Illinois domestic stock insurance company, No. 2015CH00885, Ill. Cir., Cook Co., Chanc. Div.).
LAKELAND, Fla. - An insurer provided insufficient evidence to support rescinding a homeowners insurance policy at dispute over a sinkhole claim, a Florida appeals panel ruled Jan. 23 (Luis Mora and Rosaura Mora v. Tower Hill Prime Insurance Co., No. 2D13-4125, Fla. App., 2nd Dist.; 2015 Fla. App. LEXIS 812).
COLUMBUS, Ohio - A federal judge in Ohio on Jan. 22 partially granted an insured's motion for certificate of appealability in an insurance bad faith lawsuit, ruling that the insured has properly shown that the Sixth Circuit U.S. Court of Appeals' ruling in Akers v. Alvey supports interlocutory appeal (Howard Industries Inc. v. ACE American Insurance Co., et al., No. 13-0677. S.D. Ohio; 2015 U.S. Dist. LEXIS 7275).
SAN DIEGO - A trial court wrongfully precluded an insured from arguing that unallocated settlement proceeds are not an offset to contract damages or are allocated to the tort damages in an insurance coverage lawsuit regarding an underlying construction defects case, a California appeals panel ruled Jan. 22 (McMillin Companies LLC v. American Safety Indemnity Co., No. D063586, Calif. App., 4th Dist., Div. 1; 2015 Cal. App. LEXIS 53).
PRESCOTT, Ariz. - An Arizona federal judge on Jan. 16 dismissed a self-funded employee welfare benefit plan's subrogation lawsuit against the estate of a plan participant regarding settlement proceeds in an underlying wrongful death action because the participant's children did not incur health care expenses for which another party is responsible (MedCath Incorporated Employee Health Care Plan v. Dustin Stratton, et al., No. 14-08099, D. Ariz.; 2015 U.S. Dist. LEXIS 5514).
PHILADELPHIA - A Pennsylvania federal judge on Jan. 21 concluded that Pennsylvania law governs the scope of any duty to defend that a professional liability insurer owed to its insured for an underlying lawsuit that resulted in a $1.65 million settlement against the insured (FLS US Holdings Inc., et al. v. Liberty Mutual Fire Ins. Co., No. 13-2511, E.D. Pa.; 2015 U.S. Dist. LEXIS 6544).