ALBUQUERQUE, N.M. - A New Mexico federal judge on Feb. 6 ruled in favor of an errors and omissions insurer in a title services company insured's lawsuit alleging breach of contract, bad faith and violation of New Mexico's Unfair Claims Practices Act (Aztec Abstract & Title Insurance, Inc. v. Maxum Specialty Group & Maxum Indemnity Co., No. 16-103, D. N.M., 2018 U.S. Dist. LEXIS 19305).
NEW YORK - A surgeon who was found guilty of one count of health care fraud, three counts of making false statements related to health care matters and two counts of money laundering was sentenced by a federal judge in New York on Feb. 7 to 196 months in prison and ordered to pay $7.2 million in restitution (United States of America v. Syed I. Ahmed, No. 17cr277, E.D. Mich.).
CHICAGO - In a lawsuit alleging a kickback scheme in lender-placed insurance, an Illinois federal judge on Feb. 8 dismissed most of the claims except for breach of contract and bad faith claims pertaining to alleged overcharging of nonexistent inspections (Mariusz Dolegiewicz v. U.S. Bank Trust, N.A., et al., No. 17-4737, N.D. Ill., 2018 U.S. Dist. LEXIS 21089).
PITTSBURGH - An insured is not in contractual privity with a reinsurer under an insurance policy or a reinsurance agreement, a Pennsylvania federal judge held Feb. 8, dismissing breach of contract, bad faith and civil conspiracy claims (Three Rivers Hydroponics LLC v. Florists' Mutual Insurance Co., et al., No. 15-00809, W.D. Pa., 2018 U.S. Dist. LEXIS 20699).
TAMPA, Fla. - An insurer and an out-of-network health care provider engaged in a battle over what constitutes the proper reimbursement rate under Florida law and whether those claims implicate ERISA asked a federal court to dismiss the case with prejudice on Feb. 7 (Premier Inpatient Partners LLC, et al. v. Blue Cross and Blue Shield of Florida Inc., Nos. 17-3000, 17-3001, M.D. Fla.).
MADISON, Wis. - Three attorneys who represented a man during his prosecution for submitting fraudulent automobile insurance claims provided him effective assistance, a federal judge in Wisconsin ruled Feb. 7 in denying a motion to vacate his sentence, holding that any issues that arose during the proceedings stemmed from his dishonesty with the court (John E. Henricks III v. United States of America, No. 17-cv-630, W.D. Wis., 2018 U.S. Dist. LEXIS 19668).
MIAMI - Finding that "collapse" is not defined in an "all-risk" insurance policy, a Florida federal magistrate judge on Feb. 5 held that an insurer is obligated to cover sagging and falling down ceilings at a condominium complex (Key Biscayne Ambassador Condominium Association Inc. v. Aspen Specialty Insurance Co., No. 16-24564, S.D. Fla., 2018 U.S. Dist. LEXIS 19440).
SAN FRANCISCO - A claim for pension disability benefits was properly denied because the disability claimant failed to submit medical records detailing his disability as requested on multiple occasions by the plan at issue, a California federal judge said Feb. 6 (Vanmark Strickland v. AT&T Pension Benefit Plan, No. 17-01393, N.D. Calif., 2018 U.S. Dist. LEXIS 19566).
NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on Feb. 6 affirmed a lower federal court's finding that there is no coverage under a financial institution bond for a bank's $7.77 million loss caused by the purported fraudulent lending activities of its former employee, concluding that the bond does not consider commissions a type of financial benefit that triggers coverage (Renasant Bank v. St. Paul Mercury Insurance Co., No. 17-60168, 5th Cir., 2018 U.S. App. LEXIS 2903).
INDIANAPOLIS - An Indiana federal magistrate judge on Feb. 2 denied a disability claimant's motion to compel discovery on the basis that the claimant failed to meet her burden of proving that the plan operated under a conflict of interest that would entitle her to conduct discovery (Angel Allen v. The Lilly Extended Disability Plan, et al., No. 16-2224, S.D. Ind., 2018 U.S. Dist. LEXIS 17290).
BOWLING GREEN, Ky. - A doctor pleaded guilty on Feb. 5 in Kentucky federal court to intentionally distributing and dispensing controlled substances outside the course of professional practice and submitting fraudulent bills to Medicare and Medicaid and agreed to serve eight years in prison (United States of America v. Charles F. Gott, No. 15cr13, W.D. Ky.).
MISSOULA, Mont. - The efficient proximate cause of homeowners' loss was repeated seepage or leakage of water over an extended period of time, which is an excluded peril under a homeowners insurance policy, a Montana federal judge ruled Feb. 5 (Tafford and LaRayne Oltz v. Safeco Insurance Company of America, No. 16-124, D. Mont., 2018 U.S. Dist. LEXIS 18743).
LINCOLN, Neb. - In a dispute over whether a reinsurer owes $152,616.35 under a promissory note executed pursuant to a reinsurance participation agreement (RPA), the reinsurer filed a counterclaim on Feb. 2 in the Nebraska federal court, alleging that an insurer fraudulently charged employer-insureds inflated premiums and costs for workers' compensation insurance (Applied Underwriters Inc. v. Top's Personnel Inc., No. 15-90, D. Neb.).
LEXINGTON, Ky. - A Kentucky federal judge on Feb. 5 affirmed a disability plan's denial of long-term disability benefits after determining that the evidence supports the denial of benefits for the claimant's injury and that the plan provided a reasoned explanation for its denial of benefits (Tracy Kellar v. Aetna Life Insurance Co., et al., No. 17-81, E.D. Ky., 2018 U.S. Dist. LEXIS 18065).
CINCINNATI - The Sixth Circuit U.S. Court of Appeals on Feb. 6 reversed a lower federal court's finding that a professional liability insurer has no duty to defend or indemnify its lawyer insured against a legal malpractice lawsuit (Spiros E. Gonakis, Sr. v. Medmarc Casualty Insurance Co., No. 17-3463, 6th Cir., 2018 U.S. App. LEXIS 2861).
OKLAHOMA CITY - In a Feb. 2 discovery order, an Oklahoma federal judge partly granted an injured motorist's motion to compel certain claims and training materials from her employer's insurer, deeming some irrelevant to her underinsured motorist (UIM) claim and finding some to be likely protected by attorney-client privilege (Nickie Amber O'Brien v. Travelers Property Casualty Company of America, et al., No. 5:16-cv-01176, W.D. Okla., 2018 U.S. Dist. LEXIS 17421).
CHARLOTTE, N.C. - Chapter 11 debtor Bestwall LLC is willing to take $750,000 in cash now from a purchaser of a defunct insurer's asbestos policy rather than wait for years to see if it can collect the policy's remaining $3.75 million from the insurer's liquidation proceedings, Bestwall says in a Feb. 1 motion in North Carolina federal bankruptcy court (In re Bestwall LLC, No. 17-31795, W.D. N.C. Bkcy.).
SEATTLE - An insurer's denial of defense, unsupported by evidence from a complaint against an insured, was a breach of its duty to defend, a Washington federal judge ruled Feb. 5, also finding that the insurer acted in bad faith despite its "later change of heart" (2FL Enterprises LLC v. Houston Specialty Insurance Co., No. 17-676, W.D. Wash., 2018 U.S. Dist. LEXIS 18605).
TULSA, Okla. - An Oklahoma federal judge on Feb. 2 denied an insurer's motion for summary judgment on breach of contract and bad faith claims in a dispute over coverage for earthquake and mold damages after determining that the insureds offered sufficient evidence to support their claims (Larry W. Thomas, et al. v. Farmers Insurance Co., No. 16-17, N.D. Okla., 2018 U.S. Dist. LEXIS 17418).
COLUMBIA, S.C. - An insurer and a bank filed a joint status report on Feb. 5 informing a South Carolina federal judge that they have reached a tentative settlement over accusations that the bank mishandled reinsurance funds (Companion Property and Casualty Insurance Co. v. U.S. Bank National Association v. Redwood Reinsurance Spc. Ltd., et al., No. 15-01300, D. S.C.).
ALBANY, N.Y. - After hearing oral arguments on Feb. 6, the New York Court of Appeals is set to decide whether an excess insurer owes coverage to its insured for the time periods when the insured was unable to purchase environmental liability insurance coverage even if the excess insurer's policies specifically stated that coverage is afforded only for damages occurring during the policy period (KeySpan Gas East Corp. v. Munich Reinsurance America Inc., et al., No. APL-2016-00236, N.Y. App.).
SAN FRANCISCO - The Ninth Circuit U.S. Court of Appeals on Feb. 5 affirmed a lower court's ruling in favor of a business insurer on insureds' claims for breach of contract and bad faith, finding that theft of business merchandise over the course of multiple days is still considered to be one "occurrence" under the insurance policy (Patrick E. Patterson, et al. v. American Economy Insurance Co., No. 16-16445, 9th Cir., 2018 U.S. App. LEXIS 2846).
NEW ORLEANS - A Louisiana federal judge on Feb. 1 granted a motion to remand a lawsuit arising over flood damage to state court, declining to exercise supplemental jurisdiction over the insureds' remaining state law claims against their insurance broker (Peggy Enriques Miranda, et al. v. Selective Insurance Company of the Southeast, et al., No. 16-12555, E.D. La., 2018 U.S. Dist. LEXIS 16439).
PORTLAND, Ore. - The Ninth Circuit U.S. Court of Appeals on Feb. 1 affirmed a lower court's denial of a commercial general liability insurer's motion to compel arbitration of a coverage dispute over an underlying defamation counterclaim brought against an insured, finding that the policy's arbitration clause was invalid under Washington law (Technical Security Integration, Inc. v. Philadelphia Indemnity Insurance Company, No. 15-35683, 9th Cir., 2018 U.S. App. LEXIS 2574).
BALTIMORE - A Maryland federal magistrate judge on Jan. 31 ordered a defendant in a lead paint coverage suit to amend two answers in response to an insurer's requests for admission after determining that the defendant can learn additional information regarding the insured property's conditions from her grandmother and legal guardian who lived with the defendant at the insured property (CX Reinsurance Co. Ltd., et al. v. Homewood Realty Inc., et al., No. 15-3136, D. Md.; 2018 U.S. Dist. LEXIS 15339).