LexisNexis® Legal Newsroom
Mealey's Insurance - Disability Insurer Did Not Breach Contract By Enforcing Offset Provision

PHOENIX - An Arizona federal judge on Aug. 7 denied a disability claimant's motion for partial summary judgment on the basis that the insurer did not breach its contract by enforcing the policy's offset provision when it reinstated the claimant's disability benefits (Benjamin McClure v. Country...

Mealey's Insurance - Podiatry Firm, Owner Get Fraudulent Billing, Spoliation Claims Dismissed

CHICAGO - A federal judge in Illinois on Aug. 7 granted a motion for summary judgment filed by a podiatry firm and its owner that are accused by a former employee of violating the Illinois Insurance Claims Fraud Protection Act (IICFPA) and illegally destroying medical records, finding that there was...

Mealey's Insurance - Magistrate Judge Issues Sanctions In Favor Of Reinsurer In Promissory Note Dispute

LINCOLN, Neb. - A Nebraska federal magistrate judge on Aug. 7 granted a reinsurer's motion for sanctions against an insurer for its failure to provide complete answers to interrogatories in a dispute concerning sums allegedly owed under a promissory note executed in connection with a reinsurance...

Mealey's Insurance - Entrustment Exclusion Bars Coverage, Louisiana Panel Rules In Reversal

SHREVEPORT, La. - A Louisiana appeals panel on Aug. 9 held that a lower court erred in finding that an insurance policy's entrustment exclusion does not apply to bar coverage for an underlying dispute over a restaurant business, reversing the lower court's $40,177.11 award in favor of the insured...

Mealey's Insurance - No Coverage Owed For Mold Damages, Alabama Federal Judge Says

HUNTSVILLE, Ala. - No coverage is owed to an insured for mold damages to an insured's home because the policy at issue contained an endorsement that specifically excluded coverage for mold, an Alabama federal judge said Aug. 9 in granting the insurer's motion for summary judgment (Prithpal Singh...

Mealey's Insurance - 7th Circuit Reverses Ruling, Finds Insurers Owe Defense For Insured's Leaky Windows

CHICAGO - Insurers have a duty to defend an insured against class action claims of leaks in windows because neither the economic loss doctrine nor the "your work" exclusion precludes coverage, the Seventh Circuit U.S. Court of Appeals held Aug. 8, reversing an underlying judgment and remanding...

Mealey's Insurance - Insurer Asserts No Waiver In Right To Arbitrate $1.3M Suit With Reinsurer

MONTGOMERY, Ala. - A nonprofit public insurer argues to an Alabama federal court in an Aug. 9 brief that it did not waive its right to arbitrate its $1.3 million lawsuit under a reinsurance agreement and that a reinsurer will not be prejudiced in sending the dispute to arbitration (Alabama Municipal...

Mealey's Insurance - 9th Circuit: Qui Tam Plaintiffs Cannot Intervene In Criminal Forfeiture Action

SAN FRANCISCO - A Ninth Circuit U.S. Court of Appeals panel on Aug. 10 held that two medical assistants who filed a qui tam lawsuit under the False Claims Act (FCA) against a podiatrist they worked for could not intervene in a criminal forfeiture action brought by the federal government seeking $1.2...

Mealey's Insurance - Panel Finds Error In Ruling That Reinsurance Agreement Is An Insurance Contract

RICHMOND, Va. - A trial judge erred in applying the doctrine of judicial estoppel to hold that a "reinsurance participation agreement" (RPA) constituted an insurance contract under Virginia law, the Fourth Circuit U.S. Court of Appeals ruled Aug. 11, reversing in part a ruling and remanding...

Mealey's Insurance - Federal Judge Finds Questions Of Fact Exist On Amount Of Coverage Owed

ABERDEEN, Miss. - A Mississippi federal judge on Aug. 10 denied an insurer's motion for summary judgment in a suit alleging that the insurer acted in bad faith by failing to pay the insured the full replacement cost of his home after determining that genuine issues of material fact exist regarding...

Mealey's Insurance - Appeals Court Affirms Man's Convictions For Setting Fire For Insurance Money

DENVER - A Colorado appeals panel on Aug. 10 affirmed a man's convictions for first-degree arson, criminal mischief, theft and attempted theft for intentionally setting fire to a house he lived in with his mother and then-girlfriend to obtain insurance proceeds, finding that the trial judge did not...

Mealey's Insurance - Pollution Exclusion Bars Coverage For Carbon Monoxide Injuries, Appeals Panel Says

ST. LOUIS - The Eighth Circuit U.S. Court of Appeals on Aug. 14 affirmed a district court's ruling that a policy's pollution exclusion precludes an insurer's duty to indemnify an underlying personal injury suit arising out of carbon monoxide poisoning because the underlying injuries clearly...

Mealey's Insurance - 8th Circuit: Faulty Fire System Is Not An 'Accident' Under Insurance Policy

ST. LOUIS - Replacing drywall and insulation as a result of a subcontractor's faulty fire suppression system did not constitute an "accident" under a general liability insurance policy, the Eighth Circuit U.S. Court of Appeals held Aug. 11, affirming the dismissal of breach of contract...

Mealey's Insurance - Trust Bank Seeks Lift Of Stay In Insurer's Receivership, Seeks Preliminary Injunction

BOISE, Idaho - A trust bank on Aug. 14 moved for an order in an Idaho federal court to lift a stay pending an insurer's receivership proceedings and for a preliminary injunction, arguing that the receiver has ignored a summary judgment ruling for more than two years and recommended that the insured...

Mealey's Insurance - Tennessee Insurance Guaranty Association Seeks Remand Of Reimbursement Suit

NASHVILLE, Tenn. - The Tennessee Insurance Guaranty Association (TIGA) argues in an Aug. 14 brief that a Tennessee federal court should remand its reimbursement dispute over a workers' compensation claim against book publishers because diversity jurisdiction is not present (Tennessee Insurance Guaranty...

Mealey's Insurance - Appeals Panel Says ERISA Preempts California Law Barring Discretionary Clauses

SAN FRANCISCO - The Ninth Circuit U.S. Court of Appeals on Aug. 15 vacated and remanded a district court's ruling that a de novo standard of review rather than an abuse of discretion standard of review should be applied in a disability benefits dispute because the Employee Retirement Income Security...

Mealey's Insurance - Parties Were Properly Aligned In Coverage Dispute, 6th Circuit Affirms

CINCINNATI - The Sixth Circuit U.S. Court of Appeals on Aug. 15 affirmed a lower federal court's finding that parties were properly aligned in a dispute over whether additional coverage is owed to satisfy an underlying $3,736,278 judgment against an insured for breaching its duty to exercise ordinary...

Mealey's Insurance - Owner Of 2 Home Health Companies Found Guilty Of Health Care Fraud

HOUSTON - A registered nurse who owned two home health care companies was found guilty on Aug. 10 by a federal jury in Texas of one count of conspiracy to commit health care fraud and four counts of health care fraud for her role in a $20 million Medicare fraud scheme (United States v. Evelyn Mokwuah...

Mealey's Insurance - Florida Majority Reverses Ruling In Bad Faith Suit Over Sinkhole Damage

DAYTONA BEACH, Fla. - A majority of a Florida appeals panel on Aug. 11 held that no Florida statute or case law precludes an insured from filing a civil remedy notice (CRN) while a demand for appraisal is outstanding, reversing and remanding a lower court's ruling in favor of the insurer in a bad...

Mealey's Insurance - Reinsurance Executives Say $50M RICO Suit With Insurers Should Be Sent To Arbitration

NEW YORK - Reinsurance executives argue in an Aug. 14 reply brief that a New York federal court should compel arbitration of insurers' $50 million Racketeer Influenced and Corrupt Organizations Act case or, alternatively, stay the dispute "in the interests of fairness and judicial economy"...

Mealey's Insurance - Judge Trims Some Of GEICO's Claims From Fraudulent Billing Suit

BOSTON - A federal judge in Massachusetts on Aug. 16 trimmed some claims from a lawsuit brought by the Government Employees Insurance Co. (GEICO) against a chiropractic firm and its owners, finding that while the insurer's claims were timely and not barred by Massachusetts' Strategic Litigation...

Mealey's Insurance - Disability Insurer Did Not Misclassify Claimant's Own Occupation, Federal Judge Says

KALAMAZOO, Mich. - A disability insurer did not act arbitrarily and capriciously when it classified a claimant's own occupation as sedentary because it relied on information from the claimant and the claimant's employer, a Michigan federal judge said Aug. 15 (Daniel Venier v. Liberty Life Assurance...

Mealey's Insurance - 5th Circuit Affirms Doctor's Convictions For Health Care Fraud, Kickbacks

NEW ORLEANS - A Fifth Circuit U.S. Court of Appeals panel on Aug. 17 affirmed a jury's verdict convicting a man of committing health care fraud and paying and receiving kickbacks for approving patients for home health care when they did not need such treatment (United States v. Warren Dailey, No...

Mealey's Insurance - Punitive Damages Award Upheld; Award Justified Based On Insurer's Deceit

ST. LOUIS - A jury's award of $2.75 million in favor of a plaintiff who was injured while a passenger in an insured vehicle was not excessive and was justified based on the jury's finding that the insurer deceived the passenger regarding coverage on the insured vehicle, the Eighth Circuit U.S...

Mealey's Insurance - Judge Declines To Stay Coverage Action Pending Insurer's Liquidation

ST. LOUIS - A Missouri federal judge on Aug. 16 refused to stay a professional liability insurer's dispute against an insolvent insurer over wrongful act claims submitted by the insolvent insurer because she found that the contractual issues are not pivotal to the underlying state court liquidation...