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Mealey's Insurance - 4th Circuit Reinstates Retaliation Claim In Suit Over Overbilling Clinics

RICHMOND, Va. - A federal judge in Virginia erred in finding that a physical therapist assistant's retaliation claim against his employer should be dismissed, finding that they were not subject to the False Claims Act's (FCA) first-to-file rule, a Fourth Circuit Court of Appeals ruled March 16...

Mealey's Insurance - Judge: Jury Instructions Not Needed To Properly State Law In Bad Faith Suit

ATLANTA - A federal district court did not abuse its discretion in denying a third party's proposed jury instructions in an insurance bad faith lawsuit because the proposed instructions were not necessary "to correctly state the law," an 11th Circuit U.S. Court of Appeals panel ruled March...

Mealey's Insurance - Panel Reverses Ruling Against Insurer In Professional Liability Coverage Dispute

INDIANAPOLIS - An Indiana appeals panel on March 16 reversed a lower court's denial of a professional liability insurer's motion for summary judgment and its entry of a declaratory judgment in favor of the insured's estate in a coverage dispute erupting from an underlying malpractice claim...

Mealey's Insurance - Judge Finds Dismissal Of Couple's Claim Does Not Establish Unfair Practices

NEW HAVEN, Conn. - A federal judge in Connecticut on March 17 dismissed a couple's claim that their insurer engaged in unfair and deceptive practices in violation of the Connecticut Unfair Insurance Practices Act (CUIPA) and the Connecticut Unfair Trade Practices Act (CUTPA) when denying their claim...

Mealey's Insurance - Judge: Insurer Breached Duty To Defend, Indemnify Construction Suit Settlement

ANCHORAGE, Alaska - An insurer breached its duty to defend and indemnify an insured for a settlement of underlying claims arising out of a breach of contract dispute on a construction project, an Alaska federal judge ruled March 16; however, the judge held that the insurer did not breach its duty of...

Mealey's Insurance - Reinsured Says It Is Not Necessary To Show Reasons For Settling Asbestos Claims

NEW HAVEN, Conn. - An insurer told a federal court in Connecticut on March 20 that its reinsurer is putting requirements on it that are not universally accepted as necessary under the follow-the-settlements doctrine (Travelers Casualty and Surety Company, f/k/a The Aetna Casualty and Surety Company v...

Mealey's Insurance - Insurer's Data Satisfies Florida's Definition Of Trade Secret, Majority Affirms

TALLAHASSEE, Fla. - A majority of a Florida appeals court on March 20 affirmed a lower court's ruling that an insurer's quarterly supplemental reporting (QUASR) data satisfies the definition of trade secret under state law and is, therefore, exempt from public disclosure (Office of Insurance...

Mealey's Insurance - Reinsurer Says Insurer Never Asked For Policy To Be Reinsured

PHILADELPHIA - A reinsurer asked a federal court in Pennsylvania on March 21 to dismiss an insurer's breach of contract counterclaim because the insurer allegedly never linked an underlying policy to a facultative certificate and, therefore, there is no contract between the parties reinsuring that...

Mealey's Insurance - Judge Agrees With Special Master, Finalizes Receivership Disallowance Of Claim

AUSTIN, Texas - A Texas judge on March 20 approved an application by an insolvent insurer's special deputy receiver (SDR) and declared the disallowance of a certain house fire claim final (The State of Texas and the Texas Department of Insurance v. Vesta Fire Insurance Corporation, et al., No. D...

Mealey's Insurance - Lawsuit Fails To Trigger Professional Liability Coverage, 7th Circuit Affirms

CHICAGO - The Seventh Circuit U.S. Court of Appeals on March 21 affirmed a lower federal court's ruling that an underlying lawsuit against an insured does not assert a claim that plausibly falls under her professional liability insurance policy, rejecting an appeal by a homeowners insurer seeking...

Mealey's Insurance - 9th Circuit Affirms $6.1M Judgment In Favor Of Insured In Dispute With Excess Insurer

PASADENA, Calif. - The Ninth Circuit U.S. Court of Appeals on March 21 affirmed a lower federal court's $6,080,568 judgment in favor of an insured in a breach of contract and bad faith lawsuit against its excess general liability insurer arising from an underlying patent infringement dispute (Teleflex...

Mealey's Insurance - Issues Of Fact Exist On Cause Of Collapse And Insured's Knowledge, Federal Judge Says

PEORIA, Ill. - Because questions of fact exist regarding the cause of the collapse of a building's second floor and the insured's knowledge of the condition of the building, an Illinois federal judge on March 21 denied an insurer's motion for summary judgment (WAMFAM5 Inc. v. Nova Casualty...

Mealey's Insurance - Excess Insurer Had No Duty To Indemnify Construction Defect Suit, Judge Finds

DENVER - An excess insurer had no duty to indemnify two insureds for a construction defect case because the primary policy was not yet exhausted, a Colorado federal judge ruled March 20, dismissing a reimbursement lawsuit filed by two other insurers seeking monies for the defect case's settlement...

Mealey's Insurance - Florida Panel Affirms Court's Refusal To Conduct New Appraisal In Wilma Suit

MIAMI - A Florida appeals panel on March 22 held that an insured's post-appraisal submission of increased costs in a Hurricane Wilma coverage dispute is not a legally sufficient basis to reopen the existing appraisal or conduct a new appraisal (Orlando Noa v. Florida Insurance Guaranty Association...

Mealey's Insurance - Insurer Properly Considered Doctoral Program Requirements When Terminating Benefits

GRAND RAPIDS, Mich. - A disability insurer's reliance on a claimant's attendance requirements for a doctoral degree program was properly considered by the insurer when it terminated the claimant's long-term disability benefits on the basis that the claimant was not disabled from performing...

Mealey's Insurance - California Appeals Panel Affirms Insurer's Restitution Award In Fraud Suit

SAN DIEGO - An insurer is entitled to $37,000 in restitution from a man who pleaded guilty to misrepresenting to the company that nurses he sent to work at skilled-nursing facilities were computer programmers to obtain a lower workers' compensation policy premium, a California appeals panel ruled...

Mealey's Insurance - Judge Says Special Deposit Cannot Be Used To Pay Guarantor Expenses

CHICAGO - An Illinois judge on March 22 sustained an insurance guaranty association's objection, finding that an insolvent insurer's special deposit cannot be used to pay the guaranty association's general administrative expenses (People of the State of Illinois, ex rel. Andrew Boron, Director...

Mealey's Insurance - Panel: Architect Did Not Have 'Deemed Allowed' Claim That Constitutes Res Judicata

NEW ORLEANS - The Fifth Circuit U.S. Court of Appeals on March 24 denied an architect's appeal seeking to reverse a ruling in favor of a home builder's insurer in a breach of contract dispute arising from an underlying $63,471,000 copyright infringement dispute, rejecting the architect's...

Mealey's Insurance - New York Law Applies In Environmental Dispute, Delaware High Court Says, Reversing

WILMINGTON, Del. - The Delaware Supreme Court on March 23 determined that the law of New York should be applied in a dispute over the allocation of environmental contamination claims because New York has the most significant relationship with the parties and applying the law of the state in which an...

Mealey's Insurance - Homeowner's Insurer Paid Full Amount Of Claims, Magistrate Judge Concludes

PHILADELPHIA - A homeowner's insurer paid the entire amount it owed to insureds for damage to their home because the insureds failed to offer expert reports to rebut the insurer's evidence that the unpaid portions were not covered, a Pennsylvania federal judge ruled March 22, granting summary...

Mealey's Insurance - Claimant Failed To Prove He Was Disabled Under Policy, 6th Circuit Panel Affirms

CINCINNATI - A disability insurer's decision to terminate a claimant's long-term disability benefits is supported by the medical evidence, the Sixth Circuit U.S. Court of Appeals said March 22, agreeing with a district court's finding that the claimant failed to show that his depression prevented...

Mealey's Insurance - Appeals Court: Grand Jury Proceedings, Evidence Supported Arson Fraud Verdict

CLEVELAND - An Ohio appeals court on March 23 affirmed a man's conviction for three counts of aggravated arson and one count of insurance fraud after overruling the defendant's argument that he was prejudiced by grand jury proceedings that involved the use of a Bureau of Alcohol, Tobacco and...

Mealey's Insurance - Insurer Acted Arbitrarily In Determining Disability Onset Date, 1st Circuit Panel Says

BOSTON - The First Circuit U.S. Court of Appeals on March 24 determined that a disability insurer acted arbitrarily and capriciously by relying on a job description of a generic "lawyer" rather than a job description of a specialized "environmental lawyer" when it determined the onset...

Mealey's Insurance - Judge Trims Some Claims Over Billing For Vein Procedures Due To Pleadings

CHICAGO - A federal judge in Illinois dismissed without prejudice claims from a man that his former employer falsely billed Medicare, Medicaid and other private insurers for endovascular laser therapy (EVLT) procedures that were not medically necessary or done with reused laser fibers, finding that the...

Mealey's Insurance - Louisiana High Court Majority Refuses To Hear Appeal In Medical Malpractice Suit

NEW ORLEANS - A majority of the Louisiana Supreme Court refused to reconsider an appeals court's affirmation of a lower court's finding that a doctor breached the standard of care applicable to an obstetrician and gynecologist in failing to obtain a patient's informed consent before performing...