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Mealey's Insurance - Special Deputy Receiver Reports Quarterly Status Of Liquidation Estate

AUSTIN, Texas - The special deputy receiver (SDR) of an insolvent insurer reported to a Texas court on Sept. 15 the financial status of the liquidation estate and outlined details of reinsurance recoverables and recoveries (The State of Texas v. San Antonio Indemnity Company, No. D-1-GV-13-001153, Texas...

Mealey's Insurance - DOJ: Skilled Nursing Company, Board Members To Pay $30M Over False Billing

WASHINGTON, D.C. - The U.S. Department of Justice announced Sept. 19 that North America Health Care Inc. (NAHC), its chairman of the board and a senior vice president have agreed to pay a total of $30 million to resolve allegations that they violated the False Claims Act (FCA) by submitting false claims...

Mealey's Insurance - Washington Federal Judge: Additional Briefing Needed On Discretionary Clause

SEATTLE - A Washington federal judge on Sept. 19 ordered parties involved in a disability benefits dispute to submit additional briefing on whether a discretionary clause, included in a disability plan that was issued in the State of Texas, is valid in the State of Washington where the claimant resides...

Mealey's Insurance - Judge: Reinsurers Failed To State A Claim For Relief In Breach Of Contract Suit

WASHINGTON, D.C. - Dismissal of claims in an insurance breach of contract and bad faith lawsuit is proper because reinsurers have failed to state a claim for relief against the Federal Crop Insurance Corp. (FCIC) regarding its modification of the methodology that sets crop premiums, a federal judge in...

Mealey's Insurance - Coverage For Qui Tam Action Limited To $25,000, Federal Judge Rules

LAS VEGAS - A Nevada federal judge on Sept. 19 held that coverage for an underlying qui tam action is available under a professional liability insurance policy's billing errors endorsement up to the $25,000 sublimit of liability, rejecting the insureds' argument that they are owed $2 million...

Mealey's Insurance - Man Says Reinsurance Dispute Does Not Involve Him

ATLANTA - A man purportedly associated with a reinsurer sued for allegedly avoiding payment obligations tells a federal court in Georgia in a Sept. 21 brief that claims against him should be dismissed because the court does not hold personal jurisdiction over him (Canal Insurance Company, et al. v. Golden...

Mealey's Insurance - Reinsurer Says Magistrate Judge's Discovery Orders Are Fundamentally Unfair

SYRACUSE, N.Y. - A reinsurer in a Sept. 19 brief asks a federal court in New York to reconsider its discovery rulings that the reinsurer says require it to produce reserve information while not requiring its reinsured to produce the same category of documentation (Utica Mutual Insurance Company v. Century...

Mealey's Insurance - Insured Did Not Comply With Terms Of Insurance Policy, Federal Judge Rules

HOUSTON - An insured is not entitled to coverage under a one-year casualty insurance policy for losses as the result of a burglary because the insured failed to pay the premium by the required deadline, failed to disclose that he has filed similar claims under the terms of a previous policy and failed...

Mealey's Insurance - Judge: Insureds Conceded They Are Not Entitled To Defense In Insurance Dispute

TULSA, Okla. - An insurer is entitled to judgment on the pleadings on claims that it failed to properly provide a defense for insureds under the terms of a homeowners insurance policy because the insureds conceded that they were not entitled to a defense for the claims made against them, a federal judge...

Mealey's Insurance - Remodelers' Lawsuit Against Federal Flood Insurer Cannot Survive, Judge Rules

NASHVILLE, Tenn. - A Tennessee federal judge on Sept. 20 granted a federal flood insurer's motion to dismiss a breach of contract, unjust enrichment, fraudulent inducement and intentional and negligent misrepresentation lawsuit against it, finding that the claims are preempted by federal law (D&S...

Mealey's Insurance - Reinsurer Counters Motion To Vacate Arbitration Award

NEW YORK - A reinsurer told a federal court in New York on Sept. 22 that an arbitration award should be confirmed because a reinsured has not shown that an arbitration umpire was biased (Yosemite Insurance Company v. Nationwide Insurance Company, No. 16-cv-05290, S.D. N.Y.).

Mealey's Insurance - Oregon High Court Affirms Judgment Against Insurer In Water Damage Dispute

PORTLAND, Ore. - Coverage was triggered under a commercial general liability insurance policy for a negligence award against a siding contractor for water damage to a housing complex, the Oregon Supreme Court ruled Sept. 22, upholding a garnish judgment against the insurer in the amount of $433,958.16...

Mealey's Insurance - 9th Circuit Reverses Order Denying Insurer Reimbursement Of Defense Fees

ANCHORAGE, Alaska - The Ninth Circuit U.S. Court of Appeals on Sept. 23 reversed and remanded a lower federal court's order that denied a professional liability insurer reimbursement of the defense fees it incurred in an underlying lawsuit against its law firm insured (Attorneys Liability Protection...

Mealey's Insurance - California Panel Affirms Employment-Related Practices Exclusion Bars Coverage

SAN DIEGO - A California appeals panel on Sept. 23 affirmed a lower court's ruling that a commercial general liability insurance policy's employment-related practices (ERP) bars coverage for all claims alleged against an insured and its employee (Golden Eagle Insurance Corp. v. Alana Munoz, No...

Mealey's Insurance - No Joint Venture Between Insurer, Claims Administrator Exists, Judge Rules

PHOENIX - Plaintiffs in an insurance bad faith lawsuit have failed to show that any joint venture existed between an insurer and a third-party claims administrator, and, as a result, no bad faith claim exists, a federal judge in Arizona ruled Sept. 22 (Kenneth Ingram, et al. v. Great American Insurance...

Mealey's Insurance - Insurer Has No Duty To Indemnify Under Pollution Exclusion, Federal Judge Says

MINNEAPOLIS - A policy's pollution exclusion does not preclude an insurer's duty to defend an underlying personal injury suit arising out of carbon monoxide poisoning but does preclude the insurer's duty to indemnify, a Minnesota federal judge said Sept. 23 in partially granting the insurer's...

Mealey's Insurance - Judge: Excess Insurer Entitled To Recover $3.25M It Contributed To Settlement

AKRON, Ohio - An Ohio federal judge on Sept. 21 held that an excess insurer is entitled to recover from another excess insurer the $3.25 million it contributed to an underlying settlement of a malicious prosecution lawsuit against the City of Barberton, Ohio, and its police officers (Selective Insurance...

Mealey's Insurance - Kansas Federal Judge Says Issues Of Fact Exist Regarding Collapse

TOPEKA, Kan. - A Kansas federal judge on Sept. 22 denied an insurer's motion for partial summary judgment after determining that issues of fact exist regarding whether a collapse caused the damages at issue to its insureds' kitchen (Dr. Thomas C. Welton et al., v. AMCO Insurance Co., No. 14-4066...

Mealey's Insurance - Magistrate Judge Finds Government Entitled To $1.3M From Convicted Doctor

TYLER, Texas - A doctor who was recently resentenced to 135 months in prison for submitting false claims to Medicare and Medicaid was ordered by a federal judge in Texas on Sept. 26 to pay $1.3 million to the government for violations of the False Claims Act (FCA) (United States of America v. Tariq Mahmood...

Mealey's Insurance - No Coverage Owed For Water, Mold Damages, D.C. Federal Judge Says

WASHINGTON, D.C. - No coverage is afforded for water and mold damages that occurred within a vacation home because the insureds did not have a water shut-off valve to turn off the home's main water supply while the home was unoccupied, a District of Columbia federal judge said Sept. 26, noting that...