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Mealey's Insurance - Reviewer's Deposition Testimony Sparks California Investigation Into Aetna Claims Process

SACRAMENTO, Calif. - California launched an investigation into Aetna Inc.'s health insurance claims approval and prior authorization process after learning that one of the company's medical reviewers testified in a deposition that he was trained not to review medical records but instead rely...

Mealey's Insurance - Panel Vacates, Remands Denial Of Insurer's Intervention In Forfeiture Proceedings

NEW YORK - The Second Circuit U.S. Court of Appeals on Feb. 13 vacated and remanded a lower federal court's dismissal of an insurer's petition to assert a third-party interest in a criminal forfeiture proceeding but denied the insurer's appeal of the lower court's denial of its request...

Mealey's Insurance - Insurer Has Duty To Defend, Indemnify Negligent Installation Claims, Appeals Panel Finds

HARRISBURG, Pa. - A commercial general liability insurer has a duty to defend and indemnify an insured subcontractor against a contractor's claims of negligent installation, the Pennsylvania Superior Court affirmed Feb. 9 (J.J.D. Urethane Co. v. Westfield Insurance Co., et al., Nos. 1440 EDA 2017...

Mealey's Insurance - Government Did Not Violate Insurers', Reinsurers' 5th Amendment Rights, Panel Says

WASHINGTON, D.C. - The U.S. government's termination of insurers and reinsurers' lawsuits pursuant to a claims settlement agreement between it and Libya and its subsequent legislation and executive order did not constitute a compensable taking under the Fifth Amendment, the Federal Circuit U...

Mealey's Insurance - Judge Allows Insurer To Amend Complaint To Provide Details Of Fraud Scheme

FLINT, Mich. - A statutorily created insurance program that provides insurance coverage for pedestrians struck by vehicles and passengers in automobile accidents can file a second amended complaint that provides additional details of a fraudulent scheme that submitted bills to insurance companies, a...

Mealey's Insurance - Insurer, Reinsurer Submit Briefs On New York High Court Decision's Application

NEW YORK - In a coverage dispute over asbestos litigation costs, a reinsurer and insurer submitted letters on Feb. 9 to the Second Circuit U.S. Court of Appeals concerning how a New York high court ruling applies to a reinsurance contract's per-occurrence liability cap (Global Reinsurance Corporation...

Mealey's Insurance - Federal Judge Enjoins Hot Sauce Maker From Infringing On Trademarks

LOS ANGELES - A California federal judge on Feb. 12 entered a default judgment on claims for violation of California's unfair competition law (UCL) and trademark infringement asserted by a maker of hot sauce and granted a permanent injunction in its favor, enjoining another hot sauce maker from making...

Mealey's Insurance - Judge Allows Breach Of Contract Claim Against Insurer To Proceed To Trial

NEW HAVEN, Conn. - After dismissing all claims based on a "collapse" from faulty concrete against one homeowners insurer for not occurring during its policy period, a Connecticut federal judge on Feb. 13 dismissed all but a breach of contract claim against another insurer because a reasonable...

Mealey's Insurance - Federal Judge Dismisses ERISA Claim For Failure To Provide Discovery

CLARKSBURG, W.Va. - A West Virginia federal judge on Feb. 12 found that a benefits plan and insurer were not obligated to provide a plan participant with documents in relation to his discovery request because they are not the plan administrators, granting them summary judgment on his claim for violation...

Mealey's Insurance - Magistrate Judge: Insurer's Amended Complaint Adequately States RICO Claim

DENVER - A federal magistrate judge in Colorado on Feb. 12 recommended granting an insurance company's motion to file a second amended complaint, finding that it sufficiently alleged that an enterprise exists under the Racketeer Influenced and Corrupt Organizations Act against an insurance adjuster...

Mealey's Insurance - Insurer Asks For Relief From Kaiser Gypsum's Stay To Seek Settlement Reimbursement

CHARLOTTE, N.C. - An insurer of Chapter 11 debtor Hanson Permanente Cement Inc. sought relief from the automatic bankruptcy stay Feb. 13 in North Carolina federal bankruptcy court so it can pursue $2.8 million in reimbursements from other insurers for settlement payments made to asbestos personal injury...

Mealey's Insurance - Rapid-American Denied Protective Order For Insurers' Subpoenas

NEW YORK - Chapter 11 debtor Rapid-American Corp. and asbestos claimants in its bankruptcy case do not have standing to challenge subpoenas served by insurers to asbestos claims-processing facilities seeking evidence of fraud in the asbestos trust system, and besides, the information sought is relevant...

Mealey's Insurance - Panel: Insured Cannot 'Swap Horses Midstream' In Appeal Of No Coverage Ruling

PHILADELPHIA - The Third Circuit U.S. Court of Appeals on Feb. 15 rejected an insured's appeal of a lower court's ruling that it was not owed professional liability coverage for an underlying third-party complaint, finding that the insured's primary argument was never raised in the lower...

Mealey's Insurance - Panel Affirms Dismissal Of Remodelers' Suit Against Federal Flood Insurer

CINCINNATI - The Sixth Circuit U.S. Court of Appeals on Feb. 14 affirmed a lower court's dismissal of a breach of contract, unjust enrichment, fraudulent inducement and intentional and negligent misrepresentation lawsuit against a federal flood insurer, reiterating that the claims are preempted by...

Mealey's Insurance - Florida Majority Reverses $493,246 Attorney Fee Award In Sinkhole Coverage Suit

LAKELAND, Fla. - A majority of the Second District Florida Court of Appeal on Feb. 14 reversed a lower court's $493,246.50 attorney fees award against an insurer in a sinkhole coverage dispute and remanded for further proceedings (Citizens Property Insurance Corporation v. Meghan Anderson, No. 2D16...

Mealey's Insurance - Insurers Owe Defense For Claims Arising Out Of Negligence, 11th Circuit Says

ATLANTA - Commercial general liability insurers have a duty to defend allegations that an insured improperly constructed on land without taking reasonable steps to implement a workable drainage system, the 11th Circuit U.S. Court of Appeals held Feb. 13, reversing and remanding the entry of summary judgment...

Mealey's Insurance - Judge Declines To Apply 'Fraudulent Misjoinder' Standard In Bad Faith Suit

SAN FRANCISCO - Remand of an insurance breach of contract and bad faith lawsuit to state court is necessary because the Ninth Circuit U.S. Courts of Appeals has yet to adopt the "fraudulent misjoinder" standard established by the 11th Circuit, which an insurer argues is the basis for the action's...

Mealey's Insurance - Class: Life Insurer, Private Investment Firm Unlawfully Raised Prices In Policies

NEW YORK - A life insurer and a private investment firm, which acquired the insurer, unlawfully increased the cost of premiums to recoup costs associated with the acquisition, among other reasons, plaintiffs allege in a Feb. 13 class action filed in a New York federal court (Derek Fan, et al. v. Phoenix...

Mealey's Insurance - Kaiser Gypsum Debtors Agree To Claim Amount In Insolvent Insurers' Run-Off

CHARLOTTE, N.C. - A North Carolina federal bankruptcy judge on Feb. 17 approved in a minute order a settlement between Chapter 11 debtors Kaiser Gypsum Co. Inc. and Hanson Permanente Cement Inc. and the joint scheme administrator for two insolvent British insurers, setting claim values for the debtors...

Mealey's Insurance - U.S. High Court Refuses To Review Arbitration Dispute Over Sexual Abuse Claims

WASHINGTON, D.C. - The U.S. Supreme Court on Feb. 20 denied an excess insurer's petition for writ of certiorari challenging a California appeals court's denial of its motion to compel arbitration of a coverage dispute with a school district over sexual abuse claims (Safety National Casualty Corp...