After several hurricanes, a church submitted a first-party property claim. The church also had pending coverage litigation from prior tornado damage. On October 12, 2020, the independent adjuster (IA) inspected and...more
11/12/2024
/ Auto Insurance ,
Bad Faith ,
Breach of Contract ,
Cryptocurrency ,
Delay Claims ,
First-Party Coverage ,
Flood Insurance ,
Insurance Claims ,
Insurance Industry ,
Insurance Litigation ,
Policy Exclusions ,
Policy Terms ,
Proof of Loss ,
Property Damage ,
Property Insurance
A dental practice submitted a business interruption claim to its property insurers due to the COVID-19 shutdown orders. The insurers denied coverage, citing a lack of physical damage to the premises. Breaking with national...more
10/2/2024
/ Anti-Stacking Provisions ,
Business Interruption ,
Business Losses ,
Commercial Insurance Policies ,
Coronavirus/COVID-19 ,
Declaratory Relief ,
Denial of Insurance Coverage ,
Indemnification ,
Insurance Claims ,
Insurance Industry ,
Insurance Litigation ,
Liability ,
Policy Exclusions ,
Reasonable Expectations Test
Litigation arose over whether a suit for misrepresentation and breach of contract arising out of an easement triggered a Commercial General Liability (CGL) insurer's duty to defend. Internal confidential communications...more
9/9/2024
/ Appellate Courts ,
Auto Insurance ,
Commercial General Liability Policies ,
Construction Defects ,
Declaratory Judgments ,
Duty to Defend ,
Faulty Workmanship ,
Insurance Claims ,
Insurance Industry ,
Insurance Litigation ,
Life Insurance ,
Policy Terms ,
Premiums
The New York Department of Financial Services (DFS) previously circulated proposed guidance on using AI in underwriting and pricing to address discrimination. DFS requested public comment. Commenters expressed concern over:...more
8/2/2024
/ Artificial Intelligence ,
Auto Insurance ,
Commercial Insurance Policies ,
Denial of Insurance Coverage ,
Department of Financial Services ,
Insurance Claims ,
Insurance Industry ,
Insurance Litigation ,
Property Damage ,
Property Insurance ,
Storm Damage
The Florida Supreme Court ruled that PIP (Personal Injury Protection) insurers may pay 80% of a charge submitted by a provider, even when that reimbursement amount is less than the amount that would be reimbursable under the...more
6/27/2024
/ Bodily Injury ,
Commercial General Liability Policies ,
Commercial Property Owners ,
Duty of Care ,
First-Party Coverage ,
FL Supreme Court ,
Insurance Claims ,
Insurance Industry ,
Insurance Litigation ,
NJ Supreme Court ,
PIP Coverage ,
Premises Liability ,
Property Damage ,
Purchasers ,
Third-Party
The steel contractor named the general contractor an additional insured on its CGL policy. The steel contractor's welds were defective. The general contractor retrofitted the named insured's defective columns before they...more
Some jurisdictions consider the ISO-form "bodily injury" definition to be ambiguous as to whether emotional distress requires physical harm to be bodily injury. Many insurers have amended bodily injury to expressly require a...more
After a yacht ran aground, the owner filed a maritime insurance claim. Despite a New York choice of law provision in the insurance policy, the owner contended that Pennsylvania law applied. The Third Circuit had protected the...more
New York Department of Financial Services (DFS) is concerned that AI’s self-learning behavior increases the risks of unlawful or unfair discrimination. DFS will audit insurers’ use of AI. Such insurers need to maintain...more
2/28/2024
/ Anti-Stacking Provisions ,
Artificial Intelligence ,
Business Losses ,
Company Vehicles ,
Coronavirus/COVID-19 ,
Department of Financial Services ,
Insurance Claims ,
Insurance Industry ,
Insurance Litigation ,
Property Damage ,
State Farm ,
Underwriting