News & Analysis as of

Denial of Insurance Coverage

Paul Hastings LLP

Antitrust Lawsuits Accuse Insurers of Conspiring to Deny Fire Insurance to California Homeowners

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On April 18, 2025, law firms representing California homeowners filed a pair of lawsuits accusing dozens of insurance companies of conspiring to deny property insurance to homeowners in fire-prone areas of California,...more

Rivkin Radler LLP

April 2025 New York Insurance Coverage Law Update

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John H. Fisher and his P.C. represented a client in a medical malpractice action filed on February 15, 2019, alleging that the defendant medical providers failed to provide proper prenatal care to the client, causing the...more

Carlton Fields

Eighth Circuit Finds No Coverage Under “Ensuing Loss” Provision Under Arkansas Law

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“Ensuing loss” provisions have long been the subject of nuanced arguments in insurance litigation. The provisions, which sometimes afford coverage for a “covered loss” stemming from an expressly excluded peril, serve as...more

Carlton Fields

Texas Appeals Court Finds Project Owner Excluded From Coverage as Claimants’ Statutory Employer

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On April 3, 2025, a Texas state appeals court reversed a trial court order awarding Exxon Mobil $25 million under an umbrella insurance policy issued by Lexington Insurance Co. to Brock Services Ltd. The appeals court found...more

American Conference Institute (ACI)

[Event] 16th Annual Advanced Forum on Managed Care Disputes and Litigation - May 1st - 2nd, Chicago, IL

Join the industry’s top litigators and leading plan counsel at ACI’s 16th Annual Advanced Forum on Managed Care Disputes and Litigation, for two days of discussions designed to address emerging areas of concern for MCOs in...more

Wiley Rein LLP

Notice Prejudice Rule Applies to Claim Not Reported “As Soon As Practicable” But Within Policy Period

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The United States District Court for the District of Kansas, applying Kansas law, has held that an insurer must show prejudice to deny coverage when an insured provided notice of a claim within the policy’s three-year policy...more

Venable LLP

[Webinar] Insurance Coverage for PFAS Under Historical CGL, Modern Environmental and Other Insurance Policies - April 3rd, 1:00 pm...

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This program will address insurance coverage for the potential environmental impacts of PFAS, such as the costs of testing or remediation required by the government, as well as other potential non-environmental PFAS claims....more

Wiley Rein LLP

No Coverage for Lawsuit Where “Claim” First Made at Time of Pre-Inception Tolling Agreement

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In a win for Wiley’s client, a New York intermediate appellate court, applying New York law, has affirmed that no coverage is available for a legal malpractice lawsuit because the “claim” was first made before the policy’s...more

Wiley Rein LLP

Third Circuit: Changes in Exposure Provision Bars Coverage for Pre-Merger Liabilities

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In a win for Wiley’s client, the United States Court of Appeals for the Third Circuit, applying Pennsylvania law, affirmed judgment on the pleadings in favor of a group of insurers on the ground that a Changes in Exposure...more

Marshall Dennehey

Second District Court of Appeal Reinstates Homeowner’s Lawsuit, Assigns New Judge Over Bias Concerns

Marshall Dennehey on

Montes v. Universal Property & Casualty Insurance Co., Fla. 2d DCA, No. 2D2023-1200, February 12, 2025 - The Second District Court of Appeal revived an insurance coverage suit a homeowner brought against his insurance...more

Morris, Manning & Martin, LLP

Policyholder Concerns after Georgia Federal Court Takes Broad Reading of Pollution Exclusion

In Citizens Ins. Co. of Am., et al. v. Augusta Chiller Service, Inc., et al., the Southern District of Georgia granted insurers' motions for summary judgment in part on their duty to defend under a primary and excess policy...more

Marshall Dennehey

Third District Court of Appeal Rules Affidavit Lacks Evidence Linking Damage to Tropical Storm Eta

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Thomas A. Bouchard, Jr. v. Citizens Prop. Ins. Corp., Fla. 3d DCA, No. 3D12-2202, February 19, 2025 - Thomas Bouchard, the appellant, appealed a final summary judgment order entered in favor of Citizens Property Insurance...more

Carlton Fields

Eleventh Circuit Holds Course of Construction Exclusion Applies to Water Damage as Project Was Not Fully Complete

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In Liberty Surplus Insurance Corp. v. Kaufman Lynn Construction Inc., the Eleventh Circuit Court of Appeals held that a “course of construction exclusion” in a commercial general liability precluded coverage for water damage...more

Marshall Dennehey

Fourth District Court of Appeal: Noncompliance with Post-Loss Requirements Is a Contract Breach, No Prejudice to Insurer Needed

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Alton Forbes v. People’s Trust Ins. Co., Fla. 4th DCA, No. 4D2023-2375, January 8, 2025 - The Fourth District Court of Appeals ruled that the final judgment against the appellant stands because the appellant failed to comply...more

Lathrop GPM

California Courts Continue to Grapple with What Constitutes Wildfire “Direct Physical Loss or Damage”

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In Gharibian et al., v. Wawanesa General Insurance Company, the California Second District Court of Appeal found that, under California law, the insureds failed to prove smoke, soot, ash and fire debris on covered property...more

Rivkin Radler LLP

March 2025 New York Insurance Coverage Law Update

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The owners of a warehouse leased it to a commercial tenant to operate a photography studio. The lease required the tenant to procure insurance for the owners and to indemnify them for the negligent acts of the tenant’s...more

White and Williams LLP

Top Developments - 2025, Issue 1

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New Jersey appeals court concludes that claims by a condominium resident alleging injury from indoor exposure to mold did not fall within a “consumption” exception to mold exclusions* in CGL policies where the resident...more

Marshall Dennehey

Court Reverses Summary Judgment, Finding Insurer Failed to Prove Policy Exclusion

Marshall Dennehey on

Ronald and Lovelie Belizaire v. Citizens Prop. Ins. Corp., Fla. 4th DCA, No. 4D2023-2488, February 12, 2025 - The Fourth District Court of Appeal reversed the trial court’s order granting summary judgment in favor of the...more

Zelle  LLP

Balancing Discovery and Protecting the Attorney-Client Privilege In the Insurance Coverage Context

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A recent case out of Colorado highlights the continued attack on the attorney-client privilege during the claim adjustment process. In In re: Hill Hotel Owner, LLC v. Hanover Insurance Company, 557 P.3d 798 (Colo. Oct. 29,...more

Maynard Nexsen

Can ERISA Plans Avoid California Insurance Code Section 10110.6 with Choice-of-Law Provisions?

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The Ninth Circuit is considering the enforceability of a choice of law provision in an ERISA plan in William White v. Guardian Life Insurance Company, et al., Case No. 24-2681, appeal pending from the United States District...more

Katten Muchin Rosenman LLP

Are You Really Covered as an Additional Insured?

For your next construction project in New York, securing commercial general liability coverage as an additional insured may not be as simple as it would appear. Recent court rulings have interpreted the terms of insurance...more

Marshall Dennehey

Fourth District Court of Appeal Rules Policy Endorsement Prevails Over Main Policy in Case of Conflict

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Colony Insurance Company v. Titan Restoration Construction, Inc., Fla. 4th DCA, No. 4D2023-2908, January 8, 2025 - Colony Insurance Company’s insurance policy with the general contracting company, Titan Restoration...more

Maynard Nexsen

Lessons in Limitation – Contractual Limitations Provisions as a Basis for Summary Judgment

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In recent weeks, our firm obtained summary judgment under a contractual limitations provision that the plaintiff-insured argued had been equitably tolled due to the insurance carrier’s conduct. Although the good guys won, the...more

Carlton Fields

Recent Denial of Business Interruption Coverage to Cannabis Manufacturer Highlights Importance of Diving Into the Weeds of...

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In Theraplant LLC v. National Fire & Marine Insurance Co., the U.S. District Court for the District of Connecticut denied the insured cannabis cultivator’s claim for business interruption coverage because the insured failed...more

Arnall Golden Gregory LLP

UnitedHealthcare Must Face State Law Claims in Class Action Suit for AI Driven Coverage Denials of Medicare Advantage Claims

Daytime television inundates American seniors with advertisements for UnitedHealthcare’s (“UHC”) Medicare Advantage Plans. On its website, UHC claims its Medicare Advantage Plans “stand out from the rest,” providing...more

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