News & Analysis as of

Insurance Industry Denial of Insurance Coverage Appeals

Wiley Rein LLP

Second Circuit Finds Pre-Suit Letter Was a “Claim” and Remands for Determination of Whether Notice of Claim Was Timely

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The United States Court of Appeals for the Second Circuit, applying New York law, has held that a pre-suit letter sent to an insured constituted a “Claim” under a liability policy. Match Group, LLC v. Beazley Underwriting...more

BCLP

English Court Decides COVID-19 is a “Catastrophe”

BCLP on

The English Court has, for the first time, considered the meaning of a “catastrophe”, as well as how Hours Clauses work in the context of non-damage business interruption losses claimed under two Property Catastrophe Excess...more

Carlton Fields

Alabama Federal Court Finds No Duty to Defend Lawsuit Alleging Concealment of Defects in Sale of Home

Carlton Fields on

In Nationwide Mutual Fire Insurance Co. v. Carmichael, the U.S. District Court for the Northern District of Alabama, applying Alabama law, entered summary judgment ruling that Nationwide Fire Insurance Co. had no duty to...more

Sheppard Mullin Richter & Hampton LLP

The Commercial Division Rejects Yet Another Insured’s Claim for Coverage for Covid-Related Revenues Losses

Does the business harm caused by COVID-19 qualify as “direct physical loss” for insurance purposes? In Spirit Airlines, Inc. v. American Home Assurance Company, Index No. 655755/2021, Commercial Division Justice Robert R....more

White and Williams LLP

Top Developments – November 2022

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SPOTLIGHT: Third Circuit Court of Appeals Affirms No Coverage for Sex Trafficking Claims - In Nautilus Insurance Co. v. Motel Management Services Inc., the Court of Appeals granted a motion for judgment on the pleadings...more

Steptoe & Johnson PLLC

Fourth Circuit Upholds Dismissal of Insurance Claim for Pandemic Related Business Losses

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In a published decision filed March 7, 2022, the U.S. Court of Appeals for the Fourth Circuit in Uncork and Create LLC v. The Cincinnati Insurance Company, affirmed the U.S. District Court for the Southern District of West...more

Butler Snow LLP

The Fifth Circuit Court of Appeals Just Slammed the Door on Texas Businesses Seeking Insurance Coverage for Lost Revenue Due to...

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In a pair of opinions issued last month, the Fifth Circuit Court of Appeals held that Texas businesses’ COVID-19 related income loss was not covered by standard business income and extra expense (“BI/EE”) endorsement in...more

Bricker Graydon LLP

8th Circuit denies COVID-related business income claim in first federal appellate ruling

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In a relatively concise ruling, the 8th Circuit U.S. Court of Appeals issued the first U.S. Appellate Court decision on insurance coverage for COVID-19 related claims. The 8th Circuit ruling affirmed that the insurance policy...more

Spilman Thomas & Battle, PLLC

The Dome Report - 2020 West Virginia Legislature Updates, Issue 4

The 2020 Regular Session of the West Virginia Legislature just reached the 30th day, or its half way point. As of today, the House has introduced 1289 bills, while the Senate introduced 725. We will continue reporting on...more

Mitchell, Williams, Selig, Gates & Woodyard,...

Absolute Pollution Exclusion/Quarry Operations: Federal Appellate Court Addresses Coverage for Unplanned Discharge of Rock Fines

The United States Court of Appeals for the Fifth Circuit (“Court”) addressed in a January 17th opinion a company’s umbrella insurance policy’s absolute pollution exclusion. See Eastern Concrete Materials, Inc., v. Ace...more

Bradley Arant Boult Cummings LLP

Fifth Circuit Decision Excluding Coverage under Pollution Exclusion for Damage to Stream Caused by Rock Fines

In a sweeping decision, the U.S. Court of Appeals for the Fifth Circuit extended the absolute pollution exclusion to the unplanned discharge of “rock fines,” pellets produced during quarry operations, and denied coverage for...more

Pillsbury - Policyholder Pulse blog

A Recent “Event” in Wisconsin: Appellate Court Rules That a Commonly Used London Market “Occurrence” Definition Is Ambiguous

In recent years, Wisconsin generally has been a pro-policyholder jurisdiction when it comes to long-tail environmental coverage cases. That trend continues with a decision by a Wisconsin appellate court in a case involving...more

Farella Braun + Martel LLP

3 Lessons For Calif. Insureds From Late-Notice Rule Decision

In Pitzer College v. Indian Harbor Insurance Company, the California Supreme Court resolved two previously open questions in insurance law: (1) it concluded that the notice-prejudice rule is a fundamental public policy of...more

McDermott Will & Emery

Dental Company’s Indemnification Claim “Bites”

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The US Court of Appeals for the First Circuit affirmed the dismissal of a dental product manufacturer’s suit against its insurer, holding that the IP exclusion in the policy expressly excluded the trademark claims over which...more

Sheppard Mullin Richter & Hampton LLP

Court Finds That “Care, Custody Or Control” Exclusion Did Not Negate Coverage For General Contractor Who Shared Jobsite...

McMillin Homes Constr., Inc. v. National Fire & Marine Ins. Co., 35 Cal.App.5th 1042 (2019); Fourth Appellate District Court of Appeal, Division One, Case No. D074219 (June 5, 2019). McMillin Homes Construction, Inc....more

Pillsbury - Policyholder Pulse blog

Evolving Bad Faith Law: Pro-Policyholder Decision out of Minnesota

Since 2008, Minnesota has had a bad-faith statute that penalizes an insurance company for its unreasonable denial of a first-party insurance claim. But it was only earlier this month that a Minnesota appellate court...more

White and Williams LLP

Eleventh Circuit Defers to Insurer’s Definition of Professional Services

Does an Errors & Omissions (E&O) insurer have a duty to defend its insured mental healthcare provider when the policyholder was not licensed to provide such mental health counseling services? The Eleventh Circuit recently...more

Farella Braun + Martel LLP

“That Particular Part” – Yet More

Massachusetts Appeals Court Gets It Right – Mostly - Hot on the heels of the Federal Tenth Circuit Court of Appeals’ decision in MTI, Inc. v. Employers Insurance Company of Wausau, __ F.3d __, 2019 WL 321423 (10th Cir....more

Bradley Arant Boult Cummings LLP

Endorsement Read to Require Privity of Contract between Policyholder and Additional Insured to Extend Coverage - Construction and...

A recent New York case highlights the importance of thoroughly analyzing all contract language in minimizing project risk. In Gilbane Bldg. Co./TDX Construction Corp. v. St. Paul Fire & Mar. Ins. Co., the Court of Appeals of...more

Butler Snow LLP

Contracts May “Legally” Obligate a Party to Pay, Even Without a Court Judgment

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Time and again, courts have been tasked with construing ambiguous and inconsistent terms in contracts. Recently, the Sixth Circuit revisited the issue of interpreting contractual language in Dark Horse Express, LLC v. Lancer...more

Carlton Fields

Sixth Circuit Weighs In On Coverage For Marijuana-Related Property Loss

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The Sixth Circuit Court of Appeals issued a colorful opinion in a property insurance coverage dispute affirming a denial of coverage for loss arising out of an illicit marijuana growing operation in Michigan. The case is...more

Winstead PC

Bullet Proofing Your Claims Procedures

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Managing your plan’s claims procedures to avoid successful challenges requires careful attention to all of the requirements in the regulations and in the applicable plan’s or policy’s terms and continual review in light of...more

Troutman Pepper

Pa. Superior Court Vacates Bad-Faith Insurance Verdict, Cautioning Against Industrywide Condemnations

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In a highly anticipated decision, the Pennsylvania Superior Court vacated an eyebrow-raising $21 million award for an auto policyholder and found that the insurer did not act in bad faith....more

Carlton Fields

AIG Won’t Have To Defend Carfax In $50 Million Antitrust Suit

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On March 1, a New York appeals court ruled that American International Group, Inc. (AIG) need not defend Carfax, Inc. against a $50 million suit alleging the company monopolized the vehicle history report market. ...more

Carlton Fields

No Coverage For Hole-In-One Contest, Says Fore-th Circuit Court of Appeals

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They say a bad day on the golf course is better than a good day at work. For Old White Charities, Inc., a non-profit that conducted a hole-in-one contest during the Greenbrier Classic Pro-Am golf tournament, this could not be...more

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