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Policy Terms Insurance Claims 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

Houston Harbaugh, P.C.

Third Circuit: Assault on a school bus did not have sufficient connection to use of the bus to trigger auto coverage

Houston Harbaugh, P.C. on

On September 22, 2023, the U.S. Court of Appeals for the Third Circuit held in a non-precedential opinion that an insurer had no duty to defend a school bus transportation company under an auto policy for an alleged assault...more

Ervin Cohen & Jessup LLP

Ninth Circuit Deals Another Blow to Restaurants in COVID-19 Insurance Coverage Case

On June 26, 2023, a panel of judges for the United States Court of Appeals for the Ninth Circuit affirmed an insurance company’s win over a restaurant group seeking insurance coverage for pandemic-related claims in Team 44...more

Chartwell Law

Sixth District Court of Appeal Addresses the Scope of Appraisal

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In a June 9, 2023 decision, the Sixth District Court of Appeal (“DCA”) explained the role of an umpire during the appraisal process. The First Acceptance Ins. Co., Inc. v. At Home Auto Glass, LLC a/a/o Petra James trial court...more

Conn Kavanaugh

No Case is Too Big to Notify a Claims-Made Insurer

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A headline-grabbing case regarding race in the college admissions process at an elite university, appealed all the way to the United States Supreme Court, is the type of nightmare scenario that might inspire an educational...more

Lowndes

Are Economic Losses Caused by COVID Shutdowns Recoverable Under Commercial Property Insurance Policies

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As we have previously written, whether economic losses caused by COVID shutdowns can be recovered under commercial property insurance policies is a hotly-contested issue. (Past articles include, ‘Will Your Business...more

Butler Weihmuller Katz Craig LLP

Indiana Rejects Subrogation Waiver Argument Where Contractor Performed Work At The Request Of Another

In U.S. Automatic Sprinkler Corp. v. Erie Insurance Exchange, 21A-CT-580, 2022 WL 906142 (Ind. Ct. App. Mar. 29, 2022), the Indiana Court of Appeals held that a subrogation waiver in an insured’s maintenance contract did not...more

Jones Day

Policyholders Receive Needed Guidance on Use of Extrinsic Evidence in Texas When Enforcing an Insurer's Duty to Defend

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The U.S. Court of Appeals for the Fifth Circuit recently applied the newly adopted Texas Supreme Court decision outlining those circumstances in which extrinsic evidence may be used to determine an insurer's duty to defend...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

Carlton Fields

Seventh Circuit Rejects Insured’s “Claim Within a Claim” Argument

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The Seventh Circuit Court of Appeals recently had occasion to clarify the parameters of a “claim” in insurance policies. In Market Street Bancshares Inc. v. Federal Insurance Co., Judge Kanne penned an opinion holding that a...more

Carlton Fields

The Three “Musts” for a Competent Affidavit or Declaration

Carlton Fields on

Florida’s Second District Court of Appeal recently issued a decision that serves as a reminder not to take for granted a proposition that most practicing attorneys regularly encounter: a motion for summary judgment must be...more

Carlton Fields

Is Your “Securities Claim” Actually Covered Under Your D&O Policy? A Review of In Re Verizon Insurance Coverage Appeals

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The question of what constitutes a “securities claim” in the context of public company D&O policies is often debated in insurance coverage disputes, and the answer to this question can have significant effects on the scope of...more

Robins Kaplan LLP

Empire State of Mind: New York Bad Faith Update

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WHILE THERE REMAINS NO BAD FAITH CAUSE OF ACTION IN NEW YORK, A RECENT APPELLATE DIVISION CASE OUT OF THE FIRST DEPARTMENT MAKES PLAIN THAT AN INSURED NEED NOT MEET A HEIGHTENED PLEADING STANDARD WITH RESPECT TO CONSEQUENTIAL...more

Carlton Fields

Eleventh Circuit Rejects Insurer-Defended Policyholder’s Bid to Expand Florida’s Bad Faith “Excess Judgment Rule” to Include...

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In Cawthorn v. Auto-Owners Insurance Co., No. 18-12067 (11th Cir. Oct. 25, 2019), the Eleventh Circuit affirmed the U.S. District Court for the Middle District of Florida’s grant of summary judgment in favor of Auto-Owners...more

Carlton Fields

Look No Further Than the Insuring Clause: Ill-Gotten Gains Do Not Constitute Covered “Loss”

Carlton Fields on

On August 26, 2019, the Eleventh Circuit Court of Appeals, applying Florida Law, held that ill-gotten gains do not constitute covered “loss” within the meaning of a D&O policy. In Philadelphia Indemnity Insurance Co. v. Sabal...more

Rumberger | Kirk

Florida's 5th DCA Allows Carrier to Compel Appraisal When Covered Loss Is Under Deductible

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No payment? No problem ruled Florida’s 5th District Court of Appeal a few weeks ago in a homeowner’s insurance case where the carrier found partial coverage for the alleged loss, but did not issue payment because the amount...more

Carlton Fields

Autoerotic Asphyxiation Ruling Brews Circuit Split on Coverage

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In Tran v. Minnesota Life Insurance Co., the U.S. Court of Appeals for the Seventh Circuit ruled that an insured’s death from autoerotic asphyxiation fell under the policy exclusion for deaths resulting from “intentionally...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

Neal, Gerber & Eisenberg LLP

Illinois Appellate Court Holds Insurer Did Not Waive Right to Arbitrate Despite Years-long Delay in Pursuing ADR

In Caterpillar, Inc. v. Century Indem. Co., et al., 2019 IL App (3d) 190032, the Illinois Appellate Court, Third District, issued an opinion that highlights the need for parties to carefully consider alternate dispute...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

Neal, Gerber & Eisenberg LLP

Reminder Why Injured Claimants Must be Named in Declaratory Judgment Complaint

In Direct Auto Insurance Company v. Bahena, et al., 2019 IL App (1st) 172918, the Illinois Appellate Court sifted through a procedural nightmare in order to get to the very sensical conclusion that “It cannot be the case that...more

Carlton Fields

Missouri Appeals Court Rules That Insurer Must Pay Double Policy Limits in Medical Malpractice Claim Involving Birth Injuries

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In John Patty, D.O., LLC v. Missouri Professionals Mutual Physicians Professional Indemnity Association, No. ED106747 (Mo. Ct. App. Apr. 23, 2019), a Missouri appellate court rejected the lower court’s decision regarding...more

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