Mealey's Insurance Pleadings

  • December 08, 2023

    Limitation In Disability Income Policy Is Ambiguous, Claimant Tells 9th Circuit

    SAN FRANCISCO — A district court erred in finding that a disability income insurer correctly reduced the claimant’s disability income benefits according to the terms of the disability income policy because the policy’s monthly benefit limitation is ambiguous and, therefore, must be construed in favor of the claimant, a disability claimant says in an appellant brief filed in the Ninth Circuit U.S. Court of Appeal.

  • December 07, 2023

    Insurer To 11th Circuit: Coverage For Project Manager Barred By Exclusion

    ATLANTA — An insurance policy’s professional services exclusion eliminates the insurer’s duty to defend where the insured, a construction management company, is being sued for construction defects on an apartment project where it operated as a “construction manager” pursuant to a “Professional Services Agreement,” the insurer argues in an appellee brief filed in the 11th Circuit U.S. Court of Appeals.

  • December 06, 2023

    Contractor To 7th Circuit: Coverage Owed Under Subcontractor’s Policies

    CHICAGO — The Seventh Circuit U.S. Court of Appeal should reverse a district court’s ruling that insurers do not owe a general contractor a defense or indemnification as an additional insured in a coverage dispute stemming from a subcontractor’s defective welding work at O’Hare International Airport because the underlying claims are potentially within the coverage of the insurance policies at issue, the general contractor maintains in an appellant reply brief.

  • December 06, 2023

    GEICO Seeks Default In $1.8M PIP Fraud Suit Against Doctors, Pain Clinic

    NEWARK, N.J. — GEICO on Dec. 5 moved for a clerk’s entry of default in a New Jersey federal court after a doctor and his medical practice failed to respond to GEICO’s complaint alleging that they participated in a “complex fraudulent scheme” with other medical practitioners and a pain management practice to submit fraudulent personal injury protection (PIP) billing to GEICO for services that were not performed or not medically necessary, resulting in damages to GEICO of more than $1.8 million.

  • December 05, 2023

    Insurer Seeks Reimbursement From Government For Losses Caused By Contaminated Water

    HONOLULU — In a complaint filed in Hawaii federal court, an insurer claims that the U.S. government must reimburse it for more than $500,000 paid to its insured for business losses after a fuel spill at a jet fuel storage facility operated by the U.S, Navy contaminated local drinking water and forced the insured to close its fast food restaurants for approximately four months.

  • December 01, 2023

    Contractor To 11th Circuit: Insurer’s Exclusions Don’t Bar Defense In Defect Case

    ATLANTA — A contractor’s commercial general liability insurer has failed to show that construction defects a Florida couple accused the contractor of causing fall within the exclusions of the policy and thus eliminate the insurer’s duty to defend, the contractor argues in its appellee brief filed in the 11th Circuit U.S. Court of Appeals in what is the third appeal in the case.

  • November 29, 2023

    On Remand, Parties Dispute Expert Exclusion Bids In RESPA Class Lawsuit

    FRESNO, Calif. — Parties in a long-running Real Estate Settlement Procedures Act (RESPA) class action involving captive reinsurance agreements are sparring in California federal court over expert testimony regarding whether the plaintiffs have standing under an economic harm theory.

  • November 28, 2023

    Dismissal Bid Disputed In Reimbursement Row Over Reinsurance Contract

    OMAHA, Neb. — Sparring with one defendant over claims pertaining to a reinsurance contract purportedly issued decades ago, an insurer on Nov. 27 urged a Nebraska federal court to deny a dismissal motion in its suit over reimbursement for a settlement with Montana regarding alleged asbestos exposures.

  • November 28, 2023

    CGL Insurer, Insured Agree To Dismiss Coverage Suit Over Defective Flame Arresters

    SEATTLE — A commercial general liability insurer and a manufacturer of fire and explosion mitigation systems on Nov. 27 submitted a stipulated notice of dismissal in the insurer’s declaratory action over its obligation to defend and indemnify its insured for an underlying action alleging that flame arresters the company installed in five paper mills were defective.

  • November 28, 2023

    Insurer Argues That It Owes No Coverage For Judgment Against Contractor

    WILMINGTON, Del. — An insurer that filed a complaint for declaratory judgment in a federal court in Delaware against a contractor and homeowners association filed an answer to counterclaims by the association on Nov. 27, arguing that it owes no coverage for more than $8 million in damages awarded to the association in its underlying case against the contractor for excessive water infiltration and other issues.

  • November 21, 2023

    Insurers Say Contribution To Lead Abatement Fund Is Not Damages Under Policies

    COLUMBUS, Ohio — An Ohio appellate court erred in determining that an insured’s obligation to contribute to a lead paint abatement fund constitutes damages under insurance policies because the language of the policies establishes that there were no damages for which coverage is afforded, the insurers reiterate in an appellant reply brief filed in the Ohio Supreme Court.

  • November 20, 2023

    Electrical Contractor’s CGL Insurers Settle Dispute Over Coverage For Defects Suit

    EL PASO, Texas — An electrical contractor’s commercial general liability insurers on Nov. 17 notified a federal court in Texas that they had reached a settlement in their dispute over their responsibility to cover their mutual insured in an underlying construction defects action and requested that the case, which was set for a bench trial on Dec. 4, be removed from the court’s docket while they finalize dismissal documents.

  • November 20, 2023

    Judge Issues Remand, Says Guaranty Association Is Insolvent Insurer’s Obligor

    NEW ORLEANS — A Louisiana federal judge granted homeowners’ motion to file an amended complaint and name the Louisiana Guaranty Association (LIGA) as a defendant in their breach of contract suit against their now-insolvent homeowners insurer for its purported failure to adequately cover their losses from Hurricane Ida, finding that LIGA is the statutory obligor for the insolvent insurer and that the case must be remanded to state court due to the absence of subject matter jurisdiction.

  • November 17, 2023

    Real Estate Law Firm Sues Cyber Security Insurer For Breach Of Contract

    ASHEVILLE, N.C. — A real estate law firm sued its insurer and a third-party administrator in a North Carolina court, seeking cyber security coverage for gross negligence and obstruction of justice cross-claims arising from a “cyber incident” in 2021 that resulted in the misdirection of funds.

  • November 17, 2023

    Borrower, Insurer Stipulate To Counterclaims Dismissal In $14.5M Loan Default Suit

    RALEIGH, N.C — A borrower sued for $14.5 million in North Carolina federal court for its alleged failure to make a first loan interest payment and a health insurer that sued it filed a joint stipulation to voluntarily dismiss the borrower’s counterclaims against the health insurer, one of three insurers in rehabilitation who sued the borrower for breach of contract.

  • November 16, 2023

    Insurer Says Dismissal Of Claims In Hurricane Damage Suit Must Be Affirmed

    RICHMOND, Va. — The Fourth Circuit U.S. Court of Appeals should affirm a district court’s dismissal of claims alleging breach of contract, bad faith and violation of North Carolina’s Unfair and Deceptive Trade Practices Act (UDTPA) against a homeowners insurer because the district court properly found that the insured’s amended complaint did not allege sufficient facts in support of the insureds’ claims, the insurer contends in its appellee brief.

  • November 16, 2023

    Flooring Subcontractor Appeals No Coverage Ruling In Gym Floor Spat To 8th Circuit

    LITTLE ROCK, Ark. — A flooring subcontractor on Nov. 15 notified a federal court in Arkansas that it is appealing to the Eighth Circuit U.S. Court of Appeals the lower court’s ruling granting summary judgment to its insurer in its breach of contract and declaratory relief action seeking coverage for the replacement of a gym floor.

  • November 16, 2023

    Shareholder Quotes Accounting Error Report In Suit Alleging Securities Violations

    NEW YORK — Quoting a press release in which a Bermuda-based insurance holding company said it “‘identified an error in the accounting for reinstatement premium’” of a specialty casualty reinsurance treaty, an individual who bought shares in the preceding months filed a putative class action under the Securities Exchange Act of 1934.

  • November 15, 2023

    Amber Heard Asks 9th Circuit To Review Dismissal Of Counterclaims In Coverage Suit

    LOS ANGELES — Amber Heard notified a California federal court that she is asking the Ninth Circuit U.S. Court of Appeals to review the court’s dismissal of her breach of contract and bad faith counterclaims in the insurer’s declaratory judgment lawsuit alleging that it has no duty to defend or indemnify her for a defamation judgment awarded to Johnny Depp.

  • November 15, 2023

    Brokers’ Dismissal, Stay Bids Are Disputed In Row Over Coverage, Fraud Claims

    NEW YORK — Claims against brokers are the focus of briefing in a row over whether policies obtained for a facility in Afghanistan are insurance or reinsurance and whether fraud or negligence were involved, with the brokers arguing in New York federal court that the claims should be dismissed or stayed and the plaintiffs contending that the claims are sufficiently stated and there is “no legal basis” for a stay.

  • November 13, 2023

    Insured Files Supplemental Authority On Applicability Of Pollution Exclusion

    SAN FRANCISCO — A few days before oral arguments were held in the Ninth Circuit U.S. Court of Appeals in a dispute over the applicability of the pollution exclusion, the insured, seeking coverage for an underlying toxic exposure suit stemming from the cleanup of wildfire debris, filed a notice of supplemental authority, urging the Ninth Circuit to consider a ruling by the Second District California Court of Appeal in support of its argument that the pollution exclusion does not bar coverage for the underlying suit.

  • November 13, 2023

    Insurer Again Seeks Rehearing In Appraisal Dispute Over Hurricane Irma Damage

    ATLANTA — An insurer on Nov. 10 filed a second petition for rehearing en banc challenging the 11th Circuit U.S. Court of Appeals’ ruling that a lower federal court’s order compelling appraisal and staying a Hurricane Irma coverage dispute pending the appraisal is an interlocutory order that is not immediately appealable under Title 28 U.S. Code Section 1292(a)(1), 28 U.S.C. § 1292(a)(1), or under the Federal Arbitration Act (FAA).

  • November 13, 2023

    Insured Condo Association Says Coverage Owed For Hidden Water Damage

    SEATTLE — A property insurer’s denial of coverage for hidden water damage discovered in the buildings of a condominium development constitutes a breach of contract and bad faith because coverage is afforded under the policies at issue, an insured condominium association says in a complaint filed in Washington federal court.

  • November 10, 2023

    Summary Judgment Bids Are Filed In Tax Penalty Row Over Microcaptive Arrangements

    FORT MYERS, Fla. — In consolidated cases involving promotion of purported microcaptive insurance companies, the plaintiffs tell a Florida federal court that they deserve summary judgment because the government hasn’t showed that they “knowingly made false or fraudulent statements,” and the government seeks “[t]o simplify trial” by obtaining partial summary judgment “on three parts of its claims or Plaintiffs’ defenses.”

  • November 10, 2023

    Airline Pilot Files Complaint Seeking Disability Benefits For Long-Haul COVID-19

    PHILADELPHIA — A disability insurer abused its discretion and breached its duty to a commercial airline pilot suffering from the effects of long-haul COVID-19 when it denied the pilot’s claim for long-term disability (LTD) benefits, the pilot claims in a complaint filed in Pennsylvania federal court.

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