Mealey's Insurance Pleadings : Mealey's : Legal News & Analysis

Mealey's Insurance Pleadings

August 15, 2023
Parties Argue Tolling, Accrual Of Illegal Exaction Claim In ACA Reinsurance Cases

WASHINGTON, D.C. — In a U.S. Court of Federal Claims brief opposing dismissal, 10 group health plans alleging that the government illegally exacted contributions from them under the Transitional Reinsurance Program (TRP) of the Patient Protection and Affordable Care Act (ACA) argue that their claims are timely under “tolling principles that have long been applied by this Court.”
August 15, 2023
Doctor Asks 4th Circuit To Set Aside $5.5M Conditional Judgment In FCA Suit

RICHMOND, Va. — A physician and his wife urge the Fourth Circuit U.S. Court of Appeals to set aside a $5.5 million consent judgment entered by a district court against them after they entered into a settlement agreement with the federal government and state of North Carolina in a suit alleging violations of the federal False Claims Act (FCA) and North Carolina False Claims Act (NCFCA), arguing, in part, that the lower court erred by dismissing their motion to set aside the judgment without a hearing.
August 15, 2023
Hotel Owners Seek Dismissal Of Insurer’s Coverage Suit Over Sex-Trafficking Claims

HOUSTON — Hotel insureds asked a federal court in Texas to dismiss a commercial general liability insurer’s lawsuit seeking a declaration that it has no duty to defend and indemnify them against an underlying lawsuit alleging that a woman was abused and molested as a minor while in the insureds’ “care, custody or control,” arguing that the insurer’s lawsuit is not ripe for consideration and that the amended complaint does not invoke the federal court’s subject matter jurisdiction.
August 15, 2023
Insurer Says District Court’s Ruling On Misrepresentations Must Be Reversed

ATLANTA — A district court’s ruling that an insurer could not demonstrate reliance upon its insureds’ fraudulent misrepresentations regarding mold damage in an insured hotel must be reversed because the district court failed to view the evidence in the insurer’s favor as the nonmoving party, an insurer argues in a cross-appeal reply brief filed in the 11th Circuit U.S. Court of Appeals.
August 14, 2023
In Post-Trial Briefs, Parties Spar Over Nonpublic Info On Captive Reinsurer

WILMINGTON, Del. — Post-trial briefs have been filed in the Delaware Court of Chancery in a suit over a captive reinsurer that issued dividends totaling approximately $1.2 billion, with a hedge fund arguing that it is entitled to nonpublic information under Delaware law and a public holding company asserting several contentions against that premise.
August 10, 2023
Disability Plan’s Termination Of Benefits Was Arbitrary, Capricious, Claimant Says

PORTLAND, Ore. — A disability plan’s termination of long-term disability (LTD) benefits was arbitrary and capricious because the plan’s termination was not based on substantial evidence showing that the claimant was no longer disabled from performing the duties of his own occupation as a software development engineer, the claimant says in a complaint filed in Oregon federal court.
August 10, 2023
LTD Benefits Owed Under Disability Plan, Claimant Says In Complaint

BOSTON — A disability insurer wrongfully terminated a claim for long-term disability (LTD) benefits because the claimant remains disabled from performing the duties of any occupation as required by the disability plan, the claimant contends in a complaint filed in Massachusetts federal court.
August 09, 2023
Amici File Supreme Court Briefs In Support Of Insured In Marine Coverage Dispute

WASHINGTON, D.C. — Three amicus curiae briefs were filed in support of an insured asking the U.S. Supreme Court to reject a maritime insurer’s petition for writ of certiorari that was limited to the question: “Under federal admiralty law, can a choice of law clause in a maritime contract be rendered unenforceable if enforcement is contrary to the ‘strong public policy’ of the state whose law is displaced?”
August 09, 2023
Urban Outfitters Asks 3rd Circuit To Stay Appeal Of Coronavirus Coverage Suit

PHILADELPHIA — URBN US Retail LLC (Urban Outfitters) asked the Third Circuit U.S. Court of Appeals to stay its appeal of a lower federal court’s dismissal of its coverage lawsuit arising from the COVID-19 pandemic until the Pennsylvania Supreme Court has decided two cases that involve “the same issues of insurance law.”
August 08, 2023
State Farm: AI Claims Handling Allegations Don’t Establish Fair Housing Case

CHICAGO — Property insurance lacks sufficient connection to the sale of a home for liability under the Fair Housing Act (FHA), an insurer tells a federal judge in Illinois in urging dismissal of claims alleging that the company employs a discriminatory artificial intelligence during the claims handling process.
August 07, 2023
Health System Urges Magistrate Not To Reopen ‘Long-Deceased’ FCA Suit

NEW YORK — A state health system urged a New York federal magistrate judge not to grant a whistleblower physician’s motion to reopen a federal and state false claims act violations suit alleging fraudulent Medicare and Medicaid billing by the health system, asserting that there is no evidence that the alleged misconduct “deceived the Court” in the “long-deceased” case.
August 07, 2023
No Coverage Owed For Underlying PFAS Contamination Suit, Insurer Says In Complaint

HOUSTON — No coverage is owed to an insured for an underlying suit arising out of the contamination of containers with perfluoroalkyl and polyfluoroalkyl substances (PFAS) because the contamination occurred prior to the effective date of a primary pollution liability policy and an environmental excess liability policy, an insured maintains in a complaint filed Aug. 4 in Texas federal court.
August 04, 2023
Insurer Files 4th Suit Seeking Asbestos Settlement Reimbursement From Reinsurers

OMAHA, Neb. — An insurer that has invoked reinsurance contracts in seeking reimbursement for a settlement it reached with Montana regarding alleged asbestos exposures has filed its fourth similar lawsuit in Nebraska federal court.
August 03, 2023
Parties Make Summary Judgment Arguments In Defense Costs Row Involving Reinsurer

DETROIT — In competing Aug. 2 summary judgment motions in Michigan federal court in a dispute over defense costs, the parties urged different interpretations of the umbrella policies the reinsurance liability follows and the reinsurer argued that collateral and judicial estoppel apply.
August 02, 2023
Insured Responds To Insurer’s High Court Appeal Of Marine Coverage Dispute

WASHINGTON, D.C. — Arguing that a maritime insurer relies on “irrelevant dicta in old maritime cases that say nothing about the enforceability of choice-of-law provisions dictating that a particular state’s law will apply,” an insured asks the U.S. Supreme Court to reject the insurer’s petition for writ of certiorari that was limited to the question: “Under federal admiralty law, can a choice of law clause in a maritime contract be rendered unenforceable if enforcement is contrary to the ‘strong public policy’ of the state whose law is displaced?”
August 01, 2023
Summary Judgment On False Claims Act Counts Disputed In Crop Insurance Case

YAKIMA, Wash. — Opposing the government’s bid for summary judgment on counts asserted under the False Claims Act (FCA), a farmer argues in Washington federal court that the crop insurance row “stems from an essential misunderstanding of facts by the Plaintiff and conflation of various entities with” his “personal involvement.”
August 01, 2023
Insured Seeks 11th Circuit Panel Rehearing In Water Damage Suit

ATLANTA — An insured says panel rehearing of the 11th Circuit U.S. Court of Appeals’ decision affirming a district court’s ruling in favor of a commercial liability insurer in a water damage coverage dispute is warranted because the 11th Circuit panel did not properly interpret a policy’s water exclusion.
July 31, 2023
Insurer Files Complaint, Says No Coverage Owed For Underlying Lead Poisoning Suit

DETROIT — No coverage is owed to insureds for an underlying bodily injury suit arising out of lead paint exposure because the commercial general liability policy’s lead and hazardous properties exclusion bars coverage, the insurer asserts in a complaint filed in Michigan federal court.
July 28, 2023
Summary Judgment Issues In Quota Share Reinsurance Row Include Notice, Prejudice

DALLAS — Parties in a breach suit over a first-dollar quota share reinsurance contract have completed briefing on competing summary judgment motions in Texas federal court, arguing issues including whether the notice provision imposes an objective or subjective standard and whether the reinsurer can show prejudice arising from the allegedly late notice.
July 25, 2023
Farmers Cooperative Appeals Rulings In Defective Silo Construction Coverage Case

LAREDO, Texas — A farmers cooperative has appealed to the Fifth Circuit U.S. Court of Appeals a Texas federal judge’s June ruling that the insurer of a contractor it hired to build two grain silos has no duty to indemnify the contractor in the cooperative’s underlying lawsuit alleging that the construction was defective because the cooperative did not incur any “property” damage to trigger coverage and the policy exclusions bar coverage even if the underlying damages were deemed “loss of use” property damage.
July 25, 2023
Glass Installer Appeals Ruling For CGL, Umbrella Insurers To 3rd Circuit

CAMDEN, N.J. — A glass installer has appealed to the Third Circuit U.S. Court of Appeals a New Jersey federal judge’s June ruling that its commercial general liability and umbrella insurers are not liable to cover defense and indemnity costs it incurred in settling an underlying action alleging that a glass curtain wall it installed became visibly obstructed by a dark “dripping” material because there was no property damage caused by an occurrence during the policy periods.
July 25, 2023
Judge Denies Roofing Insurer’s Motion To Reconsider Dismissal Of Declaratory Action

PHILADELPHIA — A federal judge in Pennsylvania has denied an insurer’s request for reconsideration of the dismissal of its declaratory relief action stemming from two negligence and faulty work lawsuits against its roofing contractor insured, saying he “properly interpreted and applied the law, and did not rely upon erroneous factual conclusions” when he dismissed the case sua sponte for lack of jurisdiction.
July 25, 2023
Asbestos Firms, Insolvent Insurer Group Duel In Settlement Appeal

NEW ORLEANS — An appeal by two asbestos law firms of a Louisiana federal bankruptcy judge’s approval of a $1 million settlement between the Chapter 7 trustee for a bankrupt insulation supplier and the Louisiana Insurance Guaranty Association (LIGA) should be tossed because the firms’ arguments against dismissal “focus primarily on rehashing their arguments before the Bankruptcy Court,” the trustee and LIGA argue in a reply brief in federal court.
July 24, 2023
No Additional Abrupt Collapse Coverage Owed, Insurer Argues To 10th Circuit

DENVER — An insurer and its claims service manager argue to the 10th Circuit U.S. Court of Appeals that a building owner insured is owed no coverage under an insurance policy’s additional abrupt collapse coverage, contending that the insured’s building “did not collapse because its structural capacity was not ‘substantially’ or ‘significantly’ impaired.”
July 24, 2023
Insurer, Insured Stipulate To Dismissal In Classic Car Policy Coverage Dispute

DENVER — An insurer and its insured stipulated to dismissal of claims against each other in a Colorado federal court regarding alleged material misrepresentations the insured made in procuring a classic car insurance policy and the insurer’s denial of coverage for the insured’s allegedly stolen cars.