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

Mealey's Insurance Pleadings

June 18, 2024
Insured Building Owner Says Lower Court Misinterpreted Policy’s Collapse Language

CINCINNATI — The Sixth Circuit U.S. Court of Appeal must reverse a district court’s ruling entered in favor of an insurer because the lower court failed to properly interpret and apply the language of the policy regarding the coverage afforded for the collapse of a wall, an insured building owner says in its June 17 appellant brief.
June 18, 2024
Insurer Urges N.Y. Federal Judge To Allow Interlocutory Appeal To 2nd Circuit

NEW YORK — A commercial lines insurer reiterates in a reply brief filed in New York federal court that an interlocutory appeal of a New York federal judge’s ruling to the Second Circuit U.S. Court of Appeals is warranted because the issue of whether a communicable disease exclusion bars coverage for three underlying lawsuits alleging that residents of the insured properties contracted Legionnaires’ disease presents a controlling question of law and an immediate appeal could result in the dismissal of all the claims.
June 17, 2024
Settlement Reached In Suit Alleging Insurer Fraudulently Down-Coded Medical Devices

MINNEAPOLIS — The manufacturer and seller of an electrotherapy medical device and its insurer told a Minnesota federal court that they have reached a settlement in principal of the insured’s breach of contract and deceptive trade practices lawsuit alleging the insurer has a “blanket corporate policy” of fraudulently down-coding and short-paying for the insured’s H-Wave medical devices that has resulted $1.3 million in injuries to the insured.
June 17, 2024
Lakers, Insurer Dismiss Coronavirus Coverage Dispute In California Federal Court

LOS ANGELES —The Los Angeles Lakers and its commercial property insurer filed a stipulation asking a California federal court to dismiss with prejudice the insured’s lawsuit arising from its property damage and business interruption claims for losses related to the COVID-19 pandemic.
June 17, 2024
Insurer Disputes Coverage For Claims Daycare Gave Benadryl Without Consent

SEATTLE — A homeowners insurer filed a lawsuit in a Washington federal court seeking a declaratory judgment that it has no duty to defend its insureds and a child care center against underlying lawsuits alleging that their minor children were given Benadryl without parental consent to promote sleepiness at nap time.
June 10, 2024
Insurer Seeks Dismissal Of Contractor From Coverage Dispute While Appeal Continues

CHEYENNE, Wyo. — A subrogated homeowners insurer filed a stipulation of dismissal in a Wyoming federal court, seeking dismissal with prejudice of all its claims against a general contractor, while the insurer’s appeal of a Wyoming federal judge’s ruling that its claim against an engineer that designed a home’s plumbing is time-barred remains pending.
June 10, 2024
Insureds Urge 8th Circuit To Find Pollution Exclusion Does Not Bar Coverage

ST. LOUIS — A pollution exclusion does not bar coverage for an underlying bodily injury claim stemming from carbon monoxide exposure because the pollution exclusion applies only to traditional environmental pollution claims, the insureds claim in their appellant reply brief filed in the Eighth Circuit U.S. Court of Appeals.
June 10, 2024
Coverage Excluded For Child’s Injury Caused By Chemical In Mints, Insurer Says

ST. LOUIS — No coverage is owed to insureds for an underlying suit seeking damages caused by a child’s ingestion of liquid breath mints that contained a chemical that damaged the child’s esophagus because the policy’s pollution exclusion applies as a bar to coverage, an insurer says in a complaint filed in Missouri federal court.
June 07, 2024
Disability Claimant Says Any-Occupation Benefits Are Owed By Disability Insurer

SAN DIEGO — A disability insurer abused its discretion in determining that a disability claimant is not disabled from performing the duties of any occupation based on symptoms related to the claimant’s diagnoses of fibromyalgia and ankylosing spondylosis because the medical evidence submitted by the claimant supports a finding that the claimant is disabled from performing the duties of any occupation, the claimant maintains in a June 6 complaint filed in California federal court.
June 07, 2024
Former NFL Player Files Notice Of Appeal After Dismissal Of Suit

ATLANTA — A former National Football League player who claims that he is owed additional disability benefits filed a notice of appeal to the 11th Circuit U.S. Court of Appeals, seeking review of the lower court’s dismissal of his second amended complaint based on a finding that he failed to exhaust all administrative remedies and failed to show that exhaustion would be futile.
June 05, 2024
Illinois Supreme Court Considers Whether Insurer Is Entitled To Subrogation

SPRINGFIELD, Ill. — The Illinois Supreme Court heard arguments over whether an insurer can pursue subrogation on behalf of an entity it did not have a contract with based only on an “insurable interest” as the court considered whether an insurer met the prerequisites for equitable subrogation in a coverage case stemming from flooding of a Chicago college building.
June 03, 2024
Relator In FCA Suit Alleging Medicare Advantage Fraud Seeks To Compel Discovery

TAMPA, Fla. — Medicare Advantage (MA) insurers and a relator in a qui tam suit brought on behalf of the federal government filed separate motions to compel discovery in a Florida federal court in a relator’s suit alleging that medical providers and the insurers violated the federal False Claims Act (FCA) by conspiring together to increase risk adjustment scores of MA patients to obtain more federal funding than was owed.
June 03, 2024
Constructive Denial, Other Issues Disputed In Appeal Over Crop Insurance Probe

CINCINNATI — In a Sixth Circuit U.S. Court of Appeals crop insurance case where farmers who sued over a “never-ending stalled investigation” are seeking partial vacatur of a dismissal ruling, federal regulators, the insurer and the farmers have filed briefs disputing issues including sovereign immunity waivers and constructive denial.
May 31, 2024
Fund Defends Bad Faith, Other Claims Against Dismissal Bid In Reimbursement Case

MONTGOMERY, Ala. — Urging an Alabama federal court to deny dismissal motions in a dispute over reimbursement for workers’ compensation claims, the plaintiff argues in part that a bad faith claim is proper because it “is not an ‘insurer’ under Alabama law and is not a party to a reinsurance contract with Defendants.”
May 29, 2024
Winemaker Adds Bad Faith Claim In Washington Coverage Suit Over Defective Wine

SEATTLE — A wine producer amended its complaint in a Washington court adding claims against its insurer for breach of the duty of good faith and fair dealing and violations of Washington’s Consumer Protection Act and the Insurance Fair Conduct Act in its lawsuit seeking coverage for the “tragic damage to 320,922 cases of premium Washington wine” that resulted in a loss of more than $8 million.
May 28, 2024
Estate Seeks Panel Rehearing In Coverage Dispute Arising From Wrongful Death

CINCINNATI — An estate that brought an underlying wrongful death lawsuit against an insured asked the Sixth Circuit U.S. Court of Appeals to reconsider its ruling that affirmed the part of a lower federal court’s order that determined that a commercial general liability insurance policy’s assault and battery exclusion relieved the insurer of its duty to indemnify.
May 22, 2024
2 More Insurers Dismissed In Viacom’s D&O Coverage Dispute In Delaware Court

WILMINGTON, Del. — Viacom Inc. and two more of its insurers stipulated and agreed to dismiss with prejudice the claims against the insurers in Viacom’s lawsuit seeking directors and officers liability coverage for underlying claims that its directors, officers and controlling shareholders breached their fiduciary duties in connection with a 2019 merger with CBS Corp.
May 17, 2024
Burger King Franchisee Seeks Summary Judgment In BIPA Violations Coverage Suit

CHICAGO — A franchisee of the Burger King chain moved for summary judgment in its breach of contract lawsuit asking an Illinois federal judge to declare that an excess insurer has a duty to defend it against an underlying putative class lawsuit alleging that it violated the Illinois Biometric Information Protection Act (BIPA).
May 17, 2024
Pollution Exclusion Bars Coverage For Carbon Monoxide, Insurer Tells 8th Circuit

ST. LOUIS — A pollution exclusion clearly bars coverage for an underlying bodily injury claim stemming from carbon monoxide exposure because carbon monoxide qualifies as a contaminant or irritant under the pollution exclusion, an insurer says, noting in its May 16 appellee brief filed in the Eighth Circuit U.S. Court of Appeals that its interpretation of the pollution exclusion is consistent with North Dakota law.
May 16, 2024
Contractor Says 7th Circuit Opinion Conflicts With Illinois Insurance Law

CHICAGO — A general contractor petitioned the Seventh Circuit U.S. Court of Appeals for en banc rehearing, arguing that a recent opinion in which a panel found that the contractor was not owed a defense or indemnification because defective welding it performed at O’Hare International was not “property damage” under the terms of insurance policies cannot be squared away with “well settled Illinois law requiring insurers to defend policyholders unless the underlying facts pled preclude any possibility of coverage.”
May 16, 2024
Guaranty Association Says It Reached Settlement With Homeowner Over Unpaid Claim

FORT MYERS, Fla. — The Florida Insurance Guaranty Association (FIGA) notified a Florida state court that it reached a settlement in a suit filed against it by a homeowner seeking indemnification for an unpaid claim for home damage after her insurer was ordered into liquidation.
May 15, 2024
On Appeal, Parties Argue Property Interest In ACA Reinsurance Takings Case

WASHINGTON, D.C. — Arguing primarily that the Transitional Reinsurance Program (TRP) of the Patient Protection and Affordable Care Act (ACA) “did not implicate a cognizable property interest,” the government filed an appellee brief urging the Federal Circuit U.S. Court of Appeals to affirm rulings against two self-insured group health plan trusts.
May 14, 2024
Multifamily Housing Lessor Seeks Coverage For Antitrust Conspiracy Claims In MDL

DENVER — A multifamily housing lessor insured sued its primary and excess data protection liability insurers in a Colorado federal court for breach of contract and bad faith, seeking coverage for an underlying multidistrict litigation alleging that it was involved in an antitrust conspiracy when it used a revenue management software to artificially inflate multifamily housing rents above market across the country.
May 14, 2024
4 Entities Hurt By Vesttoo Collapse Sue China Construction Bank, Others For Fraud

NEW YORK — Asserting that they were some of the “biggest victims” of the alleged fraud underlying the collapse of Vesttoo Ltd., entities including Porch Group Inc. and Homeowners of America Insurance Co. (HOA) sued China Construction Bank Corp. (CCBC) and related parties in a New York federal court for fraud and negligent supervision and retention.
May 14, 2024
Insureds Take No Position On Motion For Interlocutory Appeal In Contamination Suit

EAST ST. LOUIS, Ill. — Insureds embroiled in an environmental contamination coverage dispute responded to their insurers’ motion to certify an Illinois federal judge’s choice-of-law ruling for interlocutory appeal to the Seventh Circuit U.S. Court of Appeals, noting that while they disagree with the insurers’ factual and legal analysis in the motion to certify, they understand the insurers’ desire to have the issue reviewed and take no position on the motion for leave to file an interlocutory appeal.