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

Mealey's Insurance Pleadings

June 26, 2024
CGL Insurer Disputes Coverage For Suit Against U.S. Paralympic Committee

DENVER — A commercial general liability insurer filed suit in a Colorado federal court seeking a declaratory judgment that it has no duty to defend or indemnify the U.S. Olympic and Paralympic Committee (USOPC) for a paralympic swimmer’s lawsuit alleging that a team member sexually assaulted and harassed him and that USOPC failed to warn his parents about the team member or supervise the accused.
June 25, 2024
CGL Insurer, Insured Settle And Dismiss Coverage Dispute Over Trade Secret Lawsuit

BOSTON — A commercial general liability insurer and its insured filed stipulations of dismissal after advising a Massachusetts federal court that they have settled their dispute over defense costs for an underlying trade secret lawsuit brought against the insured by its competitor.
June 25, 2024
Supermarket Sues Insurer For Bad Faith In Suit Arising From Parking Lot Shooting

ALLEGHENY, Pa. — Giant Eagle Inc. sued an insurer for bad faith, unjust enrichment and equitable contribution/indemnification seeking to recoup the more than $450,000 that it has incurred in defending against a lawsuit alleging that a police officer who was working as an off-duty security guard unlawfully shot a man in a Giant Eagle supermarket parking lot.
June 24, 2024
Insurer Appeals Rulings In Construction Insurance Suit Prompted By Sprinkler Leak

BATON ROUGE, La. — An excess insurer filed a notice indicating that it is appealing a Louisiana federal court’s rulings that first granted a manufacturer’s motion for summary judgment in a construction insurance dispute stemming from damages caused by a sprinkler leak and then dismissed all of the excess insurer’s claims against the manufacturer with prejudice.
June 24, 2024
Former Underwriter Is Sued Over Facultative Retrocession Deal, Other Allegations

MIAMI — Asserting claims for breach of contract and unjust enrichment, two affiliated companies sued a former underwriter in Florida federal court over conduct they allege included greatly exceeding his authority by executing a facultative retrocession agreement to cover a risk of more than $44 million.
June 24, 2024
District Court’s Collapse Ruling Must Be Reversed, Contractor Tells 6th Circuit

CINCINNATI — A federal judge erred in finding that no coverage is owed for a structurally unsound wall that remained standing after a portion of the wall collapsed during a building renovation because the lower court failed to apply Tennessee law in construing the meaning of the term collapse in the insurer’s policy, a building contractor says in its June 21 appellant brief filed in the Sixth Circuit U.S. Court of Appeals.
June 18, 2024
Guaranty Association Files Brief In Support Of Judgment In MSP Suit Against CMS

RALEIGH, N.C. — The North Carolina Insurance Guaranty Association (NCIGA) filed a brief in North Carolina federal court supporting its motion for summary judgment in its suit against the U.S. Department of Health and Human Services (DHHS), its secretary and the Centers for Medicare and Medicaid Services (CMS), seeking a determination that the NCIGA is not a primary plan under the federal Medicare Secondary Payer (MSP) statute and, therefore, not obligated to reimburse CMS regarding a workers’ compensation claim involving an insolvent insurer.
June 18, 2024
Insurer Says No Coverage Owed For Suit Stemming From Insured’s Fertilizer Plant

TYLER, Texas — An insurer filed suit in Texas federal court against its insured, seeking a declaration that it has no duty to defend or indemnify its insured for an underlying suit arising out of the insured’s operation of a fertilizer plant because the insured failed to timely notify the insurer of the suit and because the policies’ pollution exclusion bars coverage.
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.