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

Mealey's Insurance Pleadings

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.
November 08, 2023
Settlement Reached In Coverage Row With Care Home, Insurer, Ancillary Care Company

ASHEVILLE, N.C. — A nursing home and an ancillary care company and its insurer on Nov. 7 filed a stipulation of dismissal in North Carolina federal court advising that they settled the nursing home’s breach of contract suit against the company and insurer seeking to have them indemnify and defend the nursing home in an underlying arbitration proceeding related to the death of a former resident.
November 06, 2023
Insured Municipality Files Suit, Says Coverage Owed For Remediation Costs

TRENTON, N.J. — A premises pollution liability insurer breached its contract and acted in bad faith by denying coverage for environmental contamination remediation costs incurred by an insured municipality because the policy obligates the insurer to provide coverage for the remediation costs, the insured says in a complaint filed in New Jersey state court.
November 06, 2023
GEICO Files $1.8M Suit Against Doctor, Pain Clinic Over Fraudulent PIP Claims

NEWARK, N.J. — GEICO filed suit in a New Jersey federal court against doctors and other medical practitioners and their practices, alleging that they participated in a “complex fraudulent scheme” to submit fraudulent personal injury protection (PIP) billing to GEICO for services that were either not performed or not medically necessary, resulting in damages to GEICO of more than $1.8 million.
November 06, 2023
Contractor, Insurer Object To Recommendations In Sewer Pipe Coverage Row

SEATTLE — An insurer and a contractor have filed objections to a magistrate judge’s recommendations related to several summary judgment motions in a coverage dispute over the contractor’s alleged faulty construction of a conveyance pipe for a sewer overflow control project, with the contractor arguing that a Washington federal judge should find that it owes no duty to defend the contractor because there is no coverage available to the contractor as an additional insured and that summary judgment should be denied for the contractor’s insurer, and the contractor objecting to the magistrate’s recommendation on defense costs owed by the insurer.
November 01, 2023
Reinsurer Makes Disputed Intervention Bid In Row Between Insurer And Agent

NEW ORLEANS — A captive cell reinsurer seeking to intervene in a dispute between an insurer and a managing general agent (MGA) in Louisiana federal court argues in an Oct. 31 reply brief that it “has satisfied the Fifth Circuit’s four-part test for intervention as a matter of right.”
November 01, 2023
Employer Seeks Coverage For Class Action Suit Alleging BIPA Violations

CHICAGO — An employer sued its insurer in an Illinois federal court seeking commercial general liability and umbrella insurance coverage for an underlying putative class action alleging that it violated the Illinois Biometric Information Privacy Act (BIPA) by disseminating electronic information derived from the scanning of its employees’ biometric identifiers to third parties without their consent.
October 30, 2023
Maritime Insurer Seeks Rehearing In Suit Seeking Recoupment Of Benefits Paid

NEW ORLEANS — An insurer seeks a panel rehearing challenging the Fifth Circuit U.S. Court of Appeals’ ruling that it has a duty to pay the maintenance and cure under a maritime protection and indemnity (P&I) insurance policy for a seaman’s injuries that he incurred while employed on a lift boat, arguing that the court’s ruling “draws a line” in P&I coverage and that this line “will create significant challenges in the marine insurance industry for both underwriters and assureds.”
October 30, 2023
Fronting Company Dismisses Suit Against Captive Reinsurer Over Penalty

NEW YORK — A fronting company voluntarily dismissed a case in which it sought to hold a captive reinsurer responsible for a penalty over what it alleged were $2,207,896 in misdirected payments, filing an Oct. 27 notice in New York federal court.
October 30, 2023
Harvard Sues Broker For Failing To Notify Excess E&O Insurers Of ‘Major’ Claim

BOSTON — President and Fellows of Harvard College sued its insurance broker in a Massachusetts court for malpractice, breach of contract and declaratory relief, seeking damages for the broker’s alleged failure to provide notice to Harvard’s excess errors and omissions insurers of an underlying action alleging that its consideration of a student’s race in its college admissions process violated Title VI of the Civil Rights Act.
October 27, 2023
Physician Appeals $27M Judgment In FCA Suit Over ‘Alternative’ Therapy Billing

ROME, Ga. — A physician and his medical practice provided notice to a Georgia federal court that they are appealing to the 11th Circuit U.S. Court of Appeals a $27,567,729 judgment for violations of the False Claims Act (FCA) related to billing Medicare for use of a chelation therapy drug for “alternative” therapy not covered by Medicare after a jury returned a verdict for the U.S. government, finding that all 4,407 claims submitted for reimbursement violated the FCA.
October 26, 2023
Subcontractor’s Insurer Appeals Judgment In Pavement Coverage Row To 7th Circuit

CHICAGO — A subcontractor’s insurer on Oct. 25 appealed to the Seventh Circuit U.S. Court of Appeals an Illinois federal judge’s decision in a coverage dispute over the failure of pavement at a Michigan outlet mall to deny its motion for summary judgment and grant the competing summary judgment motion of another subcontractor’s insurer because the underlying complaint does not allege an “occurrence” or “property damage” to trigger the second insurer’s duty to defend.
October 25, 2023
Insurers, Contractor Address Rain Exclusion In Briefing Before 9th Circuit

SAN FRANCISCO — A contractor “argues it can sidestep the Rain Exclusion by recharacterizing the rain and snow that fell on the incomplete roof as a different ‘peril’ than that contemplated by the” exclusion, but the exclusion “unambiguously contemplates and excludes damage from rain and snow that damages the Project’s interior before its roof is finished,” the contractor’s all-risk insurers say in urging the Ninth Circuit U.S. Court of Appeals to affirm a lower court’s grant of summary judgment in their favor.
October 25, 2023
Homeowner Sues Guaranty Association, Cites ‘Duty To Indemnify’ For Unpaid Claim

FORT MYERS, Fla. — A homeowner alleging that her insurer failed to pay any part of a claim for home damage sued the Florida Insurance Guaranty Association (FIGA) in a Florida state court, asserting that because FIGA is the statutory receiver for the insurer that was ordered into liquidation, it “has a duty to indemnify” the homeowner for the unpaid claim.