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

Mealey's Insurance Pleadings

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.
May 13, 2024
Appellant Seeks Rehearing Of No Coverage Ruling In Dispute Over Gold Treasure

SEATTLE — An appellant on May 10 asked the Ninth Circuit U.S. Court of Appeals to rehear its April 26 opinion that affirmed a lower federal court’s summary judgment ruling in favor of an ocean marine general liability insurer in a declaratory judgment lawsuit disputing coverage for an underlying $7.5 million covenant judgment that resolved claims that the appellant was denied possession and use of the tangible and intangible work product that was created during gold salvage expeditions.
May 13, 2024
Insured Opposes Interlocutory Appeal, Says No Controlling Question Of Law Exists

NEW YORK — An insured says a commercial lines insurer’s motion for interlocutory appeal of a New York federal judge’s ruling to the Second Circuit U.S. Court of Appeals should be denied because no controlling question of law exists regarding whether a policy’s communicable disease exclusion applies as a bar to coverage for three underlying lawsuits alleging that residents of the insured properties contracted Legionnaires’ disease.
May 13, 2024
Citing Jury Verdict, Plaintiffs Seek Attorney Fees From U.S. In Microcaptive Row

FORT MYERS, Fla. — Following a Florida federal jury ruling against the government in consolidated cases over whether the plaintiffs’ involvement with purported microcaptive insurance companies constituted promotion of abusive tax shelters, the corporate plaintiffs are seeking approximately $600,000 in attorney fees and costs, and the government is countering in part that its position was “substantially justified.”
May 13, 2024
Parties Brief Summary Judgment Arguments On Reinsurance Loss Allocation

MONTGOMERY, Ala. — In renewed briefing, parties in a suit over multiple reinsurance disputes make summary judgment arguments on a single breach of contract claim, with the reinsurer arguing that the loss for the lawsuit at issue “was properly ceded to the two impacted Treaties” and the insurer contending that the policy requires the two events at issue in the lawsuit “to be treated as one Wrongful Act.”
May 10, 2024
Pharmacy Distributor Appeals No Coverage Ruling In Suit Prompted By Opioid Epidemic

VALDOSTA, Ga. — A pharmacy distributor insured indicated to a Georgia federal court that it is asking the 11th Circuit U.S. Court of Appeals to review the court’s grant of summary judgment in favor of its commercial general liability and umbrella insurers in a coverage dispute arising from the opioid epidemic.
May 10, 2024
Attorney Says Termination Of Disability Benefits Was Arbitrary, Capricious

PHILADELPHIA — A disability insurer acted arbitrarily and capriciously when it terminated an attorney’s long-term disability (LTD) benefits because the insurer failed to consider the actual duties of the claimant’s occupation when it determined that the claimant was no longer disabled from her own occupation as an attorney, the attorney says in a complaint filed in Pennsylvania federal court.
May 10, 2024
Defendants Renew Dismissal Arguments In Workers’ Comp Reimbursement Dispute

MONTGOMERY, Ala. — After an Alabama federal judge allowed the plaintiff to file an amended complaint in a dispute over reimbursement for workers’ compensation claims, the defendants started a new round of dismissal briefing regarding breach of contract, bad faith, laches and equitable estoppel claims.
May 08, 2024
Timeliness, Other Issues Raised Over Motion For Final Judgment, Certification

SPRINGFIELD, Ill. — Arguing in part that “if an interlocutory appeal were to be sought, it should have been sought in 2022,” a reinsurer urged an Illinois federal court to deny a motion in which a railroad company seeks “two alternative grounds for appellate jurisdiction” in a suit over mine subsidence claims.
May 08, 2024
Insurers Say Coverage Barred In AFFF PFAS Cases Because Harm Arises Out Of ‘Waste’

CHARLESTON, S.C. — A group of insurers has filed a sur-reply brief in South Carolina federal court arguing that the majority of lawsuits against a maker of the firefighting agent known as aqueous film forming foam (AFFF), for which the insurers are being asked to provide coverage, allege harm arising out of “waste,” rather than harm associated with a product put to its intended use, and, therefore, coverage is not owed.
May 07, 2024
Claimant Files Complaint, Says LTD Benefits Owed For Long COVID Diagnosis

PHOENIX — A denial of long-term disability (LTD) benefits was arbitrary and capricious and an abuse of discretion because the disability insurer failed to properly consider the restrictions and limitations set by the claimant’s treating physicians as a result of the claimant’s diagnosis with long COVID, the claimant contends in a complaint filed in Arizona federal court.
May 07, 2024
Pollution Exclusion Bars Coverage For Dust Emissions Suit, Insurer Says

BROWNSVILLE, Texas — No coverage is owed to an insured for an underlying lawsuit stemming from dust emissions from the insured’s facility because the policy’s pollution exclusion bars coverage for the lawsuit, an insurer maintains in a complaint filed in Texas federal court.