SEATTLE — Whether a health insurance policy’s “medically necessary” language required coverage of a man’s proton beam therapy confronts the Washington Supreme Court after it recently received supplemental briefing (John Strauss, et al. v. Premera Blue Cross, No. 74600-6-I, Wash. Sup.).
NEW YORK — A plaintiff in a proposed class action on Sept. 7 opposed a life insurer’s motion to dismiss his New York federal court lawsuit alleging breach of policies by the unlawful increase of the premium costs to recoup costs associated with an acquisition (Derek Fan, et al. v. Phoenix Life Insurance Co., et al., No. 18-01288, S.D. N.Y.).
ST LOUIS — A Missouri appeals court is set to decide whether a trial court erred in finding that a grandmother owned the car she bought for her grandson and whether his stays with her constituted a residence after hearing oral arguments on Sept. 4 (Columbia Mutual Ins. Co. v. Crystal Lee, No. SD 35153, Mo. App.).
TALLAHASEE, Fla.— An insurer recently asked the Florida Supreme Court to find, in answer to a certified question by the Fifth District Court of Appeal, that an automobile insurance policy’s personal injury protection benefits’ reimbursement limitation must be applied before the PIP deductible in its dispute with a medical provider (Progressive Select Insurance Co. v. Florida Hospital Medical Center Inc., No. SC18-278, Fla. Sup.).
DENVER — An insured recently asked the 10th Circuit U.S. Court of Appeals to reverse a lower federal court’s finding that he failed to show that material issues of fact exist as to whether his insurer acted in bad faith in denying his claim for coverage under the terms of a commercial property insurance policy (Billy Hamilton v. Northfield Ins. Co., No. 17-7049, 10th Cir.).
MADISON, Wis. — The Wisconsin Supreme Court heard oral arguments on Sept. 5 in a case in which insurance companies are debating whether the damage caused by a fire that spread over 8,000 acres constitutes one occurrence or multiple occurrences (Secura Insurance v. Lyme St. Croix Forest Company, et al., No. 2016AP299, Wis. Sup.).
WASHINGTON, D.C. — Congress’ subsequent actions clearly and unequivocally limited payments in the Patient Protection and Affordable Care Act (ACA) risk corridor to income received through the program, regardless of the language it used in enacting the program, the government said Aug. 31 in urging the Federal Circuit U.S. Court of Appeals to deny a series of insurer’s request for en banc rehearing (Land of Lincoln Mutual Health Insurance Co. v. United States, No. 17-1224, Moda Health Plan Inc. v. United States, No. 17-1994, Blue Cross and Blue Shield of North Carolina v. United States, No. 17-2154, Maine Community Health Options v. United States, No. 17-2395, Fed. Cir.).
SYRACUSE, N.Y. — An insurer and its reinsurer filed briefs on Aug. 28 regarding a variety of coverage issues in their New York federal court dispute over whether the reinsurer is obligated to pay $3.2 million in reinsurance proceeds for the insurer’s defense expenses from an asbestos claims settlement (Utica Mutual Insurance Co. v. Munich Reinsurance America Inc., Nos. 12-00196 & 13-00743, N.D. N.Y.).
WASHINGTON, D.C. — In a breach of contract dispute over a reinsurance participation agreement (RPA), a blue jean manufacturing company and its subsidiary in an Aug. 22 brief oppose a petition asking the U.S. Supreme Court to decide whether a choice-of-law clause imports “state substantive law without importing state rules impairing arbitration” or whether the clause incorporates “both state substantive law and state arbitration principles” (Applied Underwriters Inc., et al. v. Citizens of Humanity, et al., No. 18-175, U.S. Sup.).
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals should reverse a district court’s ruling that California law, rather than Alabama law, applies to an environmental contamination coverage suit because Alabama clearly has the greater interest in applying its law to the coverage dispute, an insured argues in its Aug. 20 appellant brief (Arrow Electronics Inc. v. Aetna Casualty & Surety Co., et al., No. 18-55810, 9th Cir.).
NEW YORK — An insurer on July 12 asked a New York court to appoint an umpire in its arbitration dispute with its reinsurer over asbestos-related losses because they and their appointed arbitrators have not been able to do so (National Union Fire Insurance Company of Pittsburgh, Pa. v. Employers Insurance Company of Wausau, No. 653512/2018, N.Y. Sup., New York Co.).
WASHINGTON, D.C. — A blue jean manufacturing company and its subsidiary in an Aug. 21 opposition tell the U.S. Supreme Court that review should be denied of a Nebraska Supreme Court’s ruling on the application of a choice-of-law clause in a case over a reinsurance participation agreement (RPA) because it “is an exceedingly poor vehicle for certiorari” (Applied Underwriters Captive Risk Assurance Company Inc. v. Citizens of Humanity, et al., No. 18-174, U.S. Sup.).
WASHINGTON, D.C. — In a breach of contract dispute over a reinsurance participation agreement (RPA), parties in an Aug. 6 petition ask the U.S. Supreme Court whether a choice-of-law clause imports “state substantive law without importing state rules impairing arbitration” or whether the clause incorporates “both state substantive law and state arbitration principles” (Applied Underwriters Inc., et al. v. Citizens of Humanity, et al., No. 18-175, U.S. Sup.).
ATLANTA — In what it calls a case of first impression, the Georgia Insurers Insolvency Pool (GIIP) argues to the Georgia Court of Appeals in a July 30 brief that a Georgia statute requires that a person who presents a claim to it first exhaust all coverages provided by solvent insurance companies for the claim (Rigoberto Riano v. Georgia Insurers Insolvency Pool, No. A18A1981, Ga. App.).
SAN JUAN, Puerto Rico — In a class action lawsuit filed in a Puerto Rico court on Aug. 22, a group of insureds sued 14 insurers for $2,658,780,973, alleging that they incurred damages related to the uncertainty of waiting while the insurers failed to complete the research process, adjustment, resolution and payment of their Hurricane Maria claims within the term provided by law (EMJ Properties, et al. v. MAPFRE Pan American Insurance Co., et al., No. SJ2018CV06504, Puerto Rico Super., San Juan).
JEFFERSON CITY, Mo. — An appellant recently asked a Missouri appeals court to reverse a lower court’s finding in favor of a real estate title insurer in a breach of contract, unjust enrichment and vexatious refusal to pay lawsuit arising from an underlying boundary dispute, contending that the policy’s notice requirement is a “vague, undefined and unenforceable provision” that “should, by law, be read” in his favor (Robert Lurie v. Commonwealth Land Title Company, LLC, No. ED 106156, Mo. App., Eastern Dist.).
HARRISBURG, Pa. — An abstract company and its principal recently filed a brief in the Pennsylvania Superior Court contending that a trial court abused its discretion when it granted an insurance company’s motions to join them as additional defendants in a lawsuit pertaining to a property easement that was not disclosed during a real estate transaction (John Kessock Jr. v. Conestoga Title Insurance Co. v. Delancey Abstract Corp., et al., No. 3737 EDA 2017, Pa. Super.).
LAKELAND, Fla. — The Second District Florida Court of Appeal is scheduled to hear oral arguments on Aug. 21 to determine whether a trial court properly awarded sanctions against the plaintiffs who filed a lawsuit against a renters’ insurer on the basis that the plaintiffs’ suit against the insurer was baseless (William L. Ward, et al. v. Florida Farm Bureau Casualty Insurance Co., No. 2D17-2987, Fla. App., 2nd Dist.).
SEATTLE — The Division I Washington Court of Appeals will decide whether a trial court correctly determined that the insurer of a contractor did not have a duty to contribute to the settlement of an underlying personal injury suit filed against property owners who were named as additional insureds under the contractor’s policy (Mt. Hawley Insurance Co. v. Zurich American Insurance Co., No. 77379-8-I, Wash. App., Div.1.).
ATLANTA — Indemnity claims are barred by the doctrine of sovereign immunity, an insolvent insurer tells the Georgia Supreme Court in a July 30 brief, also saying that any claim to reimburse a regulatory tech firm for any administrative expenses that were excessive was not barred and should be remanded for further proceedings (Georgia, et al. v. International Indemnity Co., et al., No. S18G0493; Regulatory Technologies Inc. v. Georgia, et al., No. S18G0499, Ga. Sup.).