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Mealey's Insurance Pleadings

  • September 19, 2018

    Insured Accuses Insurer Of ‘Profit Driven Scheme’ In Hurricane Irma Dispute

    FORT LAUDERDALE, Fla. — A Florida insured on Sept. 5 sued his homeowners insurer in a Florida court, alleging that the insurer charged Floridians for hurricane insurance and then intentionally undervalued or denied legitimate insurance claims by using unlicensed adjusters and engineers (Lawrence Malysa v. Tower Hill Prime Insurance Co., et al., No. N/A., Fla. Cir., 17th Jud. Cir., Broward Co.).

  • September 18, 2018

    Insured Objects To Magistrate’s Report Suggesting Dismissal Of Superstorm Sandy Suit

    CENTRAL ISLIP, N.Y. — An insured on Sept. 14 filed objections to a magistrate’s report that recommended dismissal of his lawsuit alleging that he was wrongfully denied $141,274.50 in insurance proceeds for Superstorm Sandy damage to his Long Beach, N.Y., home, asserting the “legal impact” of the errors in the magistrate’s report and recommendation “go far beyond this case” (David Clutter v. William B. Long, et al., No. 17-4833, E.D. N.Y.).

  • September 18, 2018

    Insurance Broker’s Former Owners Oppose Reinsurer’s Summary Judgment Motion

    SAN DIEGO — Arguing that there are triable issues of fact, the former owners of an insurance brokerage company in separate Sept. 14 briefs oppose a reinsurer’s request for summary judgment against them for payment of a $3.2 million judgment in a California federal court dispute over breached reinsurance agreements from fraudulent transfers (Odyssey Reinsurance Co. v. Richard Keith Nagby, et al., No. 16-3038, S.D. Calif.).

  • September 18, 2018

    Health Insurer Says ERISA Preempts, Pleading Deficiencies Defeat UCL Claim

    LOS ANGELES — An out-of-network substance abuse services provider’s claims are preempted by the Employee Retirement Income Security Act, and the provider fails to adequately plead its California unfair competition law (UCL) claim, an insurer tells a California federal judge in a reply Sept. 14 (Miriam Hamideh Ph.D., et al. v. Anthem Blue Cross Life and Health Insurance Co., et al., No. 18-3044, C.D. Calif.).

  • September 18, 2018

    Washington Top Court Deciding If Proton Beam Therapy Is ‘Medically Necessary’

    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.).

  • September 12, 2018

    Life Insurer’s Motion To Dismiss Breach Of Policies Case Opposed By Plaintiff

    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.).

  • September 12, 2018

    Truck Ownership, Driver’s Residence At Issue In Missouri Insurance Appeal

    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.).

  • September 12, 2018

    Reimbursement Limitation Should Be Applied Before PIP Deductible, Insurer Argues

    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.).

  • September 10, 2018

    Insured Asks 10th Circuit To Reverse Ruling As To Bad Faith, Punitive Damages

    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.).

  • September 10, 2018

    Parties Debate Definition Of ‘Occurrence’ At Wisconsin Supreme Court

    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.).

  • September 6, 2018

    No Need For En Banc Review, Government Says In ACA Risk-Corridor Cases

    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.).

  • September 6, 2018

    Insurer, Reinsurer Submit Briefs In Case Over Expenses For Asbestos Settlement

    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.).

  • September 4, 2018

    Manufacturer Asks U.S. High Court Not To Address Choice-Of-Law Clause

    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.).

  • September 4, 2018

    Insured Seeks Reversal Of Choice-Of-Law Ruling In Contamination Coverage Suit

    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.).

  • August 28, 2018

    Blue Jean Manufacturer To U.S. High Court: Review Must Be Denied In RPA Suit

    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.).

  • August 28, 2018

    U.S. High Court Asked Choice-Of-Law Clause Question In RPA Dispute

    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.).

  • August 27, 2018

    Georgia Insurers Insolvency Pool Asks Court To Address Coverage Exhaustion Issue

    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.).

  • August 24, 2018

    Insureds File Class Action Seeking $2.6B From Insurers For Hurricane Maria Damage

    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).

  • August 21, 2018

    Appellant Asks Missouri Appeals Court To Reverse Ruling In Title Insurance Dispute

    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.).

  • August 21, 2018

    Abstract Company, Principal Say Court Abused Discretion On Easement Ruling

    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.).