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

Mealey's Insurance Pleadings

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.
October 24, 2023
Leaky Roof Suit Transferred From Western District Of Texas To Southern District

AUSTIN, Texas — A federal judge in Texas has granted a commercial general liability insurer’s unopposed motion to transfer a breach of contract suit against it stemming from the replacement of a roof that later leaked to another federal court in Texas “where the relevant witnesses, the Property, key events, and documents are located.”
October 24, 2023
Guaranty Association Seeks Extension In Suit Alleging Dishwasher Leak Water Damage

WEST PALM BEACH, Fla. — The Florida Insurance Guaranty Association (FIGA) filed in a Florida state court a request for additional time to respond to a complaint against it and an insolvent homeowners insurer in the homeowners’ breach of contract suit related to purported water damage from a leaking dishwasher.
October 23, 2023
Lawyer Insured: Panel’s Ruling Guts Professional Liability Insurer’s Duty To Defend

NEW YORK — A lawyer insured on Oct. 21 filed a petition for rehearing en banc seeking to reverse the Second Circuit U.S. Court of Appeals’ ruling that a professional liability insurer has no duty to defend its construction management company against a lawsuit arising from a home renovation project because the underlying complaint fails to allege professional services that the insured provided as a lawyer to trigger coverage, arguing that the panel’s decision “abrogates decades of black-letter New York insurance law that favors insureds, effectively gutting an insurer’s duty to defend.”
October 23, 2023
Insurer Says Coverage Suit Over Legionnaire’s Disease Should Stay In Federal Court

LOUISVILLE, Ky. — A Kentucky federal court should exercise its discretion and permit an insurer’s declaratory judgment suit to proceed because litigating the issue of coverage in federal court is more judicially efficient than transferring the suit to a state court where the underlying bodily injury suit arising out of an apartment tenant’s contraction of Legionnaire’s disease is pending, the insurer says in its response to a motion to dismiss.
October 23, 2023
Insureds Seek Dismissal In Hurricane Coverage Row Involving Liquidated Insurer

ST. CROIX, Virgin Islands — Homeowners notified a federal court in the Virgin Islands that because one of the insurer defendants was never served, the case against it should be dismissed in the insureds’ Hurricane Maria coverage suit involving an insurer in liquidation.
October 23, 2023
Insurer And Its Officers Challenge 7th Circuit’s Remand Of Class Action

CHICAGO — An insurer and its directors and officers filed petitions for rehearing en banc seeking review of the Seventh Circuit U.S. Court of Appeals’ holding that a class action challenging the insurer’s practices fits within the internal affairs and home state controversy exceptions to the Class Action Fairness Act (CAFA), challenging the panel’s reversal of a lower federal court’s denial of the insured’s motion to remand.
October 23, 2023
7-Eleven Seeks Coverage For Bodily Injury Lawsuit Involving Store Employee

MIAMI — A 7-Eleven sued its insurers for declaratory relief in a federal court in Florida, seeking general liability and liquor liability coverage for a customer’s underlying bodily injury lawsuit alleging that a 7-Eleven employee physically struck him numerous times.
October 18, 2023
Debtors In Vesttoo Chapter 11 Case Ask Bankruptcy Court To Establish Bar Dates

WILMINGTON, Del. — Vesttoo Ltd. and 48 affiliated entities (collectively, the debtors) have asked a Delaware federal bankruptcy court to set a series of bar dates in their jointly administered Chapter 11 case, starting with a Dec. 1 deadline for nongovernmental entities or individuals to file proof of claims that arose before the debtors filed for bankruptcy.
October 18, 2023
Plaintiffs File Notice Of Appeal Regarding Rulings In ACA Reinsurance Row

WASHINGTON, D.C. — Two plaintiffs in a lawsuit over the Transitional Reinsurance Program (TRP) of the Patient Protection and Affordable Care Act (ACA) have filed a notice that they are appealing rulings against them that were issued in the U.S. Court of Federal Claims.
October 17, 2023
Policy Interpretations Argued In Coverage Row Over Sex Abuse Case Settlements

SEATTLE — Parties in a case over reimbursement for defense and settlement of suits alleging sexual abuse are disputing the interpretation of policy terms, with the plaintiff telling a Washington federal court in an Oct. 16 motion for summary judgment that allegations of retaliation are sufficient to state claims against a foreign reinsurer.