These appeals relate to life insurance policies that were issued by Sun Life to non-parties and that were subsequently acquired by Imperial. The district court dismissed all claims in both cases. The Eleventh Circuit held that Sun Life waived its opportunity to rely on non-forum law to interpret the policies at issue and thus interpreted the relevant policies under Florida law. In regard to Sun Life's complaint, the court affirmed the district court's dismissal of the fraud conspiracy and declaratory judgment counts; and vacated the dismissal of the RICO, RICO conspiracy, fraud, aiding and abetting fraud, and tortious interference with contractual relations counts. In regard to Imperial's complaint, the court affirmed the breach of contract count to the extent it asserted a breach of the rights-and-privileges clause. The court vacated the district court's dismissal of the breach of contract count to the extent it asserted a breach of the incontestability clause. The court remanded for further proceedings. View "Sun Life Assurance Company of Canada v. Imperial Premium Finance, LLC" on Justia Law

Hennen worked as a sales specialist for NCR, 2010-2012, and was covered by long-term disability insurance under a group policy provided by MetLife. She sought treatment for a back injury. When physical therapy and surgery failed to resolve her injury, Hennen applied for long-term disability benefits. Acting as plan administrator, MetLife agreed that Hennen was disabled and paid benefits for two years. The plan has a two-year limit for neuromusculoskeletal disorders, subject to exceptions, including on for radiculopathy, a “Disease of the peripheral nerve roots supported by objective clinical findings of nerve pathology.” After MetLife terminated Hennen’s benefits, she sued under the Employee Retirement Income Security Act of 1974, 29 U.S.C. 1001 (ERISA), arguing that MetLife’s determination that she did not have radiculopathy was arbitrary and capricious. The district court granted MetLife summary judgment. The Seventh Circuit reversed. MetLife acted arbitrarily when it discounted the opinions of four doctors who diagnosed Hennen with radiculopathy in favor of the opinion of one physician who ultimately disagreed, but only while recommending additional testing that MetLife declined to pursue. View "Hennen v. Metropolitan Life Insurance Co." on Justia Law

In this insurance dispute, the Supreme Judicial Court reversed the superior court’s allowance of the insurers’ motion for summary judgment, holding that the allegations in the underlying complaint were sufficient to trigger the insurers’ duty to defend the insured in the underlying action. The two insurers in this case had issued several general commercial liability policies to the insured. The insured was sued in federal court for improper advertising. The insurers denied coverage on the ground that a provision in the policies covering improper use of another’s advertising idea did not cover the claims raised in the action but, nevertheless, agreed to fund the insured’s defense under a reservation of rights. The insurers then sought a declaration that they were not obligated to defend the insured in the underlying action. The superior court granted summary judgment for the insurers. The Supreme Judicial Court reversed, holding that the policies that the insured purchased, which provided coverage in the event the insured was sued for alleged advertising injuries, covered the insured for the claims at issue in the underlying action. View "Holyoke Mutual Insurance Co. in Salem v. Vibram USA, Inc." on Justia Law

Dissatisfied with NYCM’s handling of his insurance claim related to a serious car accident, Clemens filed suit, asserting a contractual underinsured motorist (UIM) claim and a claim under the Bad Faith Statute, 42 Pa. Cons. Stat. 8371. After NYCM removed the case to federal court, the parties settled the UIM claim for $25,000. The bad faith claim proceeded to trial. A jury awarded Clemens $100,000 in punitive damages. As the prevailing party under the Bad Faith Statute, Clemens then sought $946,526.43 in attorneys’ fees and costs. The district court reviewed every time entry submitted, performed a traditional lodestar analysis, and concluded that 87 percent of the hours billed had to be disallowed as vague, duplicative, unnecessary, or inadequately supported by documentary evidence. In light of that substantial reduction, the court deemed Clemens’s request “outrageously excessive” and exercised its discretion to award no fee. Represented by new counsel, Clemens appealed. The Third Circuit affirmed, formally endorsing a view adopted by several other circuits: where a fee-shifting statute provides a court discretion to award attorney’s fees, such discretion includes the ability to deny a fee request altogether when, under the circumstances, the amount requested is “outrageously excessive.” View "Clemens v. New York Central Mutual Fire Insurance Co." on Justia Law

At issue before the Colorado Supreme Court in this matter was the issue of whether an insured was entitled to collect prejudgment interest when he settles an uninsured motorist claim (“UM claim”) with his insurer in lieu of filing a lawsuit and proceeding to judgment. The Court held that under the plain language of the prejudgment interest statute, 13-21-101, C.R.S (2017), an insured is entitled to prejudgment interest only after: (1) an action is brought; (2) the plaintiff claims damages and interest in the complaint; (3) there is a finding of damages by a jury or court; and (4) judgment is entered. Because the plaintiff in this case did not meet all of these conditions, he was not entitled to prejudgment interest. View "Munoz v. Am. Fam. Ins. Co." on Justia Law

The Eighth Circuit reversed the district court's grant of summary judgment to plaintiffs, holding that St. Paul Insurance's policy expressly precluded indemnification of intentional criminal acts and that David Kofoed's act of evidence tampering did not fall within the malicious prosecution exception. Kofoed was criminally convicted for evidence tampering while investigating two murders and eventually charging plaintiffs with the murders. The court held that St. Paul's policy coverage was not illusory where it excluded coverage for acts with specific intent, but did not cover general intent acts; the policy did not provide some exceptions to the exclusions to cover certain intentional acts such as malicious prosecution; and Kofoed's evidence-tampering crime was analogous to civil malicious prosecution. Because plaintiffs failed to sufficiently plead the malicious prosecution cause of action in their complaints, the district court's entry of default judgment against Kofoed did not include malicious prosecution. Because Kofoed's judgment did not include malicious prosecution, plaintiffs failed in their burden to show that an exception to the insurance exclusion applied. Therefore, St. Paul had no duty to indemnify Kofoed. View "Sampson v. St. Paul Fire and Marine Insurance Co." on Justia Law

Belsen Getty, LLC, a registered investment adviser owned by Terry Deru, obtained a claims-made financial-services-liability policy (the Policy) from XL Specialty Insurance Company covering Belsen Getty and its advisers for the period for one year. Under the policy, XL had no duty to defend. During the policy period James, Jenalyn, and Wade Morden brought claims against Belsen Getty and Deru alleging improper and misleading investment advice. XL denied coverage, asserting the Mordens’ claims and claims brought by the Securities and Exchange Commission (SEC) before the policy period concerned “Interrelated Wrongful Acts,” as defined by the Policy, and that the Policy therefore required treating the two claims as one claim made before the policy period. Belsen Getty and Deru then settled with the Mordens, assigning their rights against XL; and the Mordens sued XL in federal district court, raising the assigned claims that XL breached its covenant of good faith and fair dealing and its fiduciary duties to Belsen Getty and Deru in denying coverage under the Policy. XL counterclaimed that the Policy’s Interrelated Wrongful Acts provision precluded coverage. The Mordens moved for partial summary judgment on the counterclaim and on several of XL's affirmative defenses. XL moved for summary judgment based on the policy and for failure to prove bad faith or breach of fiduciary duty. The district court denied XL's counterclaim, but granted summary judgment on the bad-faith and fiduciary-duty claims. The Mordens appealed summary judgment against them on their bad-faith and fiduciary-duty claims and on the denial of their motion to amend their complaint to add a breach-of-contract claim. XL cross-appealed the summary judgment against it on its counterclaim that the Policy’s Interrelated Wrongful Acts provision barred all the Mordens’ claims. The Tenth Circuit reversed the denial of XL’s motion for summary judgment on its counterclaim: this reversal undermined the Mordens’ challenges to the summary judgment against them and the denial of their motion to amend. The Court therefore affirmed summary judgment against the Mordens on their claims and the denial of their motion to amend. View "Morden v. XL Specialty Insurance" on Justia Law

Packgen's customer, CRI, required a new type of intermediate bulk container (IBC) for a chemical catalyst used in refining crude oil into other petroleum products. The new IBC's outer surface consisted primarily of polypropylene fabric rather than metal; it could be collapsed for storage. CRI's catalyst is self-heating and can ignite when exposed to oxygen. Packgen engaged Berry to manufacture a laminate of woven polypropylene chemically bonded to aluminum foil, to strengthen the IBC’s exterior and serve as a barrier to oxygen, ultraviolet light, and infrared radiation. By April 2008, Packgen was selling an average of 1,261 IBCs per month to CRI and was making overtures to other petroleum refiners. While CRI personnel were lifting an IBC full of catalyst, the foil layer separated from the polypropylene, exposing the interior lining. Other failures followed, some resulting in fires. Packgen determined that foil laminate obtained from Berry was defective. CRI canceled pending orders and destroyed and refused to pay for IBCs that Packgen had provided. Word reached other potential Packgen customers. Packgen sued Berry. The First Circuit affirmed an award of $7.2 million in damages. Berry unsuccessfully demanded that Illinois National indemnify it for all but the first $1 million, which Berry’s primary liability insurer agreed to cover. The Seventh Circuit affirmed summary judgment in favor of Illinois National. The policy covers damages that Berry is required to pay “because of … Property Damage.” While some portion of the lost profits award might be attributable to property damage, Berry did not attempt to make that showing. View "Berry Plastics Corp. v. Illinois National Insurance Co." on Justia Law

Lupu refinanced his home loan and mortgage with Loan City, which transferred both to IndyMac, then they went to Fannie Mae, next to OneWest, and finally to the current holder, Ocwen. After defaulting, Lupu sued to void the instruments evidencing his debt, challenging the use of the MERS System, a private mortgage registry that allows its members to avoid county-level public recordation when transferring mortgage interests. MERS is named as the mortgagee, as its members’ nominee, so members can transfer mortgage interests among themselves without recording. The system is generally in accord with Pennsylvania law. At one point, Lupu alleged forgery, The district court dismissed his action. A Stewart Title policy insured Loan City, its successors, and assignees, requiring Stewart to pay costs, attorneys’ fees and expenses incurred in defense of the title or the lien, but not “those causes of action which allege matters not insured against.” Steward denied Ocwen's request for defense coverage, except with respect to the forgery claim, stating “Lupu’s arguments concerned the securitization of the note secured by the insured mortgage and the validity of assignments of the insured mortgage rather than the execution and witnessing of the insured mortgage.” The Third Circuit ruled in favor of Stewart, predicting that state courts would not apply the “complete defense" rule, whereby a single covered claim triggers an obligation for the title insurer to defend the entire action. The court applied Pennsylvania’s rule that potentially covered claims are identified by “comparing the four corners of the insurance contract to the four corners of the complaint.” View "Lupu v. Loan City LLC" on Justia Law

Villanueva and the class (Plaintiffs) alleged that Fidelity, an underwritten title company that handled Plaintiffs’ escrow accounts, engaged in unlawful conduct under the Unfair Competition Law (UCL) (Bus. & Prof. Code, 17200) in charging overnight mail delivery fees, courier fees, and document preparation or “draw deed” fees that were not listed in its schedule of rates filed with the Department of Insurance in violation of Insurance Code 12401–12410.10, 12414.27. Fidelity argued that the lawsuit was barred by the statutory immunity in section 12414.26 for matters related to rate-making. The trial court rejected Fidelity’s immunity claim and granted Plaintiffs injunctive relief under the UCL, but denied their restitution claims. The court of appeal reversed. Fidelity’s immunity defense is not subject to the forfeiture doctrine because it implicates the court’s subject matter jurisdiction; this claim is subject to the exclusive original jurisdiction of the Insurance Commissioner because it challenges Fidelity’s activity related to rate-making. The court directed the trial court to enter a new order awarding costs to Fidelity. View "Villanueva v. Fidelity National Title Co." on Justia Law