Justia Insurance Law Opinion Summaries

Filippo Gallina and his wife (Plaintiffs) commenced a personal injury action against Preferred Trucking Services Corp. Preferred Trucking was insured by County-Wide Insurance Company under a policy that required insureds to cooperate with Country-Wide in its investigation of a claim or defense against a lawsuit. The next year, Country-Wide disclaimed its obligation to defend and indemnify Preferred Trucking based upon Preferred Trucking’s refusal to cooperate in the defense. Supreme Court subsequently awarded judgment to Plaintiffs. Thereafter, Country-Wide filed this action against Preferred Trucking and Plaintiffs seeking a declaration that it was not obligated to defend and indemnify Preferred Trucking in the underlying action. Supreme Court concluded that Country-Wide was obligated to defend and indemnify Preferred Trucking. At issue on appeal was whether Country-Wide’s disclaimer was timely as a matter of law. The Appellate Court affirmed, concluding that Country-Wide’s disclaimer was untimely because it came four months after Country-Wide learned of the ground for the disclaimer. The Court of Appeals reversed, holding that Country-Wide was not obligated to defend and indemnify Preferred Trucking, as Country-Wide established as a matter of law that its delay was reasonable. View "Country-Wide Ins. Co. v. Preferred Trucking Servs. Corp. " on Justia Law

Plaintiff had a $1 million insurance policy from Defendant on an office building. On February 23, 2007, the building was severely damaged in a fire. Defendant paid Plaintiff the actual cash value of the destroyed building in the amount of $757,812 but withheld the cost of replacing the destroyed property until Plaintiff could replace the property. The replacement building was completed in October 2010. Plaintiff brought an action against Defendant seeking payment of the unpaid portion of the policy limits. The U.S. district court granted Defendant’s motion to dismiss, concluding that the policy barred any suits commenced more than two years after the date of the damage and that the two-year limitation period was reasonable. The Court of Appeals answered a question from the Second Circuit Court of Appeals and held that such a contractual limitation period, applied to this case in which the property could not reasonably be replaced in two years, was unreasonable and unenforceable. View "Executive Plaza, LLC v. Peerless Ins. Co." on Justia Law

Plaintiff was injured during the course of his employment when he was struck by a sheet of plywood that fell from a building under construction. Plaintiff received workers' compensation benefits for his injuries and then filed this personal injury action. Thereafter, the insurance carrier for Plaintiff's employer filed a motion to discontinue Plaintiff's workers' compensation benefits. An administrative law judge found Plaintiff had no further causally-related disability and that he had no further need for treatment. The Workers' Compensation Board Panel (Board) affirmed. Subsequently, in this negligence action, Defendants moved for an order estopping Plaintiff from relitigating the issue of causally-related disability. Supreme Court granted the motion. The Appellate Division reversed, concluding that the determination of the Board was one of ultimate fact and thus did not preclude Plaintiff from litigating the issue of his ongoing disability. The Court of Appeals affirmed, holding that Defendants failed to establish that the issue decided in the workers' compensation proceeding was identical to that presented in this negligence action. View "Auqui v. Seven Thirty One Ltd. P'ship" on Justia Law

Claimant was employed at a secure juvenile detention facility operated by the State Office of Children & Family Services (OCFS) when she was assaulted, raped, and abducted by a resident. Claimant received workers' compensation benefits for her injuries. Claimant also filed a civil rights lawsuit in federal district court against OCFS and three supervisory OCFS employees seeking, inter alia, punitive damages. The federal lawsuit was settled. The New York State Insurance Fund (SIF), the workers' compensation carrier in this case, approved the settlement. In so doing, SIF reserved its right to take a credit against Claimant's payments of benefits until the credit was exhausted. The Workers' Compensation Law judge (WCLJ) decided that SIF was not entitled to offset the proceeds of a civil rights lawsuit that sought punitive damages. On appeal, the Workers' Compensation Board found in SIF's favor. The Appellate Division affirmed. The Court of Appeals affirmed, holding that, in light of the terms of the settlement in this case, SIF could take a credit against the settlement proceeds of Claimant's lawsuit against her employer and coemployees for injuries arising from the same incident for which Claimant received worker's compensation benefits. View "Beth V. v. State Office of Children & Family Servs." on Justia Law

Plaintiff, the owner of an apartment building, complained when Armory Plaza, the owner of the lot next to Plaintiff's building, began excavating the lot to make way for a new building. The excavation purportedly caused cracks in the walls and foundations of Plaintiff's building. After Plaintiff's insurer (Defendant) rejected Plaintiff's claims under its policy, Plaintiff brought suit. The U.S. district court granted summary judgment for Defendant, holding that the alleged conduct of Armory and its contractors was not "vandalism" within the meaning of the policy. On appeal, the Second Circuit Court of Appeals certified two questions of law to the New York Court of Appeals, which answered by holding (1) for purposes of construing a property insurance policy covering acts of vandalism, malicious damage may be found to result from an act not directed specifically at the covered property; and (2) the state of mind required to find malicious damage is a conscious and deliberate disregard of the interests of others that the conduct in question may be called willful or wanton. View "Georgitsi Realty, LLC v. Penn-Star Ins. Co." on Justia Law

Plaintiffs were two limited liability companies that made loans to Goldan, LLC. Goldan failed to repay the loans. Plaintiffs later discovered that their mortgages had not been recorded as agreed upon. Plaintiffs sued Goldan and its two principals, Mark Goldman and Jeffrey Daniels, alleging a number of claims. One claim was asserted against Daniels, a lawyer, for legal malpractice for failing to record the mortgages. Daniels' malpractice carrier, American Guarantee and Liability Insurance Company (American) refused to provide defense or indemnity coverage. Daniels defaulted in Plaintiffs' action against him. Daniels assigned to Plaintiffs his rights against American. Plaintiffs subsequently brought an action against American for breach of contract and bad faith failure to settle the underlying lawsuit. Supreme Court granted Plaintiffs' motions as to the breach of contract claims and dismissed the bad faith claims. The Appellate Division affirmed. The Court of Appeals affirmed, holding (1) by breaching its duty to defend Daniels, American lost its right to rely on policy exclusions to escape its duty to indemnify; and (2) the lower courts properly dismissed Plaintiffs' bad faith claims. View "K2 Inv. Group, LLC v. Am. Guar. & Liab. Ins. Co." on Justia Law

In 2003, the Securities and Exchange Commission (SEC) notified Bear Stearns & Co. and Bear Stearns Securities Corp. of its intention to charge Bear Stearns with violations of federal securities laws. Bear Stearns agreed to pay $160 million as a disgorgement and $90 million as a civil penalty. Bear Stearns then sought indemnification from its insurers (Insurers), requesting indemnity for the $160 million SEC disgorgement payment. Insurers denied coverage. Bear Stearns subsequently brought this breach of contract and declaratory judgment action against Insurers. Insurers unsuccessfully moved to dismiss the complaint. The Appellate Division reversed and dismissed the complaint, holding that, as a matter of public policy, Bear Stearns could not seek coverage under its policies for any of the SEC disgorgement payment. Bear Stearns appealed, arguing that, while it was reasonable to preclude an insured from obtaining indemnity for the disgorgement of its own illegal gains, Bear Stearns was not unjustly enriched by at least $140 million of the disgorgement payment, the sum attributable to the profits of its customers. The Court of Appeals reversed, holding that Insurers did not meet their burden of establishing, as a matter of law, that Bear Stearns was barred from pursuing insurance coverage under its policies. View "J.P. Morgan Sec. Inc. v. Vigilant Ins. Co." on Justia Law

A minor plaintiff commenced a civil action against the Roman Catholic Diocese of Brooklyn and one of its priests alleging sexual molestation by the priest. The Diocese settled the action for $2 million and additional consideration. At issue on appeal was a dispute between the Diocese and one of its insurance carriers (National Union) regarding the Diocese's demand for reimbursement for the settlement. The Diocese sought a declaratory judgment that National Union was required to indemnify the Diocese for the settlement and certain defense costs and fees. Supreme Court granted summary judgment for the Diocese. At issue on appeal was whether the incidents of sexual abuse constituted a single occurrence or multiple occurrences that spanned several years and several policy periods. The Appellate Division reversed, concluding that the alleged acts of sexual abuse constituted multiple occurrences and that the settlement amount should be allocated on a pro rata basis over the seven policy periods. The Court of Appeals affirmed, holding that the incidents of sexual abuse constituted multiple occurrences and that any potential liability should be apportioned among the several insurance policies, pro rata. View "Roman Catholic Diocese of Brooklyn v. Nat'l Union Fire Ins. Co. of Pittsburgh" on Justia Law

An insurance company (USF&G), having settled asbestos claims for nearly a billion dollars, sought to recover a share of its settlement payment from its reinsurers. Supreme Court granted summary judgment to USF&G. The Appellate Division affirmed, with one justice dissenting on the ground that there was a genuine triable issue of fact as to whether a portion of the settlement was for bad faith claims. The Court of Appeals modified the Appellate Division's order to deny summary judgment on two issues and otherwise affirmed, holding (1) there was an issue of fact as to whether USF&G, in allocating the settlement amount, reasonably attributed nothing to the so-called "bad faith" claims made against it; and (2) there was a genuine issue of triable fact as to whether certain claims were given unreasonable values for settlement purposes. View "U.S. Fid. & Guar. Co. v. Am. Re-Ins. Co." on Justia Law

At issue in this appeal was whether an action for negligence and breach of contract lies against an insurance broker for failure to procure adequate insurance coverage where the insured receive the policy without complaint. Plaintiff commenced this action against its broker for negligence and breach of contract in connection with Defendant's procurement of insufficient insurance. Supreme Court denied Defendant's motion for summary judgment, finding that issues of fact existed as to Plaintiff's request for specific coverage. The Appellate Division reversed, concluding that Plaintiff's failure to read and understand the policy precluded recovery in this action. The Court of Appeals reversed, holding (1) because there were issues of fact as to whether Plaintiff requested specific coverage for its employees and whether Defendant failed to secure a policy as requested, summary judgment was inappropriate in this matter; and (2) Plaintiff's failure to read and understand the policy should not be an absolute bar to recovery under the circumstances of this case. View "Am. Bldg. Supply Corp. v. Petrocelli Group, Inc." on Justia Law