Justia Insurance Law Opinion Summaries

Continental issued claims-made liability policies to the architectural firm responsible for designing and overseeing the construction of a building for the DASNY. In this declaratory judgment action, the insurer appealed from the district court's ruling on summary judgment that the two design flaws in the same structure were not "related." The court concluded that the 2002 Demand Letter could not be fairly read to concern the Ice Control Issue; and, focuses entirely on the Steel Girt Tolerance Issue, it could not be fairly read as an omnibus claim concerning all architectural defects in the Baruch College building; the court agreed with the district court that the Steel Girt Tolerance Issue and the Ice Control Issue arose from two unrelated wrongful acts; and, therefore, the court affirmed the district court's declaration that the two issues were unrelated. However, the court concluded that the district court abused its discretion by awarding prejudgment interest from the date of the settlement agreement itself. Accordingly, the court vacated the award and remanded for further proceedings. View "Dormitory Authority v. Continental Casualty Co." on Justia Law

This declaratory judgment action under New York law involves Hartford's issuance to Euchner of comprehensive general liability insurance with an endorsement covering the company's employee benefits program. Hartford denied coverage and refused a defense as to a suit in which plaintiff alleged that she was sexually harassed and that she was coerced into accepting a changed status that Euchner improperly classified as an independent sales position. Euchner appealed from the district court's grant of Hartford's motion for summary judgment on the ground that the underlying suit alleged only intentional wrong. The court concluded that a reasonable possibility existed that some claims in the former employee's (amended) complaint might implicate the coverage extended by endorsement, and that Hartford therefore owed a duty to defend. The court did not reach the issue of indemnity. Accordingly, the court vacated and remanded in part. The court affirmed the dismissal of the claim brought under N.Y. Gen. Bus. Law 349. View "Euchner-USA, Inc. v. Hartford Casualty Ins. Co." on Justia Law

Plaintiff filed suit against APIC, a nondomiciliary risk retention group, under New York's direct action statute, N.Y. Ins. Law 3420, to recover an unsatisfied state court judgment that had been entered against APIC's insured. The insured was a chiropractor that plaintiff had sought treatment from and who had pled guilty to third-degree assault for his inappropriate touching of plaintiff. At issue was whether the Liability Risk Retention Act of 1986, 15 U.S.C. 3901 et seq., preempted the application of section 3420(a)(2) to APIC, which was domiciled in Arizona, but issued insurance policies in New York. The court held that any construction of New York law that would impose section 3420's direct action requirements on foreign risk retention groups was preempted by section 3902(a)(1) of the LRRA. View "Wadsworth v. Allied Professionals Ins." on Justia Law

Plaintiffs, former NBA referees, filed suit alleging breach of contract and/or seeking reformation with respect to each supplemental insurance policy that plaintiff had. Plaintiffs had relied on the insurance agent's representations that when plaintiffs where injured and unable to work as NBA referees, they would receive disability payments until the age of sixty-five. The court concluded that plaintiffs' failure to read the policy did not defeat their reasonable expectations. Pennsylvania law determined plaintiffs' right to reformation; absolved the insured from not reading the policy at delivery; and allowed the contract to be interpreted (or recast) from the date the carriers acted in a manner inconsistent with the insured's reasonable expectations of coverage. The policies that underlay Pennsylvania's substantive contract law of the reasonable expectations doctrine directly contradict those that drive Connecticut's view of when a claim for non-conforming coverage accrues. Accordingly, the court reversed the district court's decision dismissing plaintiffs' breach of contract claims and remanded for further proceedings. View "Nunn v. Massachusetts Casualty Ins." on Justia Law

A Vermont statute requires all "health insurers" to file with the State reports containing claims data and other "information relating to health care." Liberty Mutual sought a declaration that the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1001 et seq., preempted the Vermont statute and regulation. The district court granted summary judgment in favor of Vermont. The court held that the reporting requirements of the Vermont statute and regulation have a "connection with" ERISA plans and were therefore preempted as applied. The court's holding was supported by the principle that "reporting" is a core ERISA function shielded from potentially inconsistent and burdensome state regulation. Accordingly, the court reversed and remanded with instructions to enter judgment for Liberty Mutual. View "Liberty Mutual Ins. Co. v. Donegan" on Justia Law

The parties disputed ownership of life insurance policies and, according to their contract, submitted the dispute to a rabbinical arbitration panel. The arbitration panel appointed by the parties entered an award mandating the immediate transfer of the insurance policies at issue to Kolel and appellants subsequently appealed. The court concluded that the district court properly denied vacatur based on claims of bias and corruption; properly denied vacatur based on claims of premature decision and failure to consider evidence; and properly denied appellants' motion for reconsideration. Therefore, appellants have not presented any evidence that meets the high burden of proof necessary to vacate an arbitration award, and therefore the district court properly denied their motion for vacatur and granted Kolel's motion for confirmation of that same arbitration award. View "Kolel Beth Yechiel Mechil v. YLL et al." on Justia Law

Pacific issued a fire insurance policy to plaintiff on a home that was destroyed by fire during the policy period. On appeal, Pacific challenged the district court's grant of summary judgment to plaintiff on its claim for a declaratory judgment that an apportionment-of-loss clause in the policy was void as a matter of New York law, and that Pacific was liable to plaintiff for the entire amount of loss coverage shown in the fire insurance policy. Plaintiff cross-appealed from so much of the judgment as ruled that it was not entitled to recover replacement costs in excess of the stated loss coverage amount on the house. The court concluded that plaintiff's contentions were without merit and affirmed to the extent that the district court dismissed plaintiff's claim for extended replacement costs. In regards to Pacific's appeal, the court certified questions to the New York Court of Appeals. View "Quaker Hills, LLC v. Pacific Indemnity Co." on Justia Law

Plaintiff filed suit against Principal after it concluded that he was not eligible for long term disability benefits and denied his claim. The court concluded that Principal failed to properly consider plaintiff's subjective complaints and that Principal's request for objective evidence proving that he suffered from tinnitus was unreasonable. Therefore, the court held that Principal's denial of plaintiff's claim was arbitrary and capricious, and the court reversed the judgment of the district court, remanding for further proceedings. View "Miles v. Principal Life Ins. Co." on Justia Law

Plaintiffs appealed the district court's judgment in favor of Federal, denying plaintiffs indemnification under their insurance policy for the destruction of their barn by fire. The court concluded that the permissive adverse inference instruction with respect to a photograph that plaintiffs had not produced in discovery was appropriate; Federal was not entitled to attorney fees; Federal was not entitled to equitable relief to recover payments made to plaintiffs; and, therefore, the judgment of the district court was affirmed. View "Mali v. Federal Ins. Co," on Justia Law

Charter appealed the district court's holding that it was liable to CGS for its expenses in defending and settling a trademark infringement suit. The court concluded that the relevant insurance policy did not cover the liability alleged in the trademark action and Charter was not liable for the settlement amount; however, there was sufficient legal uncertainty about the coverage issue to oblige Charter to defend the action; and, therefore, the district court's ruling was affirmed insofar as it held that Charter was liable for defense costs, but reversed insofar as it held that Charter was liable for the settlement. Accordingly, the court vacated and remanded for further proceedings. View "CGS Indus., Inc. v. Charter Oak Fire Ins. Co." on Justia Law