Justia Insurance Law Opinion Summaries

A ceiling collapse at a construction site in New York injured three employees of a subcontractor, Vanquish Contracting Corporation. The general contractor, Reidy Contracting Group, LLC, had required Vanquish to procure insurance coverage that would protect Reidy as an additional insured. Vanquish obtained an excess liability policy from Mt. Hawley Insurance Company, which incorporated the terms of an underlying policy issued by Endurance American Specialty Insurance Company. After the accident, the injured Vanquish employees sued Reidy. Reidy sought defense and indemnification from Mt. Hawley, but Mt. Hawley denied coverage, arguing that Reidy was not an additional insured and that the Employers Liability Exclusion in the policy barred coverage. The United States District Court for the Western District of New York reviewed cross-motions for summary judgment. The district court found that Reidy was an additional insured under the policy and that the Employers Liability Exclusion did not bar coverage. The court reasoned that, based on the policy’s language and the Separation of Insureds clause, “the insured” in the exclusion referred to the party seeking coverage—here, Reidy, which did not employ the injured workers. Alternatively, the court found the exclusion ambiguous and construed it against Mt. Hawley as the drafter. The court also held that Mt. Hawley was precluded from contesting Reidy’s status as an additional insured because it failed to timely raise this argument as required by New York law. On appeal, the United States Court of Appeals for the Second Circuit affirmed the district court’s judgment. The appellate court held that Reidy qualifies as an additional insured and that the Employers Liability Exclusion is ambiguous; thus, the ambiguity must be resolved in favor of coverage for Reidy. The judgment granting summary judgment to Reidy and Merchants Mutual Insurance Company was affirmed. View "Reidy Contracting Group, LLC v. Mt. Hawley Insurance Company" on Justia Law

GEICO and its subsidiaries brought a lawsuit in the United States District Court for the Eastern District of New York against Dr. Bhargav Patel and his medical practice, alleging that the defendants engaged in a scheme to defraud GEICO by manipulating New York’s no-fault automobile insurance system. GEICO claimed that from 2019 to 2023, defendants submitted approximately $3.4 million in reimbursement claims for treatments that were unnecessary, experimental, excessive, illusory, or not provided at all. These claims allegedly resulted from a fraudulent scheme involving kickbacks for patient referrals and the provision of services by unlicensed individuals or contractors.After GEICO initiated its federal action, the defendants responded by filing over 600 collection actions in New York state courts and arbitration tribunals, seeking recovery for disputed or denied claims totaling more than $2 million. GEICO, facing the prospect of fragmented litigation and the risk of inconsistent judgments, sought a preliminary injunction from the district court to stay all pending state and arbitration proceedings and to prevent the defendants from filing new collection actions until the federal court resolved the RICO claims. The district court granted the injunction, finding that GEICO had demonstrated irreparable harm, serious questions going to the merits, and a balance of hardships tipping in GEICO’s favor. The court also determined it had authority under the “in aid of jurisdiction” exception to the Anti-Injunction Act to enjoin the parallel proceedings.On appeal, the United States Court of Appeals for the Second Circuit reviewed the district court’s decision for abuse of discretion and found none. The appellate court held that the preliminary injunction was justified by the real risk of irreparable harm to GEICO posed by inconsistent judgments and the inability to fully adjudicate the alleged fraudulent scheme in piecemeal state actions. The Second Circuit further held, consistent with its recent precedent in State Farm Mutual Automobile Insurance Company v. Tri-Borough NY Medical Practice, P.C., that the injunction did not violate the Anti-Injunction Act because it was expressly authorized under RICO. The court affirmed the district court’s order. View "GEICO v. Patel" on Justia Law

A Texas-based firearms retailer sold and shipped large quantities of unfinished firearm frames and receivers to New York, including products easily convertible into untraceable “ghost guns.” State and city authorities in New York alleged that the retailer intentionally marketed and sold these products to purchasers likely to be legally prohibited from owning firearms. The authorities claimed this resulted in increased gun violence and compelled them to spend additional resources on law enforcement, public health, and community services.Following these lawsuits, the retailer demanded that its liability insurers provide defense and indemnification under policies that covered damages caused by an “accident.” The insurers denied coverage and sought a declaratory judgment in the United States District Court for the Southern District of New York, arguing that the underlying suits did not allege harm resulting from an “accident” as required under Texas law and the policies’ terms. The district court granted summary judgment for the insurers, finding that the complaints alleged intentional conduct with expected consequences, not an “accident.” The judgment also encompassed indemnification after the parties agreed that the same reasoning applied.The United States Court of Appeals for the Second Circuit reviewed the case de novo. It held that, under Texas law, the policies only covered injuries arising from an “accident,” which is defined as a fortuitous, unexpected, and unintended event. The Court concluded the underlying lawsuits described intentional acts by the retailer that led to expected injuries, rather than accidental harm. Therefore, the insurers had no duty to defend or indemnify the retailer in these lawsuits. The Court of Appeals affirmed the judgment of the district court. View "Granite State Insurance Co. v. Primary Arms, LLC" on Justia Law

Nearly a million barrels of crude oil owned by a U.S. company were seized from a vessel in Venezuelan waters by Venezuelan authorities under threat of force. The oil was insured under a marine cargo reinsurance policy that covered losses arising from war-related risks, including “insurrection.” The insured company claimed that the political turmoil in Venezuela, including the contested presidency and violent suppression of opposition, constituted an insurrection as defined by the policy. The reinsurers denied coverage, arguing that the events did not meet the policy’s definition of insurrection, leading to litigation.The United States District Court for the Southern District of New York reviewed cross-motions for summary judgment. The court found the term “insurrection” in the policy to be ambiguous and, applying New York law and the doctrine of contra proferentem, construed the ambiguity in favor of the insured. The court held that the Maduro regime’s actions constituted an insurrection within the meaning of the policy. The case proceeded to trial on causation and damages, where the jury found in favor of the insured on most issues, awarding over $54 million in damages plus interest.On appeal, the United States Court of Appeals for the Second Circuit considered challenges to the district court’s summary judgment ruling, judicial notice orders, and jury instructions on causation. The Second Circuit held that the district court did not err or abuse its discretion in any of the challenged rulings. It affirmed that the policy’s “arising from” language required only but-for causation, not proximate causation. The court affirmed the district court’s judgment in all respects, upholding the award to the insured. View "CITGO Petroleum Corp. v. Ascot Underwriting Ltd." on Justia Law

A law firm sought defense and indemnification from its professional liability insurer after being sued in New York state court by a judgment creditor of its client. The creditor alleged that the firm facilitated the sale of the client’s diamond ring and received a portion of the proceeds to satisfy past fees and as a retainer for future services, despite a restraining notice prohibiting the client from transferring assets due to an unpaid judgment. The state court complaint accused the firm of fraudulent conveyance, tortious interference with judgment collection, and contempt of court.The United States District Court for the Western District of New York dismissed the law firm’s claims for defense and indemnification and denied its motion for partial summary judgment regarding the insurer’s duty to defend. The district court found that the policy’s misappropriation exclusion applied, concluding that the firm’s handling of the sale proceeds was unauthorized in light of the restraining notice, regardless of the client’s consent.On appeal, the United States Court of Appeals for the Second Circuit reviewed the district court’s rulings de novo. Applying New York law, the Second Circuit held that the allegations in the underlying complaint involved the provision of professional services by the law firm and did not constitute “misappropriation” as commonly understood, since there was no allegation that the firm acted without its client’s authorization. The court found the term “misappropriation” ambiguous and construed it in favor of the insured. The Second Circuit vacated the district court’s dismissal, reversed the denial of partial summary judgment on the duty to defend, and remanded with instructions to enter partial summary judgment for the law firm on the insurer’s duty to defend. The court did not address other policy exclusions or the insurer’s ultimate duty to indemnify. View "Marcus & Cinelli, LLP v. Aspen Am. Ins. Co." on Justia Law

A construction worker employed by a subcontractor was injured when a scaffold collapsed at a Manhattan worksite. The worker sued the property owner and general contractor in New York Supreme Court, alleging negligence and violations of state labor laws. The owner’s insurer, Liberty Insurance Corporation, sought a declaration in federal court that the subcontractor’s insurer, Hudson Excess Insurance Company, was obligated to defend and indemnify the owner as an additional insured under the subcontractor’s commercial general liability policy. The subcontract between the general contractor and the subcontractor required the latter to provide insurance coverage for the owner and general contractor.In the New York Supreme Court, summary judgment was granted to the injured worker on some claims, while other claims remained pending. The court denied summary judgment to the owner on its contractual indemnification claim against the subcontractor, finding factual questions about the scope of the subcontractor’s work. Later, after the federal district court’s decision, the state court dismissed all third-party claims against the subcontractor, finding the indemnity provision in the subcontract invalid due to lack of a meeting of the minds.The United States Court of Appeals for the Second Circuit reviewed the case. It affirmed the district court’s finding, after a bench trial on stipulated facts, that the subcontractor’s actions proximately caused the worker’s injuries and that Hudson owed a duty to indemnify the owner under the policy. The Second Circuit held that the later state court decision did not alter this result. However, the Second Circuit reversed the district court’s award of attorney’s fees to Liberty, holding that Hudson was entitled to a statutory safe harbor under New York Insurance Law, and thus was not required to pay Liberty’s attorney’s fees for the federal action. View "Liberty Insurance Corp. v. Hudson Excess Insurance Co." on Justia Law

The case involves insurance policies issued by certain surplus lines insurers at Lloyd’s, London, which contain identical arbitration clauses. The insured parties, 3131 Veterans Blvd LLC and Mpire Properties LLC, attempted to sue the insurers in Louisiana state court. The insurers then sued in New York federal court to enforce the arbitration clauses under the Federal Arbitration Act (FAA) and the New York Convention on the Recognition and Enforcement of Foreign Arbitral Awards. The insured parties argued that the arbitration clauses were unenforceable under Louisiana law, which prohibits such clauses in insurance contracts, and that the McCarran-Ferguson Act (MFA) allows state insurance laws to reverse preempt federal legislation and non-self-executing treaty provisions.The United States District Court for the Southern District of New York ruled in favor of the insured parties, holding that Louisiana law prohibits arbitration clauses in insurance contracts and that the FAA and the New York Convention were reverse-preempted under the MFA, based on the Second Circuit’s previous decision in Stephens v. American International Insurance (Stephens I).The United States Court of Appeals for the Second Circuit reviewed the case. The court concluded that its reasoning in Stephens I had been undermined by the Supreme Court’s decision in Medellín v. Texas, which established a different test for determining whether a treaty provision is self-executing. Applying the Medellín test, the court found that Article II Section 3 of the New York Convention is self-executing. As a result, the court abrogated Stephens I to the extent that it held that Article II Section 3 is not self-executing, reversed the district court decisions, and remanded the matters for further proceedings consistent with its opinion. View "Certain Underwriters at Lloyds, London, v. 3131 Veterans Blvd LLC" on Justia Law

This appeal arises out of a dispute between Century and Global over the extent to which Global is obligated to reinsure Century pursuant to certain reinsurance certificates. The district court held that the dollar amount stated in the “Reinsurance Accepted” section of the certificates unambiguously caps the amount that Global can be obligated to pay Century for both “losses” and “expenses” combined. Century contends that Global is obligated to pay expenses in addition to the amount stated in the “Reinsurance Accepted” provision and that, at a minimum, the district court erred in concluding that the certificates were unambiguous. The court certified to the New York Court of Appeals the following question: Does the decision of the New York Court of Appeals in Excess Insurance Co. v. Factory Mutual Insurance Co., impose either a rule of construction, or a strong presumption, that a per occurrence liability cap in a reinsurance contract limits the total reinsurance available under the contract to the amount of the cap regardless of whether the underlying policy is understood to cover expenses such as, for instance, defense costs? View "Global Reinsurance Corp. of America v. Century Indemnity Co." on Justia Law

Parties to a facultative reinsurance certificate differ as to which of two arbitration provisions govern the resolution of a dispute that has arisen between them. First Mutual, the ceding company, sought to compel its reinsurer, Infrassure, to submit to arbitration governed by an endorsement. Infrassure filed suit seeking a declaratory judgment that the arbitration provision contained in the body of the form is controlling. First Mutual counterclaimed. The district court held that the form’s procedures governed, granted declaratory relief in favor of Infrassure, dismissed First Mutual’s counterclaims, and denied the request to compel arbitration. The court concluded that the contract is unambiguous and the arbitration clause in the body of the certificate controls. The court explained that its reading of the facultative certificate is easily confirmed by consulting other provisions. Accordingly, the court affirmed the judgment. View "Infrassure, Ltd. v. First Mutual Transportation Assurance Co." on Justia Law

Fireman’s Fund, Great American, and MSI issued insurance policies that provided various coverages for a dry dock in Port Arthur, Texas owned by Signal. After the dry dock sank in 2009, Signal and Fireman’s Fund sought contributions from Great American and MSI for the loss of the dry dock and resulting environmental cleanup costs. The district court ruled that the Great American and MSI policies were void in light of Signal’s failure to disclose when it applied for those policies that the dry dock had significantly deteriorated and that repairs recommended by a number of consultants and engineers over several years had not been made. MSI and Signal settled and now Fireman's Fund contends that it may still pursue appeal of the issues relating to the policy issued to Signal by MSI based on the court's decision in Maryland Cas. Co. v. W.R. Grace & Co. The court held that the Great American policy was a marine insurance contract subject to the doctrine of uberrimae fidei and that Signal’s nondisclosure violated its duty under that doctrine, permitting Great American to void the policy. The court also held that MSI’s policy was governed by Mississippi law; that, under that law, Signal materially misrepresented the dry dock’s condition; and that MSI was entitled to void the policy on that basis.  Accordingly, the court affirmed the district court's finding that the policies were void. View "Fireman’s Fund Ins. Co. v. Great Am. Ins. Co." on Justia Law