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In November 2004, an excavator punctured a high-pressured petroleum line owned by Kinder. Gasoline, released into the pipe trench, was ignited by welding activities. The resulting explosion and fire killed five employees and seriously injured four others. Cal/OSHA issued Kinder two “Serious Willful” citations due to the failure of its employees to mark the location of the petroleum pipeline before the excavation to install a water line. Wrongful death and personal injury lawsuits were filed against several defendants, including Kinder and Comforce, which supplied Kinder with temporary employees. Kinder sought coverage under its insurance policies, and also under Comforce‘s primary and umbrella policies with ACE. ACE agreed to participate in Kinder‘s defense under Comforce‘s primary policy, but under a reservation of rights. ACE declined coverage under Comforce‘s umbrella policy, based on a policy exclusion for “professional services.” The lawsuits against Kinder settled before trial. When Kinder’s policy limit was exhausted, its insurer sued ACE, seeking full reimbursement of the payments it made under its excess policy, alleging that Kinder was an additional insured under Comforce‘s umbrella policy and that the ACE umbrella policy was a first-level excess policy. The court of appeal affirmed summary judgment in favor of ACE finding the policy excluded the claims in the underlying lawsuits. View "Energy Insurance Mutual Ltd. v. Ace American Insurance Co." on Justia Law

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In 2014, Haley and others filed a putative class action against Kolbe & Kolbe Millwork, claiming that windows purchased from Kolbe were defective and had allowed air and water to leak into (and damage) the plaintiffs’ homes. Kolbe tendered the defense of the defective-product claims to several insurance companies. Two companies—United States Fire Insurance and Fireman’s Fund—obtained permission to intervene in the case. United States Fire successfully moved for summary judgment, arguing that a 2016 decision of the Wisconsin Supreme Court (Pharmacal) absolved the insurers of their duty to defend Kolbe in the underlying suit. The court sua sponte awarded judgment to Fireman’s Fund. The Seventh Circuit reversed the judgment that the insurance companies had no duty to defend. The “Pharmacal” analysis does not apply because the homeowners sought compensation for the repair or replacement of individual elements of a larger structure. This kind of particularized demand was not at issue in Pharmacal, which applied an "integrated structure" analysis. Whether the walls and other elements of the plaintiffs’ homes constitute Kolbe’s “product,” such that coverage for any damage to those materials is extinguished by a policy exclusion is ambiguous. View "Haley v. Kolbe & Kolbe Millwork Co." on Justia Law

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From 1977-1984 Banco reinsured 2% of the Insurer’s business. The Insurer stopped writing policies in 1985, went into receivership in 1986, and began liquidating in 1987. Through 1993 the liquidator complied with contractual provisions requiring balances to be calculated quarterly and statements sent. If the Insurer owed reinsurers net balances for the previous quarter, it paid them; if the reinsurers owed the Insurer, bills were sent. In 1993, the liquidator stopped sending checks or bills without explanation. In 2008, the liquidator notified Banco that Banco was owed $225,000 as the net on 1993-1999 business. For periods before 1993, the Insurer was owed $2.5 million. In 2010, Banco protested the bill as untimely. Pine bought the Insurer’s receivables and, in 2012, sued Banco. Litigation about procedural issues, arising from the fact that Banco is wholly owned by Uruguay, consumed several years. The Seventh Circuit affirmed summary judgment, holding that Pine’s claim is untimely. Each contract required scheduled netting of claims and payment of the balance. Claims against Banco accrued no later than 1993. The contracts specify application of Illinois law, which allowed 10 years (until 2003) to sue on contracts. A statute concerning insurance liquidation, 215 ILCS 5/206, does not permit a liquidator to wait until the end to net the firm’s debits and credits. View "Pine Top Receivables of Illinois, LLC v. Banco de Seguros del Estado" on Justia Law

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The Court of Appeals affirmed the finding of the Workers’ Compensation Commission (WCC) that Employer and Insurer (collectively, Respondents) were entitled to offset the ordinary disability benefits already paid to Petitioner against the temporary total disability benefits paid to him by Respondents. Petitioner suffered injuries primarily to his back and neck while working for Employer. Employer received two different sets of disability benefits from Employer and Insurer, each awarded by a different state agency. Specifically, Petitioner was granted temporary total disability benefits by the WCC and ordinary disability benefits by the State Retirement Agency. The WCC found that Respondents were entitled to a credit for the ordinary disability benefits already paid to Petitioner. On judicial review, the circuit court granted summary judgment in favor of the WCC. The Court of Appeals affirmed, holding that because both sets of benefits compensated Petitioner for the same injury, pursuant to Md. Code Ann. Lab. & Empl. 9-610, the statutory offset properly applied to prevent a double recovery for the same injury. View "Reger v. Washington County Board of Education" on Justia Law

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Lori Greenwood was injured while working for J.J. Hooligans, LLC. Greenwood was informed that because of nonpayment, FirstComp Insurance Company (FirstComp) was not the workers’ compensation insurance carrier on the date of the accident. Greenwood filed a petition against J.J. Hooligan’s and FirstComp seeking workers’ compensation benefits. FirstComp filed a motion to dismiss, arguing that it was not a proper party because it had timely notified J.J. Hooligan’s that it had terminated its insurance coverage for nonpayment of its premium and therefore did not provide workers’ compensation insurance on the date of the accident. The Nebraska Workers’ Compensation Court sustained the motion to dismiss. The Supreme Court reversed, holding that FirstComp failed to present sufficient competent evidence as to whether it complied with the employer notice of cancellation requirement in Neb. Rev. Stat. 48-144.03 to warrant an order of dismissal. View "Greenwood v. J.J. Hooligan’s, LLC" on Justia Law

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Jacob Plassmeyer incurred medical expenses during a collegiate baseball practice, and his college provided its student athletes insurance with FA. Jacob's father was also insured by the Dakotas, an employee welfare benefit plan, and Jacob was covered under this Employee Retirement Income Security Act (ERISA) plan as a dependent of his father. In this case, the trustees of Dakotas brought this declaratory judgment action against FA under section 502(a)(3) of ERISA, 29 U.S.C. 1132(a)(3), seeking an order enforcing the coordination of benefits (COB) provisions in the Dakotas plan by declaring that FA's policy provided primary coverage of Jacob's claim for medical expenses already incurred. The district court denied FA's motion to dismiss and granted Dakotas' motion for summary judgment. The Eighth Circuit held that a declaratory judgment action to enforce the Dakotas plan as it applied to the claim for benefits was both consistent with the plain language of section 502(a)(3), as construed in light of historical equitable remedies available to trustees; the court agreed with the district court that FA's coverage was primary; but the district court abused its discretion in awarding attorney fees. Accordingly, the court affirmed in part, reversed in part, and remanded. View "Dakotas and Western Minnesota Electrical Industry Health & Welfare Fund v. First Agency, Inc." on Justia Law

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The Fifth Circuit affirmed the district court's grant of summary judgment for Nationwide in a suit seeking insurance coverage for an underlying complaint. The court held that the underlying complaint failed to allege an advertising injury covered under the policy because it did not allege the use of another's advertising idea, a trade dress claim, nor a claim for slogan infringement. View "Laney Chiropractic and Sports Therapy v. Nationwide Mutual Insurance Co." on Justia Law

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HRA appealed the district court's order declining to grant pre-award interest on an insurance appraisal award. The Eighth Circuit reversed and remanded, holding that the Minnesota Supreme Court subsequently ruled that Minnesota Statute section 549.09 provides for pre-award interest on such awards. On remand, the district court may decide in the first instance how to calculate the pre-award interest. View "Housing and Redevelopment Authority of Redwood Falls v. Housing Authority Property Insurance" on Justia Law

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The Supreme Court reversed the dismissal of Appellant’s complaint against American Standard Insurance Company of Wisconsin claiming wrongful denial of coverage. American Standard denied underinsured coverage to Appellant, who was in a motorcycle-motor vehicle accident, asserting that Appellant’s motorcycle insurance policy had been canceled prior to the accident. The district court granted partial summary judgment for American Standard. The Supreme Court reversed, holding that the district court erred when it found that American Standard sent a cancellation notice to Appellant by certified mail in compliance with Neb. Rev. Stat. 44-516, and therefore, American Standard was not entitled to judgment as a matter of law. View "Barnes v. American Standard Insurance Co. of Wisconsin" on Justia Law

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The Supreme Judicial Court affirmed the judgment of the superior court granting summary judgment in favor of North East Insurance Company on the reach and apply action Richardie Kelley brought pursuant to Me. Rev. Stat. 24-A, 2904. The superior court concluded that the damages awarded to Kelley in the underlying action were based on a claim that did not fall within the scope of the North East automobile insurance policy. The Supreme Judicial Court agreed, holding Kelley failed to carry her burden of showing the damages she was awarded in the underlying action were based on a claim that fell within the scope of the North East policy. View "Kelley v. North East Insurance Co." on Justia Law