K2 Investment Group et al. v. American Guarantee and Liability Insurance Company
Year: 2013
Court: New York Court of Appeals
Case Number: APL-2012-00055/117902/09
Issue:
  • Duty to Defend
State:
  • New York

UP argued that an insurer’s “duty to defend” is its most basic responsibility under the insurance contact and a failure to do is tantamount to a material breach of contract. As such, the imposition of the Lang rule, which requires insurers in the state of…
Sebo v. American Home Assurance Co.
Year: 2014
Court: Florida Supreme Court
Case Number: SC 14-897
Issue:
  • Concurrent Causation
  • Efficient Proximate Cause
State:
  • Florida

Insurance coverage in cases involving concurrent causation (i.e., multiple causes, some covered, some not) has been the subject of great debate, with courts settling on two principal rules of law – the concurrent cause and efficient proximate cause doctrines. For over a quarter-century, Florida has…
Federal Insurance Co. v. MBL, Inc.
Year: 2013
Court: California Supreme Court
Case Number: H0369296 & H036578
Issue:
  • A Policyholder’s Right to Independent Counsel (“Actual” vs. “Potential” Conflicts)
  • Reservation of Rights
State:
  • California

UP’s position in its amicus brief in this case is that policyholders have a right to independent counsel in cases where the insurer has a “potential” conflict of interest as well as in cases where the insurer’s conflict is actual.. In support of this position,…
State Farm Fire and Casualty Company vs. Shawn Brechbill
Year: 2013
Court: Alabama Supreme Court
Case Number: CV-2010-900034
Issue:
  • Bad Faith
State:
  • Alabama

UP weighed in as a friend of the court to ask that the Brechbill opinion be corrected to accurately state the law in the State of Alabama for the past 30 years with regard to insurer breach of contract and bad faith. Under AL law,…
The Lincoln Electric Company v. Travelers Casualty and Surety Company, et al.,
Year: 2013
Court: Ohio Supreme Court
Case Number: 2013-1088
Issue:
  • All Sums
  • Pro Rata Approach
State:
  • Ohio

This case affords the Ohio Supreme Court the opportunity to reaffirm that an insured can employ an all sums approach to aggregate unreimbursed losses when they have accrued indemnity and defense costs arising from progressive injuries and have settled the resultant claims against primary insurers…
Nucor Corporation v. Employers Insurance Company of Wausau and Hartford Accident & Indemnity Company
Year: 2012
Court: Arizona Supreme Court
Case Number: CV-12-0403-PR
Issue:
  • Stigma Damages / Whether physical damage to an insured’s property is necessary to trigger coverage?
State:
  • Arizona

Mariposa County property owners brought suit against Nucor for the loss in value of their properties alleging that Nucor negligently let the toxic trichloroethylene, a cleaning solvent, leak into their soil and pollute their groundwater. Nucor settled the claims and then sought reimbursement from its…
Commonwealth Land Title Insurance Company vs. Stephen W. Robertson, Insurance Commissioner of the State of Indiana, on behalf of the Indiana Department of Insurance
Year: 2013
Court: Indiana Court of Appeals
Case Number: 49A04-1302-PL-00084
Issue:
  • Title Insurance
State:
  • Indiana

Title insurance rates (and profits) continue to rise despite the fact that expenses have dropped considerably due to automation and the ease of internet-based records searches. UP weighed in on this case in support of title insurance policyholders and the Indiana Department of Insurance’s efforts…
Badiali v. New Jersey Manufacturers Insurance Company
Year: 2012
Court: New Jersey Supreme Court
Case Number: A-4870-09T2
Issue:
  • Bad Faith
State:
  • New Jersey

This case affords the New Jersey Supreme Court an opportunity to review how the New Jersey lower courts have resolved bad faith claims handling since the Supreme Court’s landmark decision in Pickett v. Lloyds, 131 N.J. 457 (1993). UP’s amicus brief argues that the lower…
Fluor Corporation v. Superior Court of Orange County, CA. (Real Party in Interest Hartford Accident and Indemnity Co.)
Year: 2012
Court: California Supreme Court
Case Number: S205889
Issue:
  • Anti-assignment Clause
State:
  • California

This case involves an insurance company’s effort to cut off the coverage/protection rights of one of its insureds based on a clause prohibiting assignments without the insurer’s consent. The insured is a construction company that paid substantial premiums to the insurance company in return for…
Julie Heimeshoff v. Hartford Life & Accident Insurance Co. and Wal-Mart Stores, Inc.
Year: 2012
Court: Supreme Court of the United States
Case Number: 12-729
Issue:
  • ERISA
State:
  • United States

On July 2, 2013, United Policyholders weighed in as amicus curiae (friend of the court) in the matter of Heimeshoff v. Hartford Life & Accident Insurance Co. and Wal-Mart Stores, Inc., a case that will be heard by the U.S. Supreme Court this Fall. The…
Letter Opposing Request for Depublication: Ellena v. Department of Insurance
Year: 2014
Court:
Case Number:
Issue:
  • Regulatory Authority
State:
  • California

In response to the California Department of Insurance’s letter requesting republication, UP wrote in support of the published decision in Ellena v. Department of Insurance. UP argued that the decision that Department of Insurance must review approve and reject diability policy forms under statute. The…
Seber v. General Fire and Cas. Co. et al
Year: 2014
Court: Indiana Supreme Court
Case Number: Appeal from 53A01-1405-PL-00208
Issue:
  • Ambiguity and Omission
  • Replacement Cost Value
State:
  • Indiana

Policyholders pay higher premiums for replacement cost value policies in order to recoup additional insurance proceeds necessary to rebuild or purchase substitute property. Insurers should be prohibited from attempting to pay only actual cash value (i.e., depreciated value) based on semantic discussions of undefined or…
Kerrigan v. Metropolitan Life Insurance Company
Year: 2014
Court: New York Court of Appeals
Case Number: 111775/2003
Issue:
  • Post Claims Underwriting
State:
  • New York

“Post-claims underwriting” describes the scenario where an insurer waits until after the insured makes a claim to investigate whether the insured is eligible for coverage based on the risk he or she presents. Post-claims underwriting (also referred to as “post-loss underwriting” or “retroactive underwriting” in…
Universal American Corp. v. National Union Fire Ins. Co.
Year: 2014
Court: New York Court of Appeals
Case Number: APL-2014-00133
Issue:
  • Cyber Liability
State:
  • New York

The carrier denied coverage for payments incurred as losses for fraudulent use of the insured’s computer systems (bogus medicare payments). However, the insured had purchased a “Computer Systems Fraud” rider which the insured argued would cover such losses. Fraudulent conduct, as defined in the rider,…
Advance Cable, Inc. v. Cincinnati Ins. Co.
Year: 2014
Court: U.S. Court of Appeals, 7th Circuit
Case Number: 14-02620
Issue:
  • Direct Physical Loss - Cosmetic Damage
  • Reasonable Expectations of Coverage
State:
  • Wisconsin

Insurance contracts are to be construed in accordance with the plain meaning of terms and the reasonable expectations of the policyholder. Doing so not only ensures that parties to a contract of insurance receive the benefit of the bargain, but is also good public policy.…
Liberty Mut. Ins. Co. v. Ash Grove Cement Co.
Year: 2014
Court: U.S Court of Appeals, 9th Circuit
Case Number: 13-35900; 13-35905; 14-35298
Issue:
  • Duty to Defend - 104(e) Letters
  • Environmental Liabilities
State:
  • Oregon

UP, joined by co-amici The Marine Group, LLC, MMGL Corp. and Schnitzer Steel Industries, Inc. urged the Court to uphold a correct ruling by an Oregon District Court that a 104(e) Request for Information Letter triggers the duty to defend under a commercial general liability…
Mut. Benefit Ins. Co. v. Politopoulos et al.
Year: 2014
Court: Pennsylvania Supreme Court
Case Number: 60 MAP 2014
Issue:
  • Employer's Liability
  • Separation of Insureds
State:
  • Pennsylvania

Under a correct reading of an Umbrella Policy, an Employer’s Liability exclusion only applies where an insured is sued by its own employee (e.g., damages for bodily injury in a suit brought by a co-insured). Pennsylvania law supports this interpretation. An Umbrella policy’s provisions are…
Russell v. Catholic Healthcare, UNUM et al.
Year: 2014
Court: U.S, Court of Appeals, 6th Circuit
Case Number: 13-4084
Issue:
  • ERISA
  • Statute of Limitations
State:
  • Ohio

ERISA plan administrators must include a time limit for judicial review (i.e., a statute of limitations to file suit) in a letter denying disability benefits. In the absence of such a notification, contractual limitations cannot be enforced against the participant, as required by federal regulations.…