Peoples Insurance Counsel Division v. State Farm
Year: 2014
Court: Maryland Court of Appeals
Case Number: 21 - September Term 2014
Issue:
  • Contract Interpretation
State:
  • Maryland

Maryland law does not apply the rule of contra proferentem, accepted by a majority of states – that ambiguous terms in insurance contracts are to be construed strictly against the insurer-drafter; instead, Maryland law treats an insurance contract like any other contract, drafted by parties…
Vandana Upadhyay v. Aetna Life Ins. Co.
Year: 2014
Court: U.S. Court of Appeals, 9th Circuit
Case Number: 14-15420
Issue:
  • ERISA
State:
  • California

In this case, the District Court held that the insured’s ERISA action was untimely under the provisions of the Long-Term Disability Plan because the contractual deadline for filing suit ended on July 1, 2010, even though the insured had a right to file her claim…
Pistorese v. Transamerica Life Insurance Company
Year: 2014
Court: U.S. Court of Appeals, 9th Circuit
Case Number: 14-35027
Issue:
  • Contract Interpretation
  • Long Term Care Insurance
State:
  • Washington

Under Washington law, insurance contracts are to be interpreted based on the principle of contra preferentem – ambigious terms must be strictly construed against the drafter-insurer and in favor of the insured as to effectuate coverage. UP argued in its brief, that in the long-term-care…
Thomson, Inc. et al. v. XL Insurance, Inc. et al.
Year: 2014
Court: Indiana Supreme Court
Case Number: 49A05-1109-PL-470
Issue:
  • Allocation
  • Contract Interpretation
State:
  • Indiana

On appeal from a decision in error by the Indiana Court of Appeal, UP argued in its brief that the presumptive rule in determining the scope of coverage under a Commercial General Liability Policy (“CGL”) should be “all-sums” or joint and several liability. For “long-tail”…
Allstate Property and Casualty Co. v. Jared Wolfe
Year: 2014
Court: Pennsylvania Supreme Court
Case Number: 39 MAP 2014
Issue:
  • Assignment of Bad Faith Claims
  • Public Policy and Tort Remedies
State:
  • Pennsylvania

On certified question from the U.S. Court of Appeals for the Third Circuit, the Pennsylvania Supreme Court confronted the issue of whether statutory bad faith claims may be assigned to an injured third party when the insured settles its claim and/or chooses not to pursue…
Street Surfing, LLC v. Great American E&S Ins. Co.
Year: 2014
Court: U.S. Court of Appeals, 9th Circuit
Case Number: 12-5531
Issue:
  • Commercial General Liability
  • Duty to Defend
State:
  • California

Under California law, the duty to defend is broader than the duty to indemnify. In fact, under Montrose Chem. Corp. v. Superior Court, 6 Cal. 4th 287, 300 (1993), “the insured must prove the existence of a potential for coverage, while the insurer must establish…
Thomas Nickerson v. Stonebridge Life Ins. Co.
Year: 2014
Court: California Supreme Court
Case Number: S213873
Issue:
  • Punitive Damages
State:
  • California

Punitive damages awards are subject to heightened Due Process scrutiny after the U.S. Supreme Court’s decision in State Farm v. Campbell. While the Campbell ruling did not establish a bright-line rule, many state and federal courts, including California, have announced that no more than a…
Recall Total Information Management Inc., et al. v. Federal Insurance Co.
Year: 2014
Court: Connecticut Supreme Court
Case Number: S.C. 19291
Issue:
  • Advertising Injury
  • Data Breaches
  • Duty to Defend
  • Reasonable Expectations
State:
  • Connecticut

Under Commercial General Liability policies (“CGL”) and Umbrella policies, “publication” of usually defamatory statements to a third person will trigger coverage for “advertising injury” and a carrier’s duty to defend. Here, the Court of Appeal erroneously found that loading confidential personal employee data onto encrypted…
Cedar Bluff Townhome Condominium Assn. v. American Family Mut. Ins. Co.
Year: 2014
Court: Minnesota Supreme Court
Case Number: A13-0124
Issue:
  • Like Kind Replacement
  • Uniform Appearance/spot-repairs
  • Unjustfied Premiums
State:
  • Minnesota

Under Minnesota law, insurers are required to replace damage and undamaged property with the same “like kind construction and similar use” to ensure uniform appearance and prevent decreased property values resulting from mismatched repairs. UP urged the Court to estop insurers from conducting “spot-repairs” and…
In re: Deepwater Horizon
Year: 2014
Court: Texas Supreme Court
Case Number: 13-0670
Issue:
  • Interpretation
  • Sophisticated Policyholders
State:
  • Texas
Wellpoint Inc., Anthem Ins. Co v. Nat. Union. Fire Ins. Co.
Year: 2014
Court: Indiana Supreme Court
Case Number: 49A05-1202-PL-92
Issue:
  • Errors and Omissions
State:
  • Indiana

This case arises from a class-action lawsuit alleging that the insurer unlawfully conspired to systematically delay, deny, and diminish payments to doctors under a health plan. The insuring agreement in the policy at issue provided coverage for “errors and omissions” (E&O) arising out of “professional…
Estate of Rochow v. Life Insurance Co. of North America
Year: 2014
Court: U.S. Court of Appeals, 6th Circuit
Case Number: 12-2074
Issue:
  • Disgorgement of Profits
  • ERISA
State:
  • Michigan

Where an insurer has wrongfully delayed or denied a covered claim, extra-contractual remedies are necessary to punish the conduct at issue and deter similar conduct in the future. UP argued in its brief that disgorgment of profits is an appropriate remedy for bad faith denial…
Thornell et al v. State Farm and Seattle Service Bureau
Year: 2015
Court: Washington Supreme Court
Case Number: 91393-5
Issue:
  • Scope of State Consumer Protection Law
  • Unfair Debt Collection Practices
State:
  • Washington

Under the Washington state Consumer Protection Act (“CPA”) consumers are protected from harassing and misleading collection notices from unscrupulous debt collectors who target, at the behest of insurers, policyholders who in actuality do not owe any money to settle claims. In more egregious cases, policyholders…
Maplewood Partners v. Indian Harbor Ins. Co.
Year: 2015
Court: U.S. Court of Appeals, 11th Circuit
Case Number: 15-11953
Issue:
  • Attorney-Client and Work-Product Privilege
  • Tripartite Relationship
State:
  • Florida

The District Court set a dangerous precedent in regards to the discovery and use of documents protected by the attorney-client privilege and work product immunity in insurance coverage cases. If the decision is allowed to stand, communications between an insured and the attorney it hires…
St. Paul Mercury Ins. Co. v. American Bank Holdings, Inc.
Year: 2015
Court: U.S. Court of Appeals for the 4th Circuit
Case Number: 15-1559
Issue:
  • Duty to Defend
  • Notice-prejudice
State:
  • Maryland

UP addressed two issues in its brief: (1) under Maryland law, an insurer must show actual prejudice in order to escape coverage for a valid claim that is reported after the policy deadline; and (2) duty to defend principles applicable to the insurer should not…
California Fair Plan Association v. Marlene Garnes
Year: 2015
Court: California Court of Appeal, First Appellate District, Division Two
Case Number: A143190
Issue:
  • Loss Settlement Valuation for Actual Cash Value Policies
State:
  • California

Under the California Insurance Code, the California Fair Plan, the state’s insurer-of-last-resort, is required to, in the case of a partial loss to a policyholder’s home, pay the lesser of the cost of repair or the policy limits under an actual cash value policy. In…
Letters to California Judicial Council re: Civil Jury Instructions for Bad Faith and Insurer Defense Cost Reimbursement
Year: 2015
Court:
Case Number:
Issue:
  • Bad Faith
State:
  • California

UP submitted letters to the California Judicicial Council regarding proposed revisions to California Civil Jury Instructions (“CACI”) Nos. 2330-2337 and 2351: First, UP argued that the proposed language of CACI 2330-2337 conflates the standard for “bad faith” claim by collapsing the “unreasonably” and “without proper…
Centex Homes v. St. Paul Ins. Co.
Year: 2015
Court: California Supreme Court
Case Number: E060057
Issue:
  • Independent (Cumis) Counsel
State:
  • California

UP and the Consumer Attorneys of California submitted a letter supporting a petition for review in an important case involving a policyholder’s right to independent counsel. A policyholder’s right to independent counsel when a conflict arises between the insured and the insurer, both represented by…