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…
Schnitzer Steel et al v. Continental Casualty Co et al.
Year: 2015
Court: U.S. Court of Appeals. 9th Circuit
Case Number: 15-35101
Issue:
  • Attorney's Fees
  • Environmental Liabilities
State:
  • Oregon

Under Oregon law, policyholders who sue their insurance company for delaying or denying legitimate claims can recover their attorney’s fees. UP reminded the Court that Oregonians currently have few protections available to them when insurance companies refuse to honor their contractual obligations. Indeed, as Oregon…
Montanile v. Board of Trustees of the National Elevator Industry Health Plan
Year: 2015
Court: U.S. Supreme Court
Case Number: 14-723
Issue:
  • Health insurance and Social Security reimbursement under ERISA
State:
  • U.S. Supreme Court

UP weighed in because the Court’s decision could have broad-reaching implications for participants in disability plans as well as health plan participants. Most, if not all, employer-sponsored disability benefit plans coordinate benefits with other sources of disability income, the most important of which are Social…
U.S. Metals v. Liberty Mutual Group
Year: 2015
Court: Texas Supreme Court
Case Number: 14-0753
Issue:
  • Contract Interpretation - Ambiguity
  • Physical injury requirement for property coverage
State:
  • Texas

On certified question from the U.S. Court of Appeals for the 5th Circuit, the Texas Supreme Court was confronted with the question of whether the “your product” and “impaired property” exclusions in CGL policies, are the terms “physical injury” and/or “replacement” ambiguous? UP argued, inter…
De La Fuente v. Florida Insurance Guaranty Association
Year: 2015
Court: Florida Supreme Court
Case Number: SC15-519/2D13-3543
Issue:
  • Covered claims
  • Insolvency obligations
State:
  • Florida

Under Florida law, when insurers become insolvent, the Florida Insurance Guaranty Association (“FIGA”) becomes legally obligated to pay covered claims. In cases where the policy is amended, either by the carrier or by legislative or FIGA directive, insurance money must be available when a policyholder…
Catherine Cadle v. GEICO
Year: 2015
Court: U.S. Court of Appeals, Eleventh Circuit
Case Number: 15-11283
Issue:
  • Bad Faith/Summary Judgment
  • Failure to Settle
State:
  • Florida

Under Florida law, whether a liability insurer has failed to settle in good faith when it could and should have settled a claim is determined under the totality of the circumstances standard, with each case determined on its own facts. Ordinarily, the question of failure…
Artun Vardanyan v. AMCO Ins. Co.
Year: 2015
Court: California Court of Appeal, Fifth District
Case Number: F069953
Issue:
  • Causation
  • Jury Instructions
State:
  • California

California is among a minority of states that recognize the Efficient Proximate Cause (“EPC”) doctrine. Under the EPC, when multiple perils combine to cause loss of damage to an insured property, even if one cause is excluded, if the efficient proximate cause (the most important/predominant…
World Harvest Church v. Grange Mutual
Year: 2015
Court: Ohio Supreme Court
Case Number: 14-1161
Issue:
State:
  • Ohio

When a policyholder purchases a separate endoresment providing insurance coverage for intentional torts of employees, insurers may not disclaim coverage by using vicarious liability as a shield. Further, when an insurer has a duty to defend, it becomes liable for all damages awarded against the…
Tabares et al v. Equitrust Life Ins. Co.
Year: 2015
Court: California Court of Appeal, Second District, Division Seven
Case Number: B254409
Issue:
  • Breach of Contract - Consumer Protection
  • Life Insurance - Indexed Annuities
State:
  • California

Indexed annuities are life insurance products that promise high yields for consumers. However, some of these products are sold with “premium bonuses” that in actuality tax the return of the product over time resulting in little or no net gain. Agents and brokers are paid…
Raffone et al v. First American Title Ins. Co.
Year: 2015
Court: Court of Appeal, First District
Case Number: 1D14-4791/2004-CA-78
Issue:
State:
  • Florida

Florida law imposes a non-delegable duty on title insurers to charge a lower reissue rate when a property is refinanced with clear title. UP argued in it’s brief that title insurers are sophisticated data collectors who can and should be able to locate prior owner’s…
Demetrio v. Stewart Title Insurance
Year: 2015
Court: New York Court of Appeals
Case Number: 2010/101760
Issue:
  • Contract Interpretation
State:
  • New York

A court faced with textual ambiguity may review extrinsic evidence to assist the trier of fact in ascertaining what the parties intended in entering into the contract. UP argued in its brief that an insurance company ought not to be able argue to the court,…
Zurich American Ins. Co. v. Sony
Year: 2015
Court: New York Appellate Division, Manhattan
Case Number: 651982/11
Issue:
  • Contract Interpretation
  • Data Breach/Cyber Liability
State:
  • New York

Insurance coverage for data breach should be available under a commercial general liability policy’s “publication” provision. Under New York law, coverage should be available for situations where the insured is alleged to have intentionally published material and when it negligently permits a third party to…