Georgia Farm Bureau Mut. Ins. Co. v. Bobby Chupp and Amy Smith
Year: 2015
Court: Georgia Supreme Court
Case Number: S15G1177
Issue:
  • Pollution Exclusion and Coverages
State:
  • Georgia

Claims for personal injury resulting from lead-based paint ingestion are not excluded from coverage pursuant to pollution exclusions typically included in commercial general liability (“CGL”) insurance policies. Often referred to as the “absolute” or “total” pollution exclusion, this provision – as evidenced by, inter alia,…
Monarch et al v. National Union Fire Ins. Co.
Year: 2015
Court: New York Court of Appeals
Case Number: 102187/11
Issue:
  • Prior Approval of Policies
  • Regulatory Authority
State:
  • New York

Under the California Insurance Code, the Worker’s Compensation Insurance Rating Bureau is required to submit policy forms to the Department of Insurance for review before they may be approved for sale to the public. Insurers may not alter policy forms after they are reviewed and…
Rooftop Restoration, Inc. v. American Family Mut. Ins. Co.
Year: 2017
Court: Colorado Supreme Court
Case Number: 2017SA3
Issue:
  • Statute of Limitations
State:
  • Colorado

Under Colorado law, a policyholder may bring action under the “prompt payment statute” when an insurance company unreasonably delays or denies payment on a valid insurance claim. On certified question from the Colorado Federal District Court, the Colorado Supreme Court was confronted with the issue…
Liberty Surplus Insurance Corporation v. Ledesma and Meyer Construction Co., Inc.
Year: 2017
Court: California Supreme Court
Case Number: S236765
Issue:
  • Accident/Occurrence
  • Employee's Torts and Negligence
  • Employer's Vicarious Liability
State:
  • California

California courts have long held that liability insurance covers an employer’s vicarious liability for employee negligence as well as intentional torts. In countless decisions over the years, California courts have upheld coverage for employer’s vicarious liabilities for intentional, willful acts and torts of their employees…
The Doe Run Resources Corp. v. American Guarantee and Liability Insurance Co. et al
Year: 2017
Court: Missouri Supreme Court
Case Number: No. SC96107
Issue:
  • Contract Interpretation
  • Duty to Defend
State:
  • Missouri

Insurance companies have the burden to draft express and clear exclusions when they desire to limit the coverage they sell to their policyholders. Pollution exclusions in particular must be clear and unambiguous. These exclusions have caused an enormous amount of litigation and confusion in the…
Continental Ins. Co. et al v. Honeywell International, Inc
Year: 2017
Court: New Jersey Supreme Court
Case Number: A-1071-13T1, A-1100-13Tl
Issue:
  • Allocation
  • Unavailability of Insurance
State:
  • New Jersey

Under the seminal case of Owens-Illinois v. United Ins. Co., the New Jersey Supreme Court held that under the Keane rule, a policyholder’s entire liability can be allocated to a single triggered policy. The policyholder can only assume the portion of the risk for which…
In re State Farm Lloyds
Year: 2017
Court: Texas Supreme Court
Case Number: No. 15-0903
Issue:
  • Claim File
  • Rules of Discovery - Native Form Documents
State:
  • Texas

When homeowners file claims, insurance companies have a duty to conduct a prompt, reasonable investigation of the damage. When insurance companies fail to do so, they may be held accountable by law. They can be held accountable for the failure to investigate as well as…
Hotchalk Inc. v. Scottsdale Ins. Co.
Year: 2017
Court: U.S. Court of Appeals, 9th Circuit
Case Number: 16-17287
Issue:
  • Duty to Defend
State:
  • California

In California, coverage wording in insurance policies are interpreted broadly so as to afford the greatest possible protection to the insured, while exclusions are construed narrowly and against the insurer. Exclusions must be conspicuous, plain and clear. If provisions in an insurance policy are ambiguous,…
Hartford Fire Ins. Co. v. Tempur-Sealy Int’l Ins. Co.
Year: 2017
Court: U.S. Court of Appeals, 9th Circuit
Case Number: 16-16056
Issue:
  • Duty to Defend
State:
  • California

The most fundamental obligation of a liability insurer is to defend it’s insured against suits alleging bodily injury or property damage. The duty to defend is broader than the duty to indemnify. This duty is triggered when any of the allegations of the complaint potentially…
Stein v. AXIS Insurance Company
Year: 2017
Court: California Court of Appeal, Second District, Division One
Case Number: B265069
Issue:
  • D & O
  • Directors & Officers
  • Final Adjudication
  • Fraudulent or Criminal Acts
  • Scope of an Exclusion
State:
  • California

In this letter requesting publication, UP urged publication because the decision addresses an issue of great importance to the insurance community, on which there is no published appellate decision, and no citable California decision: for purposes of standard form exclusions in director and officer (“D&O”)…
Ryan Escobar v. Tower Hill Signature Ins. Co.
Year: 2017
Court: Florida Court of Appeal, Third District
Case Number: 15-28620 CA 01
Issue:
  • Actual Cash Value
State:
  • Florida

The Florida Legislature has mandated under Fla. Stat. § 627.7011(3)(a) that a property insurer must pay the actual cash value (“ACV”) of a homeowner’s property loss without first requiring repairs to the property. Here, the insurer made a payment based upon its adjuster’s estimate of…
Jesus Camacho et al v. Nationwide Mut. Ins. Co.
Year: 2017
Court: U.S. Court of Appeals, 11th Circuit
Case Number: 16-14225
Issue:
  • Duty to Settle
  • Good Faith and Fair Dealing
State:
  • Georgia

An insurer’s duty of good faith and fair dealing extends to settling claims against its insured. In a liability case, such as an automobile accident, an insurer must take and active role in settlement negotiations and where a reasonable settlement offer within policy limits is…
Richard L. Fowler et al v. Caliber Home Loans et al
Year: 2017
Court: U.S. Court of Appeals, 11th Circuit
Case Number: 16-16585
Issue:
  • Force-placed Insurance
  • Regulatory Approval of Rates
State:
  • Florida

In general, state insurance regulators must approve an insurer’s rates before their insurance products are sold to the public. The effect of this is that generally plaintiffs are barred from bringing claims against insurers for unfair or discriminatory rates. This is known as the “filed-rate”…
Rancosky v. Washington National Ins. Co.
Year: 2017
Court: Pennsylvania Supreme Court
Case Number: 28 WAP 2016
Issue:
  • Bad Faith
State:
  • Pennsylvania

Under Pennsylvania law, insurance companies are subject to attorneys fees and punitive damages for acting in bad faith towards their policyholders. State law also provides that courts may award interest 3% above the prime rate when a policyholder prevails in a bad faith claim. This…
Mount Vernon Fire Ins. Co. v. VisionAid, Inc.
Year: 2016
Court: Massachusetts Supreme Judicial Court
Case Number: SJC-12142
Issue:
  • Duty to Defend
State:
  • Massachusetts

Under Massachusetts law, an insurance company’s duty to defend is broad and encompasses the prosecution of a policyholder’s counterclaims. UP reminded the court that the rule in Massachusetts is “in for one, in for all.” By including counterclaims that are “inextricably intertwined” which the litigation…
Scot and Joanna Sobieski v. American Family Ins. Co. et al
Year: 2017
Court: Arizona Supreme Court
Case Number: CV-16-0253-PR
Issue:
  • Punitive Damages
State:
  • Arizona

In a brief supporting a petition for review, UP argued that when a reviewing court disregards a jury’s finding that punitive damages were warranted in an insurance bad faith case, it is harmful to consumers. When an insurance company acts in bad faith, the discretion…
James Nalder v. United Automobile Ins. Co.
Year: 2016
Court: Nevada Supreme Court
Case Number: 70504
Issue:
  • Duty to Defend
State:
  • Nevada

Under contract principles, a party that breaches a duty owed under a contract is liable for losses consequential for that breach when there is a special circumstance present. Contracts of insurance present a special circumstance given the special relationship between the parties and nature of…
Labrier v. State Farm Fire and Cas. Co.
Year: 2016
Court: U.S. Court of Appeals, 8th Circuit
Case Number: 16-3185/16-3562
Issue:
  • Labor Depreciation
State:
  • Missouri

Depreciation of labor in an actual cash value payment is fundamentally at odds with the the purpose of insurance – to indemnify the policyholder in case of a loss. Physical components such as shingles, for example, do lose integrity and value over time due to…