A homeowners insurance policy often covers every member of a family, and many policies state that the insurance applies separately to each insured. The same policies usually exclude coverage for intentional acts. But what happens when one insured is accused of negligently permitting a different, separately-covered family member to cause harm intentionally? Last month, in American National Property & Casualty Company v. Clendenen, No. 16-0290 (W. Va. Nov. 17, 2016), ... Keep Reading »
Automobile
Eleventh Circuit Clarifies “Permanency” Requirement under Florida Bad Faith Statute
In Cadle v. GEICO Ins. Co., Case No. 15-11283 (11th Cir. Sept. 30, 2016), the Eleventh Circuit held that GEICO had not acted in bad faith when it failed to settle a claim after the insured did not provide any evidence of permanency during the cure period as is required by Florida law. With A Friend Like This… On July 2007, Catherine Cadle was rear-ended by Derek Friend, an underinsured motorist driving down I-95. Cadle had previously purchased insurance providing ... Keep Reading »
Look, up in the sky! It’s a bird, it’s a plane, it’s… uh oh… a Super Lien!
Liability insurers have always gnashed teeth over the dreaded “super lien” – aka a lien asserted by Medicare for treatment expenses where the patient is reimbursed through a settlement obtained in personal injury litigation. This is because Medicare has a right of action against the primary payer (e.g., a tortfeasor’s liability insurer) that is effectively absolute, even if the insurer has already paid settlement funds to the injured party that includes an amount meant ... Keep Reading »
Not Seeing Double: In Reversal, New York Court Holds That Third-Party Liability Payments May Not Offset UIM Benefits
In New York, uninsured/underinsured motorist coverage “does not function … to fully compensate … insureds for their injuries.” Weiss v. Tri-State Consumer Ins. Co., 98 A.D.3d 1107, 951 N.Y.S.2d 191 (2d Dep’t 2012). UIM coverage is subject to limits, and those limits are generally reduced by the amount of coverage available to the person who caused the injury. Standard UIM endorsements also provide that coverage “shall not duplicate” payments the insured receives from ... Keep Reading »
Round Up The Usual And Customary Suspects: Insurers May Determine UCR Prices By Shopping At Retail Outlets
For more than a decade, medical providers have tried to limit the discretion of automobile insurers to pay less than the billed amount for services and equipment offered to injured insureds. Most of these efforts involve challenges to the use of automated bill review systems. But in Freedom Medical Supply Inc. v. State Farm Fire & Cas. Co., No. 14-1628 (3rd Cir. June 8, 2016), a company charging 1,000% mark-ups on equipment it bought at Bed Bath & Beyond argued ... Keep Reading »
Step-Up, Insurer! Your Step-Down Provision Is Not Triggered
“Sometimes nothin' can be a real cool hand.” -- Frank Pierson Where an automobile policy covers someone other than the named insured, a “step-down” provision may subject the amount of available coverage to the limit on “similar coverage” that is imposed by the injured person’s own policy. Sometimes, however, that second policy does not cover a particular risk at all. Last month, in Rivera v. McCray, No. A-2337-14T1 (N.J. App. Div. May 2, 2016), a New Jersey appellate ... Keep Reading »
In Examinations Under Oath, Friends Must Let Friends Testify Alone
The cooperation provisions in most personal lines insurance policies require policyholders to sit for Examinations Under Oath ("EUO") to answer questions about the validity of a claim. What if the insured refuses to attend without having his non-lawyer friend sit beside him? May the insurer insist on examining the insured without the friend in the room? That was the question in Foremost Insurance Company v. Freeman, 2016 WL 380126 (S.D. Miss. Jan. 29, 2016). When Bad ... Keep Reading »
Florida Makes it Safer to Collect Subrogation Claims from Consumers
As insurers show increasing interest in pursuing recovery opportunities after paying claims, they face increased exposure to litigation hazards associated with the debt collection industry. A recent decision by a federal court in Florida will help ameliorate that risk—at least within the Sunshine State. In Schaefer v. Seattle Service Bureau, Inc., No. 2:15-cv-444 (M.D. Fla., Dec. 16, 2015), the court ruled, as a matter of first impression, that insurance subrogation ... Keep Reading »
Too Little, Too Late: The Harsh Bright Line of Suit Limitation Provisions
Approximately twenty percent of Americans have been classified as chronic procrastinators, which means one in five policyholders faces a potential problem when suing for coverage. While the statute of limitations for breach of contract varies by state, it is typically three years or more. However, insurance policies often impose their own, contractual suit limitations, and it is often only a year or two. When and how these provisions operate to bar coverage varies ... Keep Reading »
Second Circuit’s Policy Language Interpretation Leaves Insurer Down in the Dumps
So this dump truck can’t make it through an overpass on I-90; the crash knocks the dump box off the truck and into the road. Five minutes later (or 30 seconds, if you believe some people), along comes Mr. Itzkowitz, with his wife and five children, and plows right into the dump box. Then, after another few seconds (or 20 minutes, according to some people), ka-pow: Mr. Compton’s car, with another six passengers, does the same thing. What are you gonna do? In National ... Keep Reading »