Given the broad duty to defend rules in most jurisdictions, liability insurers often find that they must — or perhaps should out of an abundance of caution — defend an insured against a claim that in all likelihood will not implicate the duty to indemnify, such as when extrinsic evidence strongly suggests that an exclusion will apply. In these situations, insurers in many states are permitted to offer a defense under a reservation of rights to withdraw and seek ... Keep Reading »
Missouri Appeals Court Rules That Insurer Must Pay Double Policy Limits in Medical Malpractice Claim Involving Birth Injuries
In John Patty, D.O., LLC v. Missouri Professionals Mutual Physicians Professional Indemnity Association, No. ED106747 (Mo. Ct. App. Apr. 23, 2019), a Missouri appellate court rejected the lower court’s decision regarding liability limits in a medical malpractice suit involving injuries to both mother and baby. Specifically, the court held that because allegations of a physician’s negligence included acts and omissions, which occurred not only before and during a cesarean ... Keep Reading »
Destination Arbitration: Court Holds Service-Of-Suit Clause Does Not Conflict With Policy’s Arbitration Requirement
Coverage disputes often come down to the interplay between endorsements and the body of the policy. But this tension is not limited to terms addressing coverage. It can also extend to areas such as dispute resolution. In Southwest LTC-Management Services, LLC v. Lexington Insurance Co., No. 1:18-cv-00491-MAC (E.D. Tex. Apr. 17, 2019), the court held that a service-of-suit endorsement did not supersede the arbitration clause in the policy. A group of carriers paid $2.5 ... Keep Reading »
Back to Basics: The Georgia Court of Appeals Distinguishes Acceptance From Counteroffer
The Georgia Court of Appeals recently reiterated the fundamentals of contract law within the context of insurance settlement negotiations in Yim v. Carr. In this case, the plaintiff offered to settle within policy limits and to release liability against specific persons or entities. The defendant's insurer agreed to the settlement in principle, but sought clarification about who would be included in the release. Ultimately, the court held that this did not constitute ... Keep Reading »
Tennessee Supreme Court Holds That Replacement Cost Less Depreciation Does Not Allow for Depreciation of Labor When Calculating Actual Cash Value of a Property Loss
Insurance policies are designed to indemnify an insured by putting the policyholder in the same position he or she would have been in had no loss occurred. In the context of property insurance policies, damaged property is typically valued based on its estimated actual cash value (ACV) if it is not repaired or replaced. In order to calculate ACV, an insurer will often calculate the replacement cost (RCV) based on the cost to repair or replace the property with materials ... Keep Reading »
Florida Legislature Passes Sweeping Assignment of Benefits Legislation
Significant changes appear to be in the pipeline for Florida property insurers after the Florida legislature passed sweeping assignment of benefits (AOB) reform legislation last week. If the legislation is signed into law (Governor DeSantis has indicated it will be), it will take effect on July 1, 2019. The legislation applies to residential and commercial property insurance policies and includes new restrictions on AOBs, changes to the fee-shifting framework for AOB ... Keep Reading »
California Federal Court Holds Scope of Duty to Defend Is Determined by the Language of the Contract
In Harper Construction Co. v. National Union Fire Insurance Co. of Pittsburgh, No. 3:18-CV-00471-BAS-NLS (S.D. Cal. Mar. 28, 2019), the Southern District of California rejected an insured's attempt to expand a CGL policy's definition of "suit" to encompass mere demands without a formal proceeding for damages. In 2007, the federal government awarded a contract for a military training facility in Fort Sill, Oklahoma, to an insured general contractor. After structural ... Keep Reading »
Federal Court Declines to Dismiss Excess Carrier’s Suit Seeking Reimbursement of Amounts Paid in Underlying Medical Malpractice Settlement
Reprinted with permission in Medical Liability Monitor In Ironshore Specialty Insurance Co. v. Conemaugh Health Systems, Inc., No. 3:18-cv-153 (W.D. Pa. Feb. 28, 2019), the Western District of Pennsylvania refused to dismiss an excess carrier's suit seeking reimbursement from its insured for settlement amounts the excess carrier paid in an underlying medical malpractice lawsuit. According to the court, Ironshore plausibly alleged that Conemaugh Health Systems Inc. ... Keep Reading »
Break Out Your Crystal Ball: New York’s First Department Relies on Policy’s Mitigation Provision as Support for Allegation That Consequential Damages Were Foreseeable
An insured sought coverage under its commercial property insurance policy for property damage incurred after construction work was performed in an adjoining building. Contending the insurer’s “investigatory process has taken so long and become so attenuated that the structural damage to the building has worsened,” the insured brought suit for breach of contract for failure to pay a covered loss under its insurance policy and breach of the implied covenant of good faith ... Keep Reading »
Coverage Issues Relating to Drones Take on New Heights: A California District Court Finds Drone-Related Injury Falls Within Policy’s Aircraft Exclusion
In Philadelphia Indemnity Insurance Co. v. Hollycal Production Inc. et. al., No. 5:18-cv-00768-PA-SP (C.D. Cal. Dec. 7, 2018), a California district court held that Philadelphia Indemnity Insurance Co. was not obligated to defend or indemnify a photography firm whose drone blinded a wedding guest in one eye, finding that the drone-related injury fell within the policy’s aircraft exclusion. Darshan Kamboj, a guest at a California wedding, claimed that she lost sight in ... Keep Reading »
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