An assignment of benefits (AOB) is a legal tool that allows a third party to be paid for services performed for an insured property owner who would normally be reimbursed by the insurance company directly after making a claim. An AOB is commonly used when a property owner experiences a loss and contacts a contractor for assistance. Most AOB agreements allow the contractor to stand in the shoes of the property owner for insurance collection purposes. These agreements are ... Keep Reading »
War: What is it good for? Business Loss and the War Exclusion
In summer 2014, Israel and Hamas were engaged in armed conflict. Thousands of residents of Gaza and Israel were killed or injured, and much of Gaza City was destroyed by rocket fire and other heavy weapons. The Israeli Defense Force dispatched tens of thousands of ground troops to the area, and international attention from the United Nations and other interested parties, including the United States, focused on the “conflict.” But was it a “war?” The United States has ... Keep Reading »
Ninth Circuit Confirms Privacy Exclusion Bars TCPA Claims
Claims under the Telephone Consumer Protection Act (TCPA) present numerous issues for insurance companies and policyholders. Because TCPA claims lend themselves to class action suits, the potential exposure can be significant. For years, liability insurers have argued that invasion of privacy exclusions bar coverage for claims under the TCPA. These arguments received a boost when the Ninth Circuit held that “a liability insurance policy that unequivocally and broadly ... Keep Reading »
SDNY Rules SEC Investigation Is A “Claim” Within Pending and Prior Acts Exclusion
The U.S. District Court for the Southern District of New York has held that a long-running investigation by the SEC constituted a “Claim” triggering the pending and prior claims exclusion in an excess directors and officers (“D&O”) policy. See Patriarch Partners, LLC v. AXIS Ins. Co., No. 16-cv-2277 (VEC) (S.D.N.Y. Sept. 22, 2017). This case stems from a high-profile SEC investigation into plaintiff Patriarch Partners, LLC (“Patriarch”) relating to certain ... Keep Reading »
Pennsylvania Supreme Court Clarifies Showing Required for Bad Faith Insurance Claims
The Pennsylvania Supreme Court has, for the first time in the 37-year history of Pennsylvania’s bad faith insurance statute, 42 Pa.C.S. § 8371, considered the necessary elements of such a claim, and it has determined that proof of an insurer’s motive of self-interest or ill will are not required. See Rancosky v. Washington Nat'l Ins. Co., 28 WAP 2016 (Pa. Sept. 28, 2017). The case arose from a supplemental cancer insurance policy that plaintiff LeAnn Rancosky ... Keep Reading »
Georgia Federal Court Rules on Questions of Efficient Proximate Cause, Manifestation/Continuous Trigger and Pro Rata Allocation of Damages
In ACE American Ins. Co. v. Exide Technologies, Inc. and The Wattles Co., No. 1:16-CV-1600-MHC (N.D. Ga. Sept. 20, 2017), the Federal District Court for the Northern District of Georgia applied a continuous trigger theory to an all risk property policy and declined to allocate damage, resulting in a single first-party property carrier being responsible for several years of damage. This case demonstrates that courts in some jurisdictions may require that policy language ... Keep Reading »
Navigating Florida Property Coverage Waters After Hurricane Irma
As the waters recede from Hurricane Irma, there are many issues for property insurers to consider as they adjust claims in Florida, including unique issues raised by assignment of benefits, Florida law on concurrent causation, and time element considerations. Assignment of Benefits An assignment of benefits (AOB) is a legal tool that allows a third party to be paid for services performed for an insured property owner who would normally be paid or reimbursed by the ... Keep Reading »
Third Circuit Clarifies Abstention Doctrine in Insurance Coverage Declaratory Action
Insurers looking to remove declaratory judgment actions to courts in the Third Circuit were recently given some clarity — and, for one defendant insurer, a welcome reversal. On August 21, the U.S. Court of Appeals for the Third Circuit held that the Eastern District of Pennsylvania abused its discretion by applying an overly broad definition of what constitutes a “parallel proceeding” in determining whether to abstain from hearing an action under the Declaratory Judgment ... Keep Reading »
Texas Appeals Court affirms Class Certification in Case Alleging Roofer Violated Insurance Code
Texas homeowners Joe and Stacci Key sued their roofer, Lon Smith Roofing Contractors (“LSRC”), alleging LSRC violated the Texas Insurance Code by acting as an unlicensed public insurance adjustor. The trial court granted class certification, and LSRC sought interlocutory review. The Texas Court of Appeals affirmed in a case captioned Lon Smith & Assocs., Inc. v. Key, No. 02-15-00328-CV (Tex. Ct. App. Aug. 3, 2017). When it Hails… The Keys retained LSRC to make ... Keep Reading »
The Privilege Maintains Its Power: Texas Supreme Court Blocks Discovery of Insurer Attorney’s Billing Information
When (if ever) are an insurer’s attorney’s fees and billing information discoverable in a coverage dispute? Though the question is straightforward, the answer can vary from case to case and jurisdiction to jurisdiction. The Texas Supreme Court recently weighed in on the issue and found that an insurer’s attorney-billing information is not discoverable merely because the insurer challenges the insured’s request for attorney’s fees in coverage litigation. See In re Nat'l ... Keep Reading »
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