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If it Races like a Tortoise: Connecticut Deconstructs a Policyholder

October 1, 2014 by John C. Pitblado and Robert D. Helfand

Picture of a Toy Race Track

From Zeno of Elea to the Washington Nationals, images of racing have ceaselessly troubled Western thought.  But as ancient metaphysics has given way to philosophy of language, the questions we ask ourselves have changed.  In Sonson v. United Services Auto. Ass'n  No. 35890 (Conn. Ct. App. Sept. 16, 2014), an automobile policyholder had to show that a "racing" exclusion did not apply, so he argued that Achilles could never overtake the tortoise if he was not "competing ... Keep Reading »

With Sewers Backing Up, Messy Damage Claims are On the Rise

September 25, 2014 by John C. Pitblado

Picture of Men Working in a Sewer

Andy crawled to freedom through five hundred yards of - - - smelling foulness I can't even imagine. Or maybe I just don't want to. Five hundred yards. The length of five football fields. Just shy of half a mile. –The Shawshank Redemption (1994) Many homeowners and other property insurance policies contain an exclusion to address one of the by-products of the increased frequency of severe weather: it bars coverage for property damage caused by "water which backs up ... Keep Reading »

Claims Handlers: It’s Time to Adjust Our Claims!

September 22, 2014 by Jonathan Sterling

Picture of Children Picketing

Many insurers have a longstanding practice of paying claims adjusters a set weekly salary, regardless of the number of hours they actually work.  The practice has support in federal labor regulations; the regulations expressly exempt claims adjusters from the overtime requirements of the Fair Labor Standards Act (FLSA), if their duties include discretionary and administrative activities such as interviewing witnesses, inspecting property damage, reviewing information for ... Keep Reading »

Leap of Bad Faith: TPAs May Be Sued for Aiding Their Own Actions

September 18, 2014 by Daniel G. Enriquez

Picture of a Contortionist

Insurers have a duty to process claims in good faith, but sometimes they farm the job out to third-party administrators (TPAs).  If the TPA fouls up, many states hold that the insurer is still liable—for its own breach of duty, even if a doctrine of vicarious liability does not apply.  The rule is summed up in the statement that the duty of good faith is not delegable; the insurer must either handle the claim in good faith or cause someone else to do so. But what ... Keep Reading »

Drive, He Said: When “Yes” Means “Don’t Shoot!”

September 17, 2014 by John W. Herrington

Picture of a Shotgun Shell Ejecting

Bad things can happen to innocent people, and sometimes the people responsible for them are judgment-proof.  When that happens—and when the perpetrator also has potential coverage under an automobile or homeowners policy—victims sometimes view the circumstances of their injury more generously; they describe them with words like "careless" and "negligent" in place of harsh, judgmental terms, such as "intentional" or "criminal." Something of this sort seems to have been ... Keep Reading »

Property Insurance Law 101 – A Primer from Texas

September 15, 2014 by Heidi Hudson Raschke

Picture of a Mother reading to her Child

On the Fourth of July in 2011, a fire damaged a nightclub in Beaumont, Texas.  The fire was not unusual, but the lawsuits it generated—O’Quinn v. General Star Indemnity Company, No. 1:13-CV-471 (E.D. Tex. Aug. 5, 2014), and Debes v. General Star Indemnity Company, No. 09-12-00527 (Tex. Ct. App. July 10, 2014)—review many of the ABCs of property insurance law in the Lone Star State. Everybody Goes to Alibi’s Alibi’s, a nightclub and restaurant, was open nightly from ... Keep Reading »

“So What?”: Montana’s Supreme Court Turns a Deaf Ear to Insurers Charged With Breaching the Duty to Defend

September 11, 2014 by Meredith Whigham Caiafa and Robert D. Helfand

Picture of Miles Davis

Earlier this year, in K2 Investment Group v. American Guaranty & Liability Ins. Co., 983 N.Y.S.2d 761 (N.Y. 2014), New York’s highest court adopted—but then decided against—a rule under which a liability insurer that has breached its duty to defend would be prevented from asserting coverage defenses in connection with the duty to indemnify.  That rule is settled law in Montana, however, and last month, in Tidyman’s Management Services, Inc. v. Davis, 330 P.3d 1139 ... Keep Reading »

If a Tree Falls on the Internet … An Insurer Has a Duty to Defend

September 5, 2014 by Christopher B. Freeman

Picture of a Fallen Tree

Legal bloggers sometimes ask themselves:  If my post appears on the Internet, but there’s no evidence anyone has read it, have I been published?  The question has not yet been finally resolved among law firm compensation committees, but, in the data privacy context, a federal court in Virginia recently offered an emphatic "yes."  In Travelers Indemnity Company of America v. Portal Healthcare Solutions, LLC, No. 1:13-cv-917(GBL) (E.D. Va. Aug. 7, 2014), the court found ... Keep Reading »

If Rainwater Lands Where it Doesn’t Belong, It’s Still “Surface Water” in the Eleventh Circuit

September 4, 2014 by Heidi Hudson Raschke

Picture of Granite Falls

The Eleventh Circuit recently affirmed a decision of the Southern District of Georgia, finding an insured’s claim for water damage fell within an exclusion for loss or damage caused by "surface water." In Williams v. State Farm Fire and Casualty Insurance Company, Case No. 14-11100 (11th Cir. July 17, 2014), the dispute arose after the insured’s home was damaged by "thigh deep" water runoff from a rainstorm.  The water should have flowed away from the plaintiff’s home, ... Keep Reading »

“Blinded By the Light of God and Truth and Right”: Constitutional Arguments Carry the Day Against Zealous Insurance Receiver

September 3, 2014 by Daniel C. Brown

Picture of Florida from taken from Space

Insurance receivers have the unenviable job of liquidating failed insurance companies: collecting the insolvent insurers’ assets and paying claims against the failed insurers in accordance with a statutory claim priority regimen.  Given what they see in their line of work, receivers often come to presume that every owner of a failed insurance company has been guilty of some sort of ethical or legal misconduct.  Influenced by that preconception—and by the conviction that ... Keep Reading »

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