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7th Cir. Holds Insurance Coverage Applies to Settlement Payments for Alleged Anti-Kickback and False Claims Act Violations

June 2, 2023 by Matthew Lewis

On May 3, 2023, the Seventh Circuit Court of Appeals, in Astellas US Holding Inc. v. Federal Insurance Co., held that a liability insurer was required to contribute its limits toward its insured’s payment to settle potential anti-kickback claims because the insurer did not show that such amounts were uninsurable restitution. Astellas, a Japanese drugmaker, launched a drug to treat metastatic prostate cancer in 2012. Astellas priced the treatment at $7,800 per month, ... Keep Reading »

Fifth Circuit Holds No Liability Coverage for Negligence Claim Premised on Allegations of Intentional Conduct

May 31, 2023 by Andrew Daechsel

In Gold Coast Commodities, Inc. v. Crum & Forster Specialty Insurance Co., issued May 22, 2023, the U.S. Court of Appeals for the Fifth Circuit held that a pollution liability policy did not provide coverage for a negligence claim premised on allegations of intentional conduct. In Gold Coast, the insured, Gold Coast Commodities sought defense and indemnity coverage for an underlying lawsuit filed against it by the city of Brandon, Mississippi. In that lawsuit, the ... Keep Reading »

Second Circuit Affirms Ruling That Prior Knowledge Exclusion Barred Coverage for Legal Malpractice Lawsuit

May 19, 2023 by Novera H. Ahmad

The Second Circuit Court of Appeals recently affirmed a lower court’s ruling, which declared that North River Insurance Co. had no duty to defend or indemnify its insured in connection with a legal malpractice lawsuit. Background In September 2019, Max Leifer and his law office applied for professional liability insurance with North River. Leifer’s application was approved, and North River issued the policy, which covered damages and defense expenses for claims ... Keep Reading »

11th Cir. Affirms That Georgia’s Implied Waiver Doctrine Cannot Be Used to Create Coverage

May 12, 2023 by Roben West

In Century Communities of Georgia LLC v. Selective Way Insurance Co., the Eleventh Circuit Court of Appeals affirmed that the Georgia Supreme Court’s 2012 opinion in Hoover v. Maxum Indemnity Co. does not apply to “coverage defenses” — that is, whether a loss is potentially covered under a policy in the first place. Rather, under Hoover, only certain “policy defenses,” meaning whether a procedural condition of the insurance contract has been fulfilled, may be subject to ... Keep Reading »

No Coverage for Delinquent Payments: Mobile Home Park Operator Cannot Recover for “Expected or Intended” Injuries

May 10, 2023 by Lauren Silk

On May 1, 2023, in West American Insurance Co. v. Del Ray Properties Inc., the U.S. District Court for the Western District of Washington held that general liability insurers owed no coverage obligations to a mobile home park operator in connection with delinquent payments of utility bills that jeopardized its residents’ water and garbage services because the underlying claims were for “expected or intended” injuries. Del Ray Properties Inc. is a Washington ... Keep Reading »

Third Circuit Limits Pennsylvania’s “Reasonable Expectations” Doctrine

April 21, 2023 by Chad W. Dunham

In Hemphill v. Landmark American Insurance Co., issued April 5, 2023, the Third Circuit Court of Appeals outlined limits on an insured’s use of Pennsylvania’s “reasonable expectations” doctrine — the legal theory that purports to provide coverage under a policy based on the “reasonable expectations” of the insured — and found that, among other things, the doctrine does not apply to commercial insureds. The case involved a coverage dispute for an underlying claim by an ... Keep Reading »

Mass. Court Holds Unprovoked Attack Not “Physical Abuse” Within Meaning of Abuse and Molestation Exclusion

April 17, 2023 by Nicole Stone

In Dorchester Mutual Insurance Co. v. Miville, the Supreme Court of Massachusetts discussed the basis for its reversal of the Superior Court’s grant of summary judgment in favor of Dorchester Mutual based on its interpretation of what constitutes “physical abuse” in the context of an abuse and molestation exclusion as it applies to the insured’s unprovoked attack on an individual. The facts regarding the unprovoked attack by the insured, William Brengle, on Leonard ... Keep Reading »

Florida Broadens Use of Proposals for Settlement by Enacting House Bill 837: Proposals for Settlement Can Now Be Served in Civil Insurance Cases Seeking More Than Just Damages

March 31, 2023 by David R. Wright

On March 24, 2023, Gov. Ron DeSantis signed House Bill 837, “Civil Remedies,” into law. While other articles have discussed the wide-ranging effects of this new law, this post focuses specifically on how the law alters Florida’s proposal for settlement landscape. Before March 24, proposals for settlement, sometimes referred to as offers of judgment, were exclusively governed by Florida Statutes section 768.79 and Florida Rule of Civil Procedure 1.442. No ... Keep Reading »

Florida Overhauls Bad Faith Law, Repeals One-Way Attorneys’ Fee Statutes, Adopts Modified Comparative Negligence and Other Tort Reforms

March 27, 2023 by Benjamin Stearns

On March 23, 2023, the Florida Legislature passed HB 837, a bill enacting major reforms to Florida tort law. Gov. Ron DeSantis wasted no time, signing the bill into law shortly after the bill was presented to him the next morning. Below is a summary of the many significant changes made to Florida laws, including changes to Florida's bad faith law, the repeal of one-way attorneys’ fee statutes, a reduction of the statute of limitations applicable to negligence actions, ... Keep Reading »

New Jersey Federal Court: Policyholders Must Plead Specific Policy Provisions to Maintain Suits

March 24, 2023 by Kevin Major

In Law Office of Drew J. Bauman v. Hanover Insurance Co., the U.S. District Court for the District of New Jersey affirmed that policyholders must allege, under New Jersey law, the specific provisions of the insurance policy in order to state a claim for relief under the insurance contract. In doing so, the court bolstered the growing national judicial trend of restricting policyholder coverage litigation to those involving specific allegations of a carrier’s purported ... Keep Reading »

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