Posts in Insurance Law.
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Analysis of how forum defendants are able to remove cases to home-state federal courts with the developing practice of snap removal.

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Examines: appellate ruling on trial court’s right to decide order of presenting evidence in consolidated proceedings; key issues determining residency for insurance coverage

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Analysis of recent Illinois Appellate Court ruling that exclusion clause did not apply and the insurer had a duty to defend and indemnify its insured driver

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Case studies highlight how well-trained claims personnel and vigilant discovery during litigation can help combat organized prescription medication fraud

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Examines Missouri appellate court ruling affirming owned-vehicle exclusion in automobile liability insurance policies involving uninsured motorist coverage

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Discussion of the consequences to Missouri motorists who drive a vehicle without purchasing automobile liability insurance

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Analysis of a court decision delineating insurance policy language that does/does not trigger “direct physical loss” coverage

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Analysis of impact on insurance coverage for liability suits if Missouri governor signs SS HB 345, which protects insurers rights to/timing of intervention

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Analysis of appellate court decision on whether an insurance company had a duty to defend a municipality on claims of wrongful arrest and conviction

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Analyzes the importance of an attorney’s client being legally defined as an insurance producer versus an insurance agent or insurance broker

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Property insurers should be cautious interpreting and applying vacancy exclusions since interpretations of them vary widely by jurisdiction

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Property insurance policies typically contain provisions requiring the insured to cooperate with the insurer in the investigation and adjustment of the loss. As part of those post-loss obligations, the insured may be required, if requested by the insurer, to submit to an examination under oath and produce documents and records related to the claim. The typical policy provision is phrased as follows:

Your Duties After Loss

After a loss to which this insurance may apply, you shall see that the following duties are performed:

As often as we reasonably require, submit to and subscribe ...

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Anyone who has spent time reviewing claim forms and bills submitted by medical providers has probably encountered at least some of the more typical fraud schemes: overbilling, false claims, or maybe even kickbacks and bribery. Sophisticated technology, investigative techniques, and data analytics let us zoom in – and out – to identify these traditional forms of fraud at the individual claim level and on a system-wide scale.

But a recent opinion by the New York Court of Appeals, the state’s highest court, should serve as a reminder to look out for a different sort of fraud that ...

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Environmental contamination lawsuits frequently involve polluting activities which took place decades ago – long before the advent of computers and before it was possible for businesses to store information in an electronic format. When these lawsuits arise and a claim is tendered to an insurance carrier for defense and indemnity, the parties often struggle to verify the existence and terms of any applicable insurance policies in light of the ease with which paper documents can be misplaced over the years. The inability of the parties to locate complete copies of all potentially ...

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In a recent decision, the Illinois Appellate Court, Third District, considered what should and should not be considered by a trial court when making a determination on a motion to stay a declaratory judgment action on insurance coverage pending resolution of the underlying litigation. Pekin Insurance Company v. Johnson-Downs Construction, Inc., 2017 IL App (3d) 160601. The underlying suit in Johnson-Downs concerned an injured employee of a subcontractor who sued the general contractor. Originally, the plaintiff employee alleged negligence and premises liability theories ...

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Illinois courts have long made clear that when a conflict of interest exists between an insured and its insurer, the insured is entitled to independent counsel of the insured’s own choosing and at the insurer’s reasonable expense. See Maryland Cas. Co. v. Peppers, 64 Ill.2d 187, 193 (1976). What is less clear, however, is when exactly a conflict of this nature arises.

We know that a conflict giving rise to independent counsel does not exist simply because the insurer provides a defense under reservation of rights. We also know that certain types of cases, such as those involving ...

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Independent insurance producers often are thought to be, well, independent from the insurance companies for which they sell policies. Independent producers typically sell insurance policies for a number of carriers, and often work with intermediaries to sell policies for even more carriers, so that they can offer their policyholder clients the insurance product most suitable to their needs.

A recent unpublished decision from the Illinois Appellate Court, Fifth District, in Founders Insurance Company v. Flores, 2018 IL App (5th) 160404-U, however, shows that in some ...

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As we have learned in recent days, we all need to be careful with the things we say, for sometimes those things we say can be used against us. But the life lessons do not end there. We also need to read things carefully, for the things we fail to read can be used against us as well, especially holders of insurance policies.

A recent opinion from the Illinois Appellate Court, Third District, in Laurent v. Johnson, 2017 IL App (3d) 160627, shows just how far an insured’s duty to read his or her insurance policy can reach. The Laurent plaintiff sued the lawyer of her deceased husband’s estate for ...

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The Missouri Court of Appeals, Southern District, issued an opinion on Jan. 31, 2018, in Shelter Mutual Insurance Company v. Lester that allowed stacking of full auto liability coverage policy limits on four separate policies. The underlying matter involved bodily injury claims brought by multiple claimants. Each of the auto insurer’s liability policies had applicable bodily injury limits of $50,000 per person / $100,000 per accident. Each policy also had the following anti-stacking provision:

If more than one policy issued by Shelter Mutual Insurance Company or Shelter ...

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It is commonplace in construction projects for a contractor to require its subcontractors to purchase liability insurance that protects against certain claims and that includes the contractor as an additional insured. The problem is that many times the policy that the subcontractor purchases does not on its face meet the requirements set forth in the written agreement between the contractor and subcontractor. For example, the construction agreement may require liability insurance with higher limits of liability than that actually provided by the subcontractor’s policy, or ...

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Background

Virtually all property policies provide an insurer with the right to rescind coverage when there’s evidence that the insured intentionally concealed or misrepresented material facts in their application for insurance. For a misrepresentation to be deemed material, it must have been an untrue fact that would have, if the truth was known, caused the insurer to reject the application. In other words, an insurer is entitled to truthful responses so that it can determine whether the applicant meets its underwriting criteria.

Under that backdrop, the U. S. Court of Appeals ...

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Over the past few years, insurance companies have learned that handling liability claims in Missouri with coverage issues or policy-limit settlement demands can be an incredibly complex, and in some cases, dangerous endeavor. Much of that complexity stems from Missouri Revised Statute § 537.065, a statute which has been used as a powerful sword against carriers to collect rather large judgments in many cases.

On April 26, 2017, the Missouri General Assembly voted to repeal the current § 537.065 and replace it with a modified version. That replacement, House Bill 339, was signed into ...

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In insurance coverage litigation, does an insurance company have to identify and produce documents regarding the company’s handling of prior unrelated claims?

Insurance companies often object to such requests on the grounds that they are irrelevant, overly broad, unduly burdensome, and even protected by a privilege. In the Illinois Appellate Court Fifth District’s recent decision in Zagorski v. Allstate Ins. Co., 2016 IL App (5th) 140056, however, the appellate court rather emphatically held that the insured could seek such discovery, at least under the facts and ...

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In his commencement address for Washington University in St. Louis’ graduating Class of 1998, political commentator George Will shared a cautionary tale of youth. “I grew up in Champaign, Illinois, midway between Chicago and Saint Louis,” Will began. “And at an age too tender for life-shaping decisions, I made one. While all my friends were becoming Cardinals fans. I became a Cubs fan,” he said. “My friends, happily rooting for Stan Musial, Red Schoendienst, and other great Redbirds, grew up cheerfully convinced that the world is a benign place. So, of course, they ...

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Is your bracket busted yet? Unless you predicted No. 14 UAB knocking out No. 3 Iowa State 60-59 in the first round of the NCAA’s Men’s Division I Basketball Championship, it probably is. That upset has added to what was already a difficult year for corn. (Iowa State is located in, well, Iowa, where 90% of the land is dedicated to agriculture — i.e. the “Corn State”). Earlier this year, college basketball fans at the University of Wisconsin attempted to intimidate their Big Ten rival the Nebraska Cornhuskers by donning T-shirts that decried corn as the “WORST VEGETABLE ...

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After leaving almost 10,000 empty seats in its Champions League game against Roma last September, the professional football team in Manchester City chose to offer a buy-one-get-one-free deal on tickets at its October match against CSKA Moscow. ("Football" here is meant in the European sense, a game most Americans call "soccer", which in the fall of 2016 may be the only professional football played in St. Louis. Go Ambush!) The promotion was a success in that City went on to sell out its match against CSKA. The buy-one-get-one-free deal, however, drew the derision of fans of City's rival ...

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Antonia Neshev is a Bulgarian artist who moved to Colorado in the mid-1990s to become a wildlife instructor and T-shirt decorator. In the late 2000s she designed a T-shirt that depicted three wolves howling at the moon. The manufacturer sold the shirts through Amazon, which of course allows customers to post product reviews. Brian Govern, then a 32-year-old law student in New Jersey (it’s always a law student) was so moved by the shirt that he decided to post a review on the site.

“This item has wolves on it which makes it intrinsically sweet and worth 5 stars by itself, but once I tried it ...

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Have you ever seen a corporation walk down the street? Or maybe you’ve shaken hands with a corporation lately? Perhaps you’ve witnessed a corporation do The Wiggle? Over two hundred years ago, Chief Justice Marshall wrote that a corporation is “an artificial being, invisible, intangible, and existing only in contemplation of law.” More recently, Justice Stevens wrote in dissent that “corporations have no consciences, no beliefs, no feelings, no thoughts, no desires”. Others disagree.

For example, former Massachusetts Governor Mitt Romney famously told a crowd  of ...

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He drove a blue Volkswagen Rabbit to the United States Supreme Court for many years. He wrote so many lone dissents in his first years on the court that he was dubbed the “Lone Ranger”. Years after he became Chief Justice, William Rehnquist added four gold stripes to the sleeves of his judicial robes, in tribute to the Lord Chancellor character in the Gilbert and Sullivan operas he loved. When his health declined and the press asked him when he planned to retire, he responded, “That’s for me to know and you to find out.”

Though characteristically blunt of the former Chief Justice ...

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In United Fire and Casualty Co. v. Titan Contractors Service, Inc., No. 13-1307 (8th Cir. May 13, 2014), the Eighth Circuit weighed in on just how broad the pollution exclusion in a commercial general liability insurance policy is under Missouri law – which is, according to the Eighth Circuit, rather broad. In doing so, the Eighth Circuit declined to adopt the more narrow interpretation previously applied by the Court of Appeals for the Southern District of Missouri.

United Fire’s insured, Titan, provided construction-cleanup services. Part of these services included ...

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“The Best Fans in Baseball” (or BFIB). That moniker long has been attributed to fans of the St. Louis Cardinals baseball team, or at least has been attributed by fans of that team to themselves. The original author of BFIB with respect to Cardinals’ fans remains something of a mystery-- with stories pointing to players such as Mark McGwire and Jim Edmonds, baseball commentators like Peter Gammons, former manager Tony LaRussa, or fellow manager (and Friend of Tony) Jim Leyland. The labeling of Cardinals’ fan as the BFIB has caused quite a backlash among fans from other teams ...

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“Where did you go to high school?” is a peculiar St. Louis question that perplexes newcomers to the area. For the insurance savvy traveler here, a new question may replace it: “Where do you garage this vehicle that you propose to carry me and others for compensation or a fee?”

That sort of question may gain relevance due to the introduction of two new transportation networking companies in cities across the country, Uber and Lyft. These two companies offer mobile applications for iPhone, Android and Blackberry devices that connect consumers to drivers in select cities ...

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A New York trial judge’s recent decision in Zurich American Insurance v. Sony Corporation of America has set the legal blogosphere aflutter with arguments and counter-arguments as to whether cyber liability and data breach claims fall within the “Personal and Advertising Injury Liability” coverage section (Coverage B) afforded by most commercial general liability (CGL) policies. A new set of data breach exclusionary endorsements, however, filed in many jurisdictions by Insurance Services Office, Inc. (ISO) and set to take effect this month, May 2014, appear poised to ...

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"Hello, Mr. Jones. Did you just try to make a $10,000 jewelry purchase in Brazil?" To put it mildly, that is not the type of question that want your customers-- or as an insurance company, the customers of your policyholder-- to receive. All too often, however, despite the best security efforts, data breaches of sensitive personal information, like credit card data, do occur.

The insurance industry sells a variety of differing products designed specifically to provide coverage for these types of claims and losses. But, would liability for such a data breach be covered by the backbone of ...

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Klehr v. Illinois Farmers Ins. Co., No. 121843, 1st Dist. No. 1-12-1843

The plaintiff was a passenger in a car hit by an uninsured driver. She suffered substantial injuries. And, the driver of the car in which the plaintiff rode was underinsured. Thus, her medical costs were not fully covered by insurance from either of the drivers of the vehicles in the collision.

In 2007, the plaintiff (“insured”) filed a claim for the remainder of the costs under her personal insurance policy issued by the defendant insurer.  She also invoked the policy’s arbitration clause to adjudicate the ...

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Although the battle over state income taxes between Missouri Governor Jay Nixon and the Missouri General Assembly drew national attention to this week’s Veto Session, three lesser known bills will have a more immediate impact on civil tort litigation in Missouri. On September 11, 2013, the legislature overrode the Governor’s veto on three bills that provide certain limits on tort claims against insured drivers, voluntary health care providers, and hard rock mining companies.

Uninsured Motorist Plaintiffs. House Bill 339 provides that an “uninsured motorist” waives ...

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Kerri Forsythe
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