Examines: appellate ruling on trial court’s right to decide order of presenting evidence in consolidated proceedings; key issues determining residency for insurance coverage
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
Case studies highlight how well-trained claims personnel and vigilant discovery during litigation can help combat organized prescription medication fraud
Examines Missouri appellate court ruling affirming owned-vehicle exclusion in automobile liability insurance policies involving uninsured motorist coverage
Discussion of the consequences to Missouri motorists who drive a vehicle without purchasing automobile liability insurance
Analysis of a court decision delineating insurance policy language that does/does not trigger “direct physical loss” coverage
Analysis of impact on insurance coverage for liability suits if Missouri governor signs SS HB 345, which protects insurers rights to/timing of intervention
Analysis of appellate court decision on whether an insurance company had a duty to defend a municipality on claims of wrongful arrest and conviction
Analyzes the importance of an attorney’s client being legally defined as an insurance producer versus an insurance agent or insurance broker
Property insurers should be cautious interpreting and applying vacancy exclusions since interpretations of them vary widely by jurisdiction
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
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 ...
"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 ...
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 ...
