Analyzes two recent cyber insurance subrogation cases and provides insights on how insurers can manage escalating cyber losses.
Proposes the use of an insurance industry-wide AI database for detecting insurance fraud. Discusses benefits and obstacles to such an AI database’s creation and use. Presents example of its utility in uncovering concealment and fraud.
Explores what parametric insurance is, how it works, and some of its limitations and opportunities.
Analyzes an appellate court decision affirming that when a party to a declaratory judgment action repeatedly ignores requests for documents and court orders, a district court may issue a dispositive sanction and summary judgment.
Offers practical steps insurers can take to successfully implement AI in their business models. Includes brief overview of recent and pending state legislation governing use of AI in insurance decisions.
Examines why a Missouri appeals court reversed summary judgment on the denial of an insurance claim after the insurer claimed it had not renewed the policy.
Outlines the potentially favorable change for a defendant Missouri insurer’s right to intervene to stay proceedings while an underlying determination of coverage case is pending.
Summarizes the purpose, provisions, and implications of Illinois’ newly proposed legislation to regulate the insurance industry’s use of artificial intelligence in making decisions about health insurance plans and coverage.
Analyzes a federal appellate court ruling that clarifies what’s needed in a contract for indemnification to be a valid part of it.
Offers guideposts to answering three key insurance coverage issues in benzene liability cases: when is coverage triggered, how is coverage allocated among multiple insurers, and what method triggers umbrella coverage.
Highlights key points of the Illinois Department of Insurance Bulletin on use of artificial intelligence systems in insurance. Includes guidelines for insurers, navigating third-party AI systems, and potential regulatory oversight.
Explores significance of innocent insured doctrine in safeguarding policyholders who are inadvertently implicated in disputes arising from actions of others. Provides insights into implications of the doctrine for both insurers and insured parties.
Explains how Illinois Senate Bill 1495 helps protect residents from storm-chasing public adjusters and will help combat the rise in insurance fraud.
Explores reasons why it’s been difficult for insurance carriers to cover the cannabis industry in many states, including Missouri.
Using Remprex v. Lloyd’s London, this post analyzes the mixed rulings surrounding the question: is the defense of BIPA lawsuits covered by insurance.
Analysis of how forum defendants are able to remove cases to home-state federal courts with the developing practice of snap removal.
Analyzes conflicting federal court decisions on policy exclusions insurers have pressed for denying coverage in BIPA litigation
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
Amended Missouri statute provides roadmap for insurers to avoid bad faith liability claims when insufficient coverage for multiple claimants
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 ...
A recent decision could dramatically narrow the use of protected health information (“PHI”) that is disclosed to an insurer following the conclusion of litigation in Illinois. With this decision comes possible far-reaching implications facing insurers going forward by preventing the development of future medical fraud litigation and monetary recoveries.
In Haage v. Zavala, et al. 2020 IL App (2d) 190499 (March 17, 2020), Plaintiffs filed negligence suits for auto collisions, and moved for entry of qualified protective orders pursuant to the Health Insurance Portability ...
Not long after governors and mayors issued orders shutting down non-essential businesses as a safeguard against the spread of COVID-19, we read countless emails and blog posts about how those entities’ business interruption coverages might apply to businesses shut down by the pandemic. Most writers conclude the ISO forms almost certainly will not indemnify the insured for those costs, and while there undoubtedly will be exceptions, I won’t muck about trying to add to that consensus here.
Instead, I’m curious about what happens next, when the owner of a restaurant or plastics ...
When representing an insured, trial attorneys must be attentive and recognize the circumstances under which opposing counsel may or may not present evidence that their client carries liability insurance. More importantly, attorneys must understand the actions that must be taken to preserve the record and protect the client. The Eastern District Court of Appeals recently granted a new trial based on a finding that the plaintiff made repeated, improper references to the defendant’s liability insurer in front of the jury. Collier v. Steinbach, -- S.W.3d --, 2019 WL 7159756 (Mo ...
The Missouri Supreme Court recently affirmed a trial court’s order denying an insurance company’s motion to intervene and set aside a judgment that was entered following the plaintiffs’ contract with a defendant to limit recovery of the judgment against the insurance company pursuant to Missouri Statute Section 537.065. Desai, M.D., et al. v. Seneca Specialty Insurance Company, SC97361.
Plaintiffs Dr. Neil Desai and Heta Desai filed a lawsuit for personal injuries against defendant Garcia Empire, LLC. Garcia Empire had a commercial general liability policy issued by ...
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 ...
On May 1, 2019, Senate Bill 7 was passed as part of the Missouri legislature’s overarching goal to refine Missouri’s broad venue rules, which previously had allowed plaintiffs to pursue their claims in Missouri venues with no connection to their injuries or events which led to their injuries.
Particular provisions of the new venue rules apply specifically to lawsuits involving claims against insurance companies. First, Sections 375.1800 and 508.010 now provide that domestic and foreign insurance companies are deemed a resident of the county where their registered offices ...
HeplerBroom has a long history of defending insurance producers across Illinois, with a strong appellate record on the ordinary-care duty and statute of limitations issues in particular. Western Cons. Prem. Properties, Inc., v. Norman-Spencer Agency, Inc., 845 F.3d 313 (7th Cir. 2017) (duty); RVP, LLC, v. Advantage Insurance Services, Inc., 2017 IL App (3d) 160276 (statute of limitations). We’re seeing new cases in which the producer defendant is alleged to owe a duty not only to its client to procure the policy he requests, but also to an additional insured on that policy.
The ...
It used to be in Illinois that an insurance broker could be sued for breach of fiduciary duty for just about any policy-related misdeed. See, e.g., Faulkner v. Gilmore, 251 Ill.App.3d 34 (3d Dist. 1993) (alleging breach of fiduciary duty for a broker’s failure to advise insureds to terminate their master surety agreement.) The fiduciary-duty claim did not need to involve the actual handling of client monies; the counts were essentially repackaged negligence or breach of contract allegations, labelled with a seemingly-heightened sense of breached duty.
But in 1997 the Illinois ...
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 ...
We all say things we regret. But sometimes, those things we say can be used against us. The same goes for insurance companies. So held the Illinois Appellate Court, Second District, in its recent unpublished decision in Country Preferred Ins. Co. v. Badri-Monaghan, 2017 IL App (2d) 170134-U. The court started the year with a decision finding an insurance company was estopped from asserting a coverage defense based on statements made to the insured by the agent. The policy required the insured to submit a written demand for arbitration, which she failed to do. The evidence showed ...
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 ...
In its October 31, 2017, opinion in Doe Run Resources Corp. v. American Guarantee & Liability Ins., the Missouri Supreme Court considered whether a general liability policy’s pollution exclusion barred coverage for alleged bodily harm caused by exposure to toxic emissions emanating from Doe Run’s lead production facilities in La Oroya, Peru. The exclusion removed coverage for “injury or damage or medical expenses that result from pollution at, on, in…or from any…protected person’s premises.” The policy defined “pollution” to mean “any actual, alleged ...
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 ...
