Category Archives: Insurance

Kentucky Federal Court Bifurcates Coverage Claims from Claims of Bad Faith

Summary: Dippin’ Dots wanted coverage for spoliation of its ice cream that resulted from a power outage. Travelers denied coverage and Dippin’ Dots sued Travelers for both the $750,000 value of the spoiled ice cream and for bad faith based on Travelers’ handling of this property damage claim. Dippin’ Dots, LLC v. Travelers Property Casualty Co. of America Travelers moved to bifurcate the trial of the liability and first party bad faith counts, and the Court granted Travelers’ request finding that judicial economy would be advanced by the bifurcation. Importantly, the Court also stayed discovery on the bad faith issues until the contract claim was decided. Notably, Kentucky state courts routinely grant these bifurcation motions, per the opinion. Given that contract claims for coverage are often decided based on stipulated facts or simple affidavits, getting the court to decide the coverage issue before the bad faith issue will allow a quick….. To continue reading this legal news please click Read full information...

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Wording of Additional-Insured Provisions Makes All The Difference

A New York appellate court ruled recently in Hanover Insurance Co. v. Philadelphia Indemnity Insurance Co., 2018 NY Slip Op 02121 (1st Dep’t March 27, 2018), that an insurance policy did not cover an additional named insured over a personal-injury lawsuit arising from its alleged negligence because coverage was limited only to injuries caused by the named insured.  This decision again underscores, as we advised in a recent Blog Post addressing JP Energy Marketing LLC v. Commerce and Industry Insurance Co. (which can be found here), the importance of carefully evaluating the wording of “additional insured” provisions, which can vary widely in scope and effect. Manhattan School of Music was an additional named insured under an insurance policy issued by Philadelphia Indemnity Insurance Co. to Protection Plus Security Corporation. The insurance policy provided that Manhattan School was an additional insured, but “‘only with respect to liability….. To continue reading this legal news please click Read full information...

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Another Appellate Court Holds that Faulty Work Constitutes an Occurrence – This Time Under New York Law

It is axiomatic that in order to obtain insurance coverage a policyholder must first establish that a claim falls within a policy’s insuring agreement before coverage under the policy is triggered. For construction claims brought under CGL policies, that frequently means showing that the damages at issue constitute “property damage” caused by an “occurrence” (where “occurrence” is generally defined as “an accident”). While this requirement may often seem like a simple factual question, in the context of a subcontractor’s faulty workmanship, the analysis has proven more difficult. Where alleged faulty work causes damage only to the insured’s own work product, is the property damage accidental? Continue reading →.. To continue reading this legal news please click Read full information...

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Auto Insurance Exclusions

Insurance lawyers can tell prospective clients that most pages in an insurance policy are pages explaining exclusions and limitations to what a policy will pay.  This is no different when it comes to auto insurance. The standard auto policy does not provide med pay coverage for any person for bodily injury occurring during the course of employment if worker’s compensation benefits are available for the bodily injury.  This exclusion is discussed in the 1963, San Antonio Court of Appeals opinion styled, Williams v. Employers Mutual Casualty Co.  Thus, med pay coverage will apply only if the insured does not have worker’s compensation benefits available to him or her. Like the liability coverage, med pay coverage does not extend to the named insured while he or she is occupying a vehicle, other than his or her covered auto, which is owned by him or her or furnished or available for his or her regular use.  This was discussed in the 1965, Tyler….. To continue reading this legal news please click Read full information...

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CMS Uses Regulatory Levers to Chip Away at Affordable Care Act Protections

On Monday, the Centers for Medicare and Medicaid Services (“CMS”) released (1) the Notice of Benefit and Payment Parameters for 2019 final rule (“Final Rule”), (2) the Final Annual Issuer Letter and (3) guidance on hardship exemptions and transitional policies. Some of the more significant developments contained in the documents released by CMS are as follows: Additional Options for “Benchmark” Plans:Under the Final Rule, for 2020 plan years and beyond, states will be able to select their Essential Health Benefit (“EHB”) benchmark plan from one of the 50 EHB-benchmark plans that other states used for the 2017 plan year. Alternatively, states will have the option of crafting a custom set of benefits to become its EHB-benchmark plan. This development will greatly expand the number of options states have to choose from when selecting their EHB-benchmark plans. New Hardship Exemptions: CMS issued new guidance expanding hardship….. To continue reading this legal news please click Read full information...

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