68 results for 'cat:"Fraud" AND cat:"Insurance"'.
J. King finds in favor of the insurance company on the fraud claim in the insured's complaint alleging that the insurance company must provide more coverage for an accident caused by an underinsured motorist. The insureds' claims for bad faith, negligence, fraud, Insurance Fair Conduct Act and Consumer Protection Act are all time-barred.
Court: USDC Western District of Washington, Judge: King, Filed On: May 13, 2024, Case #: 2:23cv873, NOS: Insurance - Contract, Categories: fraud, insurance, Negligence
J. Batchelder finds the lower court properly granted the insurance company's motion for summary judgment on securities claims filed by investors. None of the statements included in the company's pre-IPO release meet the heightened pleading requirements of a fraud claim, but were instead historical statements of past performance that would not have misled the ordinary investor. Affirmed.
Court: 6th Circuit, Judge: Batchelder, Filed On: April 29, 2024, Case #: 23-3392, Categories: fraud, insurance, Securities
J. Wecht finds that the superior court improperly affirmed the trial court’s decision to not award certain damages in this suit wherein a couple alleges they were fraudulently induced to purchase life insurance from a financial company. Treble damages under the Consumer Protection Law are available to the the couple in this case. Reversed.
Court: Pennsylvania Supreme Court, Judge: Wecht, Filed On: April 25, 2024, Case #: J-59-2023, Categories: fraud, insurance, Damages
J. Miller finds that the lower court properly denied the insurer's motion to dismiss fraud claims based on its alleged sale of an unlawful workers' compensation insurance program based on a forum-selection clause. The forum selection clause of an illegal insurance policy is not enforceable, and New York companies cannot be forced to litigate in Nebraska to vindicate their rights. Affirmed.
Court: New York Appellate Divisions, Judge: Miller, Filed On: April 17, 2024, Case #: 02032, Categories: fraud, insurance, Jurisdiction
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J. Kelly dismisses the insurer's interlocutory appeal of the lower court's partial denial of its motion to dismiss a consumer fraud class action. The consumers claim the insurer engaged in unfair business practices by reducing the actual cash value of totaled cars by a "typical negotiation" deduction, which is not defined in the policy. However, the court lacks jurisdiction to hear this appeal because the lower court's decision rests on its interpretation of state law, not on the Federal Arbitration Act.
Court: 8th Circuit, Judge: Kelly, Filed On: April 10, 2024, Case #: 23-1516, Categories: fraud, insurance, Class Action
J. Cain denies a request by a surplus line insurance company to dismiss a parish sheriff’s suit for damages to a public building caused by two hurricanes and a winter storm. The insurer argues coverage of the damaged building should be voided to the sheriff’s “misrepresentations” on ownership. The insurer has not shown how certain statements by the sheriff’s office are material to the insurer’s claims, “let alone pointed to any circumstances that they were made with the intent to deceive.”
Court: USDC Western District of Louisiana , Judge: Cain, Filed On: April 3, 2024, Case #: 2:21cv3947, NOS: Insurance - Contract, Categories: fraud, Government, insurance
J. Reidinger grants default judgment in favor of an insurance underwriting company after a client defrauded Medicare, violating a policy the company financed. The client, a clinical laboratory firm, knowingly submitted false claims to Medicare. Therefore, the policy between the company and firm is null and the company is free from indemnifying the firm.
Court: USDC Western District of North Carolina, Judge: Reidinger, Filed On: March 18, 2024, Case #: 1:20cv41, NOS: Insurance - Contract, Categories: fraud, Health Care, insurance
J. Coleman grants an insurance company’s motion to strike a group of policyholders’ expert testimony, and denies the policyholders’ motion for class certification. The policyholders accuse the insurance company of charging excessive premiums during the Covid-19 pandemic, bringing fraud charges under Illinois law. The court, though, finds the policyholders have not established predominance or commonality of injury sufficient to form a class.
Court: USDC Northern District of Illinois, Judge: Coleman, Filed On: March 12, 2024, Case #: 1:20cv4306, NOS: Other Contract - Contract, Categories: fraud, insurance, Class Action
J. Vascura denies the uninterruptable power supply manufacturer's partial motion to dismiss, ruling that limiting language in its contract with the industrial plant allows the plant's insurance company to plead both contract and fraud claims. The damages limitation clause would not provide nearly enough to compensate the plant for damage from the explosion, and punitive or secondary damages from a fraud claim would be necessary.
Court: USDC Southern District of Ohio, Judge: Vascura, Filed On: March 5, 2024, Case #: 2:23cv1398, NOS: Torts to Land - Real Property, Categories: fraud, insurance, Contract
J. Young denies the truck drivers motion for default judgement. The insurance company refused to cover the losses the truck driver endured when his 1999 Freightliner Classic XL truck was reportedly towed to an impound lot but went missing when he was arrested in 2015. The truck driver believes the insurance company and a separate truck company conspired to steal his vehicle to strip for parts. The truck driver failed to plead a viable private fraud claim, and further, the facts establish that the relevant statute of limitations has expired for the conversion claim.
Court: USDC Eastern District of Virginia, Judge: Young, Filed On: March 1, 2024, Case #: 3:23cv267, NOS: Other Contract - Contract, Categories: fraud, insurance, Conversion
J. Dorsey grants the taxi company's motion to dismiss the concert of action claim. The company's driver filed an insurance claim against the other driver's policy after an accident, causing the other driver's rates to go up. The other driver's concert of action claim says the claim was false but fails to identify a scheme the company had with a lawyer it referred to its driver. The only relevant allegations against the company are that its driver “most likely” knew to contact the lawyer from the cab company, which would be familiar with personal injury lawyers.
Court: USDC Nevada, Judge: Dorsey , Filed On: February 29, 2024, Case #: 2:19cv1173, NOS: Other Fraud - Torts - Personal Property, Categories: fraud, insurance, Vehicle
J. Hillman declines to reimburse costs to an insurer accused of manipulating premiums to force a real estate development and management company to pay more because even if the company prolonged litigation by pursuing a meritless appeal, the insurer had other remedies related to costs.
Court: USDC New Jersey, Judge: Hillman , Filed On: February 16, 2024, Case #: 1:19cv13638, NOS: Insurance - Contract, Categories: fraud, insurance
J. Hochhalter grants an insurance company's motion for summary judgment in a matter involving a check fraud scheme perpetrated against a law firm. The firm's professional liability policy contained an exclusion for conversion, misappropriation, or wrongful disbursement of trust account funds.
Court: USDC North Dakota , Judge: Hochhalter, Filed On: January 30, 2024, Case #: 1:21cv212, NOS: Insurance - Contract, Categories: fraud, insurance
J. Crabtree grants Blue Cross Blue Shield's motion for summary judgment concerning defamation claims brought by a health insurance billing service. Blue Cross sufficiently showed in court that it did not set out to ruin the health insurance billing service's reputation by investigating submitted claims.
Court: USDC Kansas, Judge: Crabtree, Filed On: January 25, 2024, Case #: 5:19cv4007, NOS: Assault, Libel, & Slander - Torts - Personal Injury, Categories: fraud, insurance, Defamation
J. Gleason denies a substance abuse treatment center's motion to dismiss an insurance company's claim that the center defrauded the insurer of approximately $3.3 million in falsified claims. The insurer claims that the center recruited Alaska residents as patients, and that these patients would have been eligible for Medicaid, but the center had them enroll in the insurer's plan because the center could charge the insurer more for out-of-state treatment. The insurer has adequately alleged an injury that is traceable to the center's alleged actions. The insurance company's motion to amend the complaint is granted.
Court: USDC Alaska, Judge: Gleason, Filed On: January 17, 2024, Case #: 3:23cv132, NOS: Other Statutory Actions - Other Suits, Categories: fraud, insurance
J. Rothstein remands the car collision victim's complaint that the insurance company's attorney, acting on behalf of their at-fault insured driver, falsely claimed that he had a $25,000 policy limit to cover car collision victim's damages when there were supposed to be "no limits" for this policy. The insurance company and others do not show that the in-state accused parties were fraudulently joined, so there is no reasonable justification to keep this case in federal court.
Court: USDC Western District of Washington, Judge: Rothstein, Filed On: January 9, 2024, Case #: 2:23cv1349, NOS: Insurance - Contract, Categories: fraud, insurance
J. Frank denies the securities intermediaries' motion to dismiss the death benefit proceed claimants' suit seeking the proceeds of alleged stranger-originated life insurance policies for lack of standing. Insureds' estates may pursue claims to recover proceeds from policies alleged to have been wagers on their decedents' lives.
Court: USDC Minnesota, Judge: Frank, Filed On: January 9, 2024, Case #: 0:23cv45, NOS: Insurance - Contract, Categories: fraud, insurance
J. Dever remands this suit against an insurance company brought by an environmental waste handler for failure of payment after the handler pumped spilled hog waste from a methane gas facility to unused hog barns for two weeks straight. The handler moved the waste for 12 hours a day during it operation, billing the facility over $411,000, which the facility passed on to the insurance company. The insurer argues that the handler is not party to the contract between itself and the facility, and therefore lacks standing. However, this argument prevents the insurance company from carrying its burden to show this matter belongs in federal court.
Court: USDC Eastern District of North Carolina, Judge: Dever, Filed On: December 29, 2023, Case #: 7:23cv1171, NOS: Other Fraud - Torts - Personal Property, Categories: fraud, insurance, Jurisdiction
J. Chun defers ruling as to whether the insureds fraudulently concealed or misrepresented facts in their underlying lawsuit, in which the insurance company asserts it does not have a duty to defend or indemnify the insureds. At this state of litigation, it is unclear as a matter of law if the insureds concealed or misrepresented facts and thus prejudiced the insurance company, and analyzing the insurance policy and the underlying lawsuit cannot resolve these issues. However, discovery is not closed yet, so the insureds may renew this request after it is.
Court: USDC Western District of Washington, Judge: Chun, Filed On: December 29, 2023, Case #: 2:21cv1389, NOS: Insurance - Contract, Categories: fraud, insurance, Contract
[Consolidated.] J. Bianco finds that the district court improperly ordered the destruction of financial records obtained by federal labor agents and used in prosecuting a fraudulent life insurance scheme that caused over $50 million in losses. The criminal case had been resolved, but records may be required to defend against anticipated collateral attacks on that conviction and to preserve evidence should retrial occur.
Court: 2nd Circuit, Judge: Bianco, Filed On: December 11, 2023, Case #: 22-1057, Categories: fraud, insurance, Discovery
J. Vascura denies, in part, the power supply manufacturer's motion for judgment on the pleadings on a fraud claim related to defective batteries. The stark difference between the condition of the batteries, including bulging cases and visible cracks, and the fully operational status reported by the manufacturer's inspectors just weeks before the failure is sufficient to allow the claim to proceed.
Court: USDC Southern District of Ohio, Judge: Vascura, Filed On: November 28, 2023, Case #: 2:23cv1398, NOS: Torts to Land - Real Property, Categories: fraud, insurance, Negligence