59 results for 'cat:"Evidence" AND cat:"Insurance"'.
J. Ashe grants summary judgment to an insurer and dismisses bad faith claims by a property owner seeking policy coverage for $298,000 in hurricane damages to a 30-year-old metal roof. The insurer did not act in an arbitrary and capricious when it denied the policyholder’s claim because it had just and reasonable grounds, including its experts’ investigations and opinions, to believe the policy exclusion applies.
Court: USDC Eastern District of Louisiana , Judge: Ashe, Filed On: December 19, 2023, Case #: 2:22cv3292, NOS: Insurance - Contract, Categories: evidence, insurance, Damages
Per curiam, the Texas Supreme Court grants a writ of mandamus filed by an insurance company seeking the medical records of a customer who sued the company after a car accident to obtain uninsured motorist benefits. The lower court improperly quashed the subpoena. The information the company was seeking is relevant to the underlying suit.
Court: Texas Supreme Court, Judge: Per curiam, Filed On: November 17, 2023, Case #: 22-0321, Categories: Corporations, evidence, insurance
J. Christopher finds that the trial court properly ruled in favor of the insurer in a suit involving alleged hurricane damage to a property. The property owners' argument regarding the exclusion of certain repair estimates lacks merit. Also, costs should have been assessed against the property owners. Affirmed as modified.
Court: Texas Courts of Appeals, Judge: Christopher, Filed On: November 2, 2023, Case #: 14-22-00292-CV, Categories: evidence, insurance, Property
J. Wang allows the parties to admit exhibits in claims contending a construction company had not been paid for restoration work on a hotel that had been damaged by a mudslide in Rio de Janeiro. The exhibits do not constitute hearsay since objections were not made when the exhibits were admitted as evidence during witness testimony.
Court: USDC Colorado, Judge: Wang, Filed On: October 31, 2023, Case #: 1:21cv1380, NOS: Other Contract - Contract, Categories: evidence, insurance
J. Jenkins grants summary judgment in favor of an insurance company in this suit that one of their insured customer’s adulterated products and sold them to an oral hygiene supply company. The supply company recalled the kits that were tainted and disposed of the solutions as required by government guidelines. The evidence is undisputed that there was no “occurrence” within the insured’s policy and the insurance company does not have to make any payments. The case is terminated for further proceedings.
Court: USDC Northern District of Illinois, Judge: Jenkins, Filed On: October 25, 2023, Case #: 1:19cv5308, NOS: Other Contract - Contract, Categories: evidence, insurance, Contract
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J. Ashe grants summary judgment to an insurance company on its argument that the romantic partner and beneficiary of a taxi driver who died as the result of a single-car, no-passenger accident is not entitled a 20% of his $325,000 accidental death policy. The accidental death benefit applies only to an insured injured while driving of driving in a “private automobile.” The policy’s definition of a private automobile is unambiguous and does not include a taxicab.
Court: USDC Eastern District of Louisiana , Judge: Ashe, Filed On: October 6, 2023, Case #: 2:23cv1438, NOS: Insurance - Contract, Categories: evidence, insurance, Transportation
J. Silva denies State Farm’s motion for partial summary judgment in this bad-faith insurance lawsuit arising from its denial of the party’s claim for hearing loss caused by airbag deployment in an auto accident. The injured party has set forth specific facts showing that there is a genuine issue for trial because, while State Farm argues that there was a reason for limiting underinsured motorist coverage, it remains unclear whether the dispute for limiting the coverage was genuine. The injured party’s cited evidence sufficiently casts doubt on whether State Farm allegedly violated its own policies when valuing the claim.
Court: USDC Nevada, Judge: Silva , Filed On: October 5, 2023, Case #: 2:21cv486, NOS: Insurance - Contract, Categories: evidence, insurance, Vehicle
J. Cain denies a request by an insurance company to dismiss “bad faith” allegations regarding the adjustment of hurricane damage by a property management firm. The insurer argued that at the time of its assignment of claims by a prior insured realty firm, the insured predecessor was satisfied with the adjustment of the claim and therefore, no bad faith claim. A review of the policy finds that the assignee may pursue its claims against the insurer. The assignee-property manager’s suggestion that additional hurricane damages were not discoverable until a tenant moved out is “suspect.” Nevertheless, the court is hesitant to dismiss a bad faith claim, which should ultimately be decided by the jury.
Court: USDC Western District of Louisiana , Judge: Cain, Filed On: October 4, 2023, Case #: 2:22cv2552, NOS: Insurance - Contract, Categories: evidence, insurance, Discovery
J. Lobree finds the trial court improperly entered a final judgment in favor of the insured in her dispute with the insurance company regarding coverage of a claim over water damages to her house. The trial court incorrectly denied the company's motion in limine to block from evidence the homeowner's replacement-cost estimate of the damages and instead limit evidence on damages to actual cash value, which resulted in the homeowner not bringing evidence of the correct estimate of damages. The trial court's order is overturned and the case is remanded for a new trial. Reversed.
Court: Florida Courts Of Appeal, Judge: Lobree, Filed On: October 4, 2023, Case #: 20-0367, Categories: evidence, insurance, Contract
J. Navarro denies the insurance company’s motion for summary judgment in this suit arising from its failure to indemnify the successor in interest for the title company which served as the escrow agent for construction loans attached to a deed which the borrower never reconveyed due to the title company’s clerical error. The successor in interest has raised a dispute of material fact. Certain exhibits demonstrate that the insurance company had acted in bad faith by not engaging in settlement offers over a period of years.
Court: USDC Nevada, Judge: Navarro, Filed On: September 29, 2023, Case #: 2:18cv1823, NOS: Insurance - Contract, Categories: evidence, insurance, Banking / Lending
J. Stephens finds that the trial court should not have denied an insurer's motion for summary judgment on a claim by the insured homeowner who was run over by a painting employee who was driving to the home to perform work. In this case, the insurance policy was for the purpose of the insured's employer's covered vehicles, and it is undisputed that the insured was not using any automobile at the time of the accident. Reversed.
Court: Louisiana Court Of Appeal, Judge: Stephens, Filed On: September 27, 2023, Case #: 55,136-CW, Categories: evidence, insurance, Contract
J. Simon reverses the insurance company's determination that the insured was not disabled as of March 25, 2020, which the insured claims resulted in the denial of her long-term disability benefits. The insured's test results show that her memory functioning was greatly impaired and the the Social Security Administration found the insured to be disabled, so the insurance company must reinstate the insured's benefits from March 25, 2020 through June 4, 2021, which is the remainder of the 24-month "own occupation" period of her long-term disability plan.
Court: USDC Oregon, Judge: Simon, Filed On: September 20, 2023, Case #: 3:21cv1019, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, evidence, insurance
J. Pechman denies summary judgment to the insurance company against the insured's bad faith claim in her lawsuit alleging that the insurance company must cover her claim for injuries to her neck, back and shoulder she sustained when an uninsured motorist struck her vehicle and horse trailer. The bad faith claim cannot be resolved with summary judgment at this time because the insured and the insurance company present contrasting and competing evidence, and to weigh in the insurance's company's favor would mean ignoring the insured's expert's opinions in an unfavorable way.
Court: USDC Western District of Washington, Judge: Pechman, Filed On: August 31, 2023, Case #: 2:22cv1116, NOS: Insurance - Contract, Categories: evidence, insurance, Contract
J. Virden finds the Board of Review properly denied the discharged employee’s claim for unemployment benefits. The employee was discharged for being absent from work and failing to notify the employer. Neither the employee nor the employer appeared before the appeal tribunal to present testimony. The employee’s claim of having had car trouble was not raised initially and the appeals court does not consider issues raised for the first time on appeal. The record and all evidence support the denial of benefits. Affirmed.
Court: Arkansas Court Of Appeals, Judge: Virden, Filed On: August 30, 2023, Case #: E-22-601, Categories: Employment, evidence, insurance
J. Rice grants summary judgment to the government for its claim that the prosser farmer knowingly presented fraudulent payment claims for reinsurance by the USDA to RCIS for the 2015 crop year indemnity payments under his insurance policy. The evidence shows that the prosser farmer sold his personal wheat with the company's wheat despite claiming the opposite, among other provable falsehoods. The prosser farmer and the company are jointly and severally liable to the government for $541,200.
Court: USDC Oregon, Judge: Rice, Filed On: August 21, 2023, Case #: 1:21cv3126, NOS: False Claims Act - Torts - Personal Injury, Categories: evidence, insurance, False Claims
J. Hicks grants a request by an insurance company dismissing bad-faith claims brought by their insureds, two Shreveport homeowners, arising from alleged roof damage caused by hail. The ruling finds no evidence exists to support a finding that the insurer acted arbitrarily or capriciously. Specifically, the homeowners have not submitted any evidence that shows that their insurer did not have a legitimate question as to whether the damage may have been caused by wear and tear. On the contrary, the insurer submitted evidence that shows that once the litigants reached an undisputed figure of $311,117, the insurer issued payment to the homeowners within the statutory time frame.
Court: USDC Western District of Louisiana , Judge: Hicks, Filed On: August 18, 2023, Case #: 5:20cv634, NOS: Insurance - Contract, Categories: evidence, insurance, Experts
J. Trauger denies the summary judgment motion filed by the decedent's wife in this lawsuit concerning the rightful beneficiary under a life insurance policy. The plaintiff insurance company filed this complaint in interpleader, after it was unable to determine who was entitled to the death benefit. The decedent's wife was designated as the sole beneficiary, but as of the date of the complaint, the death was allegedly being investigated as a homicide and she "had not been ruled out as a suspect." There are "material factual disputes" precluding summary judgment for either party at this point.
Court: USDC Middle District of Tennessee , Judge: Trauger, Filed On: August 4, 2023, Case #: 3:20cv506, NOS: Insurance - Contract, Categories: evidence, insurance
J. Kelly finds a lower court properly indicted a defendant for wire fraud. The defendant argued that he was entitled to a dismissal for insufficient evidence of crime. However, the government presented sufficient evidence in court that the defendant opened a second life insurance policy on his spouse without disclosure, paid the premiums from her bank account, forged her signature, and convinced her to undergo a physical exam, claiming it was for an existing policy. Affirmed.
Court: 8th Circuit, Judge: Kelly, Filed On: July 27, 2023, Case #: 22-1096, Categories: evidence, Fraud, insurance
J. Breen denies the defendant insurance company's motion to exclude certain expert testimony in this breach of contract case involving a home fire. The court notes that the company's arguments speak to "the accuracy of the conclusions, not to the reliability of the testimony." The expert, who is an insurance consultant and property adjuster, inspected the property and "conducted a 3-D scan of the dwelling."
Court: USDC Western District of Tennessee , Judge: Breen, Filed On: July 20, 2023, Case #: 1:22cv1079, NOS: Insurance - Contract, Categories: evidence, insurance, Experts
J. Rothstein grants partial summary judgment to the insurance company for its claim that it did not breach its duty to defend the insured in an underlying car collision lawsuit that claimed that the insured was at-fault. There is no corroborating evidence that the insurance company knew of the lawsuit's existence until Feb. 18, 2021, so the insurance company has no duty to defend the insured prior to that date.
Court: USDC Western District of Washington, Judge: Rothstein, Filed On: July 6, 2023, Case #: 2:21cv1501, NOS: Insurance - Contract, Categories: evidence, insurance, Contract
J. Snow grants the plaintiff insurance company's motion to dismiss a certain theory alleged in the amended counterclaim against it. Specifically, the allegations do not show that the insurer acted in bad faith by denying the insurance claim for a fire that destroyed a building. Additionally, the building defendants will not be allowed to amend their counterclaim again.
Court: USDC Eastern District of Oklahoma, Judge: Snow, Filed On: June 20, 2023, Case #: 6:19cv427, NOS: Insurance - Contract, Categories: evidence, insurance, Contract
J. Christel dismisses with prejudice the insured's extracontractual IFCA, CPA and bad faith claims alleging that the insurance company unreasonably refused to compensate the insured for damages he sustained in a motor vehicle accident. The insurance company conducted an investigation of the insured's claim and had a factual basis for its evaluation, which is that the insured did not provide the insurance company with evidence, such as his doctor's April 2020 opinion regarding his back injury, until after he sent a demand letter for litigation.
Court: USDC Western District of Washington, Judge: Christel, Filed On: June 14, 2023, Case #: 2:21cv1524, NOS: Insurance - Contract, Categories: evidence, insurance, Contract
J. Morrison grants the radiologist's motion for judgment on the administrative record, ruling the insurer's termination of disability benefits was arbitrary and capricious because medical opinions from two doctors expressed serious doubts as to whether he could return to work and adequately perform his job. Although there was improvement in the radiologist's vision after several surgeries and he expressed he was satisfied with his vision, this opinion is not conclusive evidence his vision had improved to the point where he would be able to interpret medical images and accurately diagnose diseases for his patients; therefore, his total disability benefits will be reinstated.
Court: USDC Southern District of Ohio, Judge: Morrison, Filed On: June 12, 2023, Case #: 2:22cv112, NOS: Employee Retirement Income Security Act (ERISA) - Labor, Categories: Erisa, evidence, insurance
J. Africk denies the property owner’s breach of contract claim against his insurer for failing to pay any of his $300,000 claim for hurricane damage. The mere facts that the property owner has an insurance policy and has not been paid for alleged damages do not constitute factual allegations sufficient to allow for the plausible conclusion the insurer’s actions are “arbitrary, capricious, and unsupported by any evidence and constitute bad faith.” The policyowner is offered one opportunity to amend his complaint to provide more specifics and facts to support his claims.
Court: USDC Eastern District of Louisiana , Judge: Africk, Filed On: June 5, 2023, Case #: 2:23cv1463, NOS: Insurance - Contract, Categories: evidence, insurance, Damages
J. Smith finds the trial court properly ruled in favor of an insurance company, granting its motion for no-evidence summary judgment in a workplace injury suit brought by a worker. Because the worker fails to raise a fact issue concerning the trial court’s ruling, it can be concluded that the court did not err. Affirmed.
Court: Texas Courts of Appeals, Judge: Smith, Filed On: June 2, 2023, Case #: 03-21-00418-CV, Categories: Civil Procedure, evidence, insurance
J. Davis denies the chicken farm owner's motion for summary judgment on fraud counterclaims filed by the insurers, ruling that although it was open about its intent to upgrade the farm following a fire, this disclosure does not insulate it from allegations it included upgrade costs in its submissions for the insurance claims. Additionally, testimony from farm employees and fire damage evaluators supports the counterclaims, which are not based merely on a difference of opinion regarding the property damage; therefore, they must be submitted to a jury.
Court: North Carolina Business Court, Judge: Davis, Filed On: May 31, 2023, Case #: 2023 NCBC 37, Categories: evidence, Fraud, insurance
J. Johnson finds that the district court should not have dismissed an injured driver's claims against the defendant driver's insurer. There are genuine issues on whether the insurer waived its affirmative defenses as to coverage because the driver submitted evidence to show that the insurer accepted liability for the accident in an email. Reversed in part.
Court: Louisiana Court Of Appeal, Judge: Johnson, Filed On: May 24, 2023, Case #: 22-CA-370, Categories: evidence, insurance, Tort