8 results for 'cat:"Fraud" AND cat:"Insurance" AND cat:"Contract"'.
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. 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
J. Blake denies a chiropractic practice’s motion for summary judgment following insurance fraud claims brought by State Farm. Allegedly, the practice billed for its own standard of treatment by reporting the same patient conditions, treatment plans and results for each person instead of individualized treatment even though their medical records stated otherwise. The practice did this between 2006-2016. State Farm initially investigated the practice in 2013 but failed to find evidence of fraud. They investigated again in 2015 and did find such evidence. The practice argues that because evidence of fraud was present in 2013 but State Farm didn’t find it, when State Farm initiated this suit in 2018, it should have been time-barred. But since State Farm did not find fraud until 2015, its 2018 suit is not barred. There is still room for reasonable disagreement, so summary judgment cannot be granted at this stage.
Court: USDC Maryland, Judge: Blake, Filed On: September 27, 2023, Case #: 1:18cv1279, NOS: Other Fraud - Torts - Personal Property, Categories: fraud, insurance, contract
J. Seeger partially declines an insurance company's motion to dismiss a suit brought by a woman whose roof was damaged in a storm. The insurance company decided the damage to the woman's roof didn't rise above her deductible under her policy, but the woman alleges the insurance company is trying to cheat her out of the coverage she is owed. The insured has sufficiently alleged her breach of contract and Illinois insurance code violation claims, but not her fraud claim.
Court: USDC Northern District of Illinois, Judge: Seeger, Filed On: July 25, 2023, Case #: 1:22cv3744, NOS: Insurance - Contract, Categories: fraud, insurance, contract
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J. Scarsi denies an insurance company's motion to dismiss for lack of jurisdiction an insured's breach of contract and fraud claims after her monthly premiums for her mortgage disability policy increased. The insured alleges that by paying the improperly increased premiums, she paid her policy in full by 2018. The insurer informed the insured that it had cancelled her policy retroactively as of 2011. The parties are completely diverse, the insurer has not established that the jurisdictional threshold has been satisfied and have not shown that the amount in controversy likely exceeds $75,000.
Court: USDC Central District of California, Judge: Scarsi, Filed On: May 24, 2023, Case #: 2:23cv1413, NOS: Insurance - Contract, Categories: fraud, insurance, contract