756 results for 'cat:"Insurance" AND cat:"Contract"'.
J. Sykes finds that the lower court properly found for the insurer, ruling that its policy with a dialysis provider contains a bacteria exclusion that precludes coverage of a $2 million judgment against the provider stemming from a patient's sepsis diagnosis after suffering repeated infections resulting from his dialysis treatment. The bacteria exclusion plainly applies, and the insurer was not required to conduct any further investigation into the man's claims before denying coverage. Affirmed.
Court: 7th Circuit, Judge: Sykes, Filed On: April 24, 2024, Case #: 22-1983, Categories: insurance, Indemnification, contract
J. Brailsford denies in part an insurance company's motion for summary judgment regarding an insurance coverage dispute following a plane crash. While the pilot walked away unharmed, the plane, which crashed shortly after takeoff, sustained extensive damage. The plane owner alleges that the insurer has not paid for certain repairs in violation of the insurance policy. A genuine dispute of material fact remains as to whether the insurer paid the amount required under the insurance policy. Because the insurance company has waived its right to compel arbitration, its motion for summary judgment on the contract claim is denied.
Court: USDC Idaho, Judge: Brailsford, Filed On: April 24, 2024, Case #: 1:22cv176, NOS: Insurance - Contract, Categories: Arbitration, insurance, contract
J. Winmill grants an insurance company's motion for expenses regarding an improperly terminated disposition. The disposition regarding a car collision was terminated by counsel when the passenger in the car, who suffered severe memory loss, was being asked about insurance claims documents and was about to be shown those documents. The attorney alleges that the insurer failed to lay the proper foundation for refreshing a witness' recollection with a document. The attorney has not shown that the insurer's counsel's questioning rose to the level of bad faith or oppressiveness. The "unilateral termination of the...disposition was therefore unjustified and warrants sanctions."
Court: USDC Idaho, Judge: Winmill, Filed On: April 24, 2024, Case #: 1:21cv498, NOS: Other Contract - Contract, Categories: insurance, Sanctions, contract
J. Copenhaver grants the insurance carrier’s motion for summary judgment in the property management company's suit seeking declaratory judgment the carrier was obligated to defend it in a counterclaim Union Carbide filed against the company claiming it bore partial responsibility for damage to not only its property, but also the nearby Davis Creek Watershed from the run-off of toxic chemicals. Since the company has failed to not only prove the existence of a policy from 1987 through 2005, but also any of the policy's material terms, the carrier has no duty to defend or indemnify it.
Court: USDC Southern District of West Virginia, Judge: Copenhaver , Filed On: April 23, 2024, Case #: 2:22cv135, NOS: Insurance - Contract, Categories: insurance, Business Practices, contract
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J. Walker grants a health insurance company’s motion to dismiss a lawsuit brought against it by a hospital trying to have the insurance company cover healthcare services it provided to one of its insured. The hospital did not exhaust the administrative process in trying to get the insurance company to cover the cost of services it provided.
Court: USDC Maine, Judge: Walker, Filed On: April 23, 2024, Case #: 2:23cv258, NOS: Other Contract - Contract, Categories: Health Care, insurance, contract
J. Tostrud partially grants the insurer's motion for summary judgment in the homeowners' association's suit seeking reimbursement for the cost to replace undamaged, non-color-matching siding on buildings damaged by hail. There is no genuine dispute of material fact that the association did not actually and necessarily spend more than the value of its loss, and it filed suit more than two years after providing notice of its claim, precluding pre-award interest. An appraisal panel's award and subsequent clarification on the issue of whether the association is entitled to matching costs for the siding were ambiguous, so that issue remains live.
Court: USDC Minnesota, Judge: Tostrud, Filed On: April 22, 2024, Case #: 0:22cv2027, NOS: Insurance - Contract, Categories: insurance, contract
J. Coghlan finds that the lower court properly granted the fiancée $176,000 after her estranged fiancé took her engagement ring then returned it after replacing the diamond with a synthetic diamond. The fiancée qualifies as an innocent insured under the policy on the ring because the contract does not contain a clear statement that it is void as to all insureds in the event of wrongdoing by one of the insureds. Affirmed.
Court: Illinois Appellate Court, Judge: Coghlan, Filed On: April 22, 2024, Case #: 230224, Categories: insurance, contract
J. Whitney orders a car insurance company and a driver who was injured in a collision in 2018 to submit supplemental briefs detailing whether the court should exercise its jurisdiction to resolve a policy coverage dispute in North Carolina or wait until an underlying suit in South Carolina is resolved. The collision occurred in South Carolina. Although the insurance of the driver at fault paid out according to its limit of $100,000 on the injured driver’s claim, he alleges that the costs of treatment for his injuries exceed this amount. The insurance company claims the injured driver is not entitled to additional coverage under its uninsured motorist policy because he failed to comply with certain notice provisions under North Carolina state law and the uninsured motorist policy. Thus, both parties must submit supplemental briefs to proceed.
Court: USDC Western District of North Carolina, Judge: Whitney, Filed On: April 22, 2024, Case #: 3:23cv28, NOS: Insurance - Contract, Categories: insurance, Vehicle, contract
J. Dever denies an electric company’s motion for judgment on the pleadings for breach of contract allegations it brought against its insurance firm after the company’s owner crashed his boat into another, killing three people. The owner, who was not engaged in business while driving his boat intoxicated, was not covered in this case because the insurance only applies to his business endeavors. For the same reason, the estates of the three people who died fail in their attempt to sue the firm for damages and funeral expenses.
Court: USDC Eastern District of North Carolina, Judge: Dever, Filed On: April 22, 2024, Case #: 7:22cv78, NOS: Insurance - Contract, Categories: insurance, contract
J. Fox finds the lower court erroneously granted the insurers' motions for summary judgment based on the policyholder's noncompliance with policy requirements. The insurers each failed to provide in writing the specific medical records needed to process his claim and also failed to give him the statutorily required 60 days to correct any defects in the records he did provide. Reversed.
Court: Colorado Court Of Appeals, Judge: Fox, Filed On: April 18, 2024, Case #: 2024COA40, Categories: Civil Procedure, insurance, contract
Per curiam, the appellate division finds that the lower court properly found for the insurer in a suit seeking damages for business losses due to the store's inability to use its premises during the Covid-19 pandemic. The store cannot show that a physical loss occurred in order to trigger coverage under the policy. Affirmed.
Court: New York Appellate Divisions, Judge: Per curiam, Filed On: April 18, 2024, Case #: 02091, Categories: insurance, Covid-19, contract
Per curium, at issue in this insurance dispute is the amount of the attorney fees awarded to the insureds. The insurance company claims the awarded amount is unreasonable, arguing the rates and number of hours billed by the insureds is excessive. The instant court finds the matter should be remanded to the lower court for further consideration. Reversed.
Court: Florida Courts Of Appeal, Judge: Per curiam, Filed On: April 17, 2024, Case #: 3D23-0940, Categories: insurance, Attorney Fees, contract
J. Miller finds the lower court improperly determined the amount of attorney fees to be awarded to an insurance company. USAA Insurance prevailed in litigating a personal injury protection case, and attorney fees were awarded, but the lower court found the attorneys were operating under a verbal flat rate agreement and reduced the fee judgment accordingly, and failed to award appellate fees in their entirety. The instant court finds no testimony presented that USAA worked under a flat rate agreement, and it is entitled to recover reasonable attorney fees. The matter is remanded to the lower court to determine and award reasonable fees, taxable costs and expert fees. Reversed.
Court: Florida Courts Of Appeal, Judge: Miller, Filed On: April 17, 2024, Case #: 2022-2032, Categories: insurance, Attorney Fees, contract
J. Pascal allows insurers to file an amended answer in an action contending total loss claims stemming from car collisions had been undervalued because the counterclaims are based on new sets of facts and plausibly allege one of the drivers had not entered a valid contract with an insurer.
Court: USDC New Jersey, Judge: Pascal , Filed On: April 15, 2024, Case #: 1:21cv20510, NOS: Insurance - Contract, Categories: insurance, contract
J. Pellegringo finds that the district court properly granted the insurers summary judgment without posting a bond in this lawsuit. The insurers allege breach of contract and violation of the Connecticut Unauthorized Insurers Act, but failed to show any genuine issue of material fact. Affirmed.
Court: Connecticut Court Of Appeals, Judge: Pellegrino, Filed On: April 15, 2024, Case #: AC45222, Categories: insurance, contract
J. Harris finds that, given State Farm's motion for rehearing, it is necessary to withdraw a previous opinion and replace it with this opinion in the insured's class action alleging State Farm was required to pay her interest on top of what it paid for her water damages claim. The trial court erred in dismissing the insured's contractual claim, as the relevant policy contains a standalone provision obligating State Farm to pay out interest which can create grounds for a cause of action not barred by statutory limitations. The case is remanded for further proceedings. Reversed.
Court: Florida Courts Of Appeal, Judge: Harris, Filed On: April 12, 2024, Case #: 23-0243, Categories: insurance, contract
J. Schroeder grants an agricultural insurance company’s motion to dismiss allegations of breach of contract, deceptive trade practices and bad faith brought by a policy holder. Specifically, the policy holder claims the company wrongfully refused to pay under its crop insurance policy. However, because the policy holder did not respond to the company’s motion, and the time to do so has passed, the motion is granted and the case dismissed.
Court: USDC Middle District of North Carolina, Judge: Schroeder, Filed On: April 12, 2024, Case #: 1:24cv116, NOS: Insurance - Contract, Categories: Agriculture, insurance, contract
J. Du grants an insurer's motion to dismiss this breach of contract claim. The homeowners sued the insurer for refusing to pay for more than 12 months of loss of use coverage after a tree fell on their house. The loss of use provision in the policy has been replaced with a "special provisions—Nevada endorsement" that requires the insurer pay additional living expenses for 12 months from the date of loss. There is no allegation or dispute it did not do this.
Court: USDC Nevada, Judge: Du, Filed On: April 11, 2024, Case #: 3:24cv60, NOS: Insurance - Contract, Categories: insurance, contract
J. Godbey finds that a property owner that submitted an insurance claim for damages after discovering that an easement for a gas line on a recently purchased property may continue litigation on the claim that the insurance company breached a contract by not fully compensating plaintiff for damages related to the adverse interest in the property. The insurance company failed to adequately show that it met all contract obligations to the property owner. Summary judgment is granted to the insurance company on three other claims by the property owner, but breach of contract survives.
Court: USDC Northern District of Texas , Judge: Godbey, Filed On: April 11, 2024, Case #: 3:21cv2837, NOS: Insurance - Contract, Categories: insurance, Real Estate, contract
J. Lobree finds the trial court improperly granted final judgment in favor of the guardian of a minor child who was in a car accident caused by the insurance company's insured. The trial court was wrong to find that the insured's cancellation of his commercial liability policy in light of him obtaining a different commercial policy was not effective on the day of the accident because the company said it did not receive it until the day after the accident, in part because the record shows the insured electronically signed and mailed the cancellation notice five days before the accident. The case is remanded for further proceedings. Reversed.
Court: Florida Courts Of Appeal, Judge: Lobree, Filed On: April 10, 2024, Case #: 23-0370, Categories: insurance, contract
Per curiam, the appeals court finds the trial court made an error granting summary judgment to the medical doctor in a dispute with his insurance company over unpaid personal injury protection benefits and the improper cancellation of his policy. The trial court granted summary judgment on a claim that was not properly pleaded, as the doctor's amended complaint sought declaratory judgment on a claim over the cancellation of his policy, not the improperly pleaded but related summary judgment claim he brought later. Reversed.
Court: Florida Courts Of Appeal, Judge: Per curiam, Filed On: April 10, 2024, Case #: 22-1529, Categories: insurance, contract
J. Levine finds that the trial court improperly ruled for an insurer in claims seeking coverage for property damage because genuine issues remain in dispute regarding the insured's refusal to participate in the examination under oath. Reversed.
Court: Florida Courts Of Appeal, Judge: Levine, Filed On: April 10, 2024, Case #: 4D2022-0378, Categories: insurance, contract
J. Aenlle-Rocha grants an insured's motion to overturn the insurer's denial of benefits for his son's treatment at a residential care facility. The treatment was denied as "not medically necessary" despite the insured's appeal with neuropsychological assessments, five letters of medical necessity from treatment providers, and thousands of pages of medical records and treatment notes. The insured "has satisfied his burden of proving medical necessity as to the treatment at issue with credible, persuasive evidence." The insurer denied the claim without sufficient explanation and "disregarded relevant medical evidence and did not afford [the insured] a full and fair review of his claims."
Court: USDC Central District of California, Judge: Aenlle-Rocha, Filed On: April 9, 2024, Case #: 2:23cv6413, NOS: Other Contract - Contract, Categories: Erisa, insurance, contract
J. Pulliam mostly grants an insurer’s motion for summary judgment in a dispute with policyholders over payout for roof damage, which the insurer contends was largely uncovered wear-and-tear. While the policyholders have not shown bad faith, and the insurer is therefore entitled to summary judgement on most of their claims, the insurer has conversely presented “no specific argument” for dismissing the remainder of the case, including for alleged violations of the Texas Prompt Payment Act.
Court: USDC Western District of Texas , Judge: Pulliam, Filed On: April 9, 2024, Case #: 5:23cv411, NOS: Insurance - Contract, Categories: insurance, contract