In Mirza v. Insurance Administrator of America, Inc., 2015 WL 5024159, (3d Cir. Aug. 26, 2015), the Court of Appeals addressed the principal question of whether under the Employee Retirement Income Security Act of 1974 (“ERISA”), 29 U.S.C. § 1001 et seq. plan administrators must inform claimants of plan-imposed deadlines for judicial review in their notifications denying benefits. 29 C.F.R. § 2560.503-1(g)(1)(iv) provides that when a plan administrator denies a request for benefits, it must set forth a “description of the plan’s review procedures and the time limits applicable to such procedures, including a statement of the claimant’s right to
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Monthly Archives August 2015
NJ Supreme Court Clarifies Amount Owed to Innocent Third Party for Bodily Injury Payment Under Voided “Basic” Auto Policy
The NJ Supreme Court recently examined the amount an insurer issuing a “basic” insurance policy, which was subsequently voided for material misrepresentation in the application for insurance, must pay for a bodily injury claim of an innocent third party. In Citizens United Reciprocal Exchange v. Perez, the Court determined that under New Jersey’s compulsory system of auto insurance, the auto insurer is liable to the innocent third party only for the statutory minimum bodily injury payment in circumstances where the insured elects to add the “basic” policy’s $10,000.00 coverage for third-party bodily injury. Notably, the Court also held that the
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NY Court Holds Injured Third Party Has No Cause of Action for Unfair Claims Practices and Bad Faith in Suit Against Insurer and Claims Examiner
A New York trial court dismissed an action for unfair claims practices and insurer bad faith against an insurer and a claims examiner that was brought by a third-party claimant injured in an auto accident. In Hunter v. Hereford Ins. Co., the Civil Court of Queens County held that plaintiff failed to state a cause of action against the insurer and additionally, as a third party, lacked privity to sue the insurer of the driver that had injured her. The court also dismissed the action against the claim examiner on the basis that she was acting as an agent of
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NJ Supreme Court Declines to Extend Residential Public-Sidewalk Immunity to Homewoners Association (HOA) Privately Owned Sidewalks
Under New Jersey law, commercial property owners have a duty to maintain the sidewalks abutting their properties and can be held liable for injuries occurring on those sidewalks. Residential landowners, on the other hand, do not have the same responsibilities and are immune from claims for personal injuries on residential sidewalks. In the 2011 case of Luchejko v. City of Hoboken, the New Jersey Supreme Court extended residential sidewalk immunity to Homeowners Associations (“HOAs”) for injuries occurring on public sidewalks adjoining residential condominium communities. Recently, the Court addressed the issue of whether this immunity also applies to claims for personal
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New Jersey Appellate Division Says When Dealing With Discovery Dispute Between Insureds and Insurers Over Privileged Documents, In-Camera Review Must Be Conducted and Discovery as to Breach of Contract and Bad Faith Claim Bifurcated
On July 27, 2015, in Alden Leeds v. QBE Specialty Ins. Co., unpublished, No. A-2034-14T1 (App. 2015), the New Jersey Appellate Division rendered an important decision addressing discovery disputes between insureds and insurers over privileged documents. Alden Leeds involved a coverage dispute with QBE Specialty and Certain Underwriters at Lloyd’s, London over whether a fire that destroyed Alden Leeds’s warehouse was a covered fire loss or an excluded flood loss. Alden Leeds, a manufacturer and seller of pool chemicals, stored chemicals in a warehouse insured by QBE and Underwriters. The warehouse was damaged by fire during Super Storm Sandy. The
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