In Millin v. Allstate Indemnity Co., et al., the insureds brought suit against Allstate for breach of contract and bad faith after Allstate partially denied their claim for water damage arising from a water leak in another apartment. Plaintiffs sought actual damages, consequential damages, punitive damages, and attorney’s fees. Allstate moved to dismiss Plaintiff’s claims for punitive damages, attorney’s fees, and consequential damages. Based on the law of New York, the court granted Allstate’s motion to dismiss the claims for punitive damages and attorney’s fees, but denied the motion as to consequential damages, finding that consequential damages are permitted when
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Archives for Insurance Law
New Jersey Federal Court Holds Ambiguous Denial Letter Tolls Suit Limitations Provision in Sandy Suit
The United States District Court for the District of New Jersey recently denied summary judgment to an insurer seeking to enforce the one year suit limitations provision of the insurance policy because the insurer’s denial letter failed to clearly disclaim coverage for the insured’s wind damage claim. In Liguori v. Certain Underwriters at Lloyd’s, London Subscribing to Policy #AJD8955, the insured filed suit 19 months after receiving the denial letter. While the insurer argued that the suit was time barred since it was filed more than one year after the denial, the insured maintained that the denial letter was insufficient
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New Jersey Court Holds Language of Lease Controls in Landlord and Tenant’s Dispute Over Sidewalk Liability
In an unpublished opinion, the Appellate Division of the New Jersey Superior Court found in favor a commercial tenant and against the landlord in an action that focused on the interpretation of the lease between the two parties to determine which party was responsible for maintenance and insurance of the common area sidewalk. In Senatore v. Kmart Inc., plaintiff brought suit against Kmart after falling on an allegedly defective portion of the sidewalk. Kmart, the tenant, tendered its defense to Belmont, the landlord, as an additional insured under Belmont’s policy. When Belmont’s insurer rejected the tender because Belmont had neglected
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Insurer’s Claims for Negligent Misrepresentation, Fraud and Civil Conspiracy Against Adjusters and Attorneys May Proceed
The United States District Court for the Eastern District of Pennsylvania ruled Monday that Church Mutual Ins. Co.’s lawsuit against a public adjusting firm and licensed public adjuster may proceed for claims of negligent misrepresentation, fraud and civil conspiracy. Church Mutual’s claims for civil conspiracy against two attorneys also survived. The action arose from two claims presented by a public adjusting firm on behalf of Church Mutual’s insured, African Episcopal Church of St. Thomas (AEC), for alleged water damage caused by frozen pipes in a chiller system and roof damage caused by hurricane Irene. Investigation into the claims and testimony
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New York Appellate Court Continues Expansive Interpretation of Additional Insured Endorsement
A New York Appellate Court recently reinforced a trend in New York to provide coverage to additional insureds under the standard Additional Insured Endorsement. In Burlington Ins. Co. v. NYC Transit Auth., the court held that the standard AI Endorsement provides additional insured coverage where there is a causal link between the named insured’s conduct and the injury, regardless of whether the named insured was negligent or otherwise at fault for causing the accident. This decision follows holdings in other cases over the past several years that broadly construed the AI Endorsement to provide coverage even when the named insured
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Third Circuit Holds ERISA Plan Administrator Must Inform Claimant of Plan-Imposed Deadline for Judicial Review in Notification Denying Benefits
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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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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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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Pennsylvania Supreme Court Adopts New Fair and Reasonable Standard When Insured Settles Without Insurer’s Consent
In an issue of first impression, the Supreme Court of Pennsylvania recently addressed whether an insured forfeits the right to insurance coverage when it settles a lawsuit without the insurer’s consent, in a case where the insurer has defended the suit subject to a reservation of rights. In Babcock & Wilcox v. American Nuclear Insurers, the Court answered that question in the negative and adopted a fair and reasonable standard limited to those cases where an insured accepts a settlement offer after and insurer breaches its duty by refusing a fair and reasonable settlement while maintaining its reservation of rights,
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