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Insurance

Aug 31, 2023

Insurance – Auto – Occurrence(s) – Company-Wide Procedures – Hog Farms – Underlying Nuisance Cases

Although plaintiffs operated 89 separate farms (and the accompanying trucks serving those farms), the multiple injuries suffered by many neighboring property owners stemmed from plaintiffs’ centralized policies and procedures, which governed the operation of their fleet of trucks. Under North Carolina’s “cause” test, there was only a single “occurrence” within the meaning of the polici[...]

Jul 12, 2023

Insurance – Long-Term Disability – ERISA – Reasoned Decision-making – Labor & Employment

The defendant-insurer acknowledged plaintiff’s history of heart problems, but noted his improved test results, the fact that he was walking three miles a day, and the fact that his job was entirely sedentary. Although plaintiff’s treating physician considered him totally disabled, the insurer obtained a peer review analysis from Dr. Sims, who concluded that plaintiff […]

Jun 2, 2023

Insurance – Fraud Counterclaim – Fire Damage – Plant Expansion

The parties have forecasted conflicting evidence as to whether the plaintiff-insured attempted to have the defendant-insurers pay, not solely for the damage that fire caused to plaintiff’s facility, but also for plaintiff’s expansion of the facility. Plaintiff is not entitled to summary judgment on defendants’ claim of insurance fraud. Motion denied. G.S. § 58-44-16(f) contains […]

May 22, 2023

Insurance – Auto – UIM – Stacking – Multiple Claimants

Despite the apparent plain language of the multiple-claimants exception to the stacking language of G.S. § 20-279.21(b)(4), Nationwide Affinity Insurance Company of America v. Le Bei, 259 N.C. App. 626, 816 S.E.2d 251 (2018), allowed stacking in a situation analogous to the one presented here: Defendant Kyrie Mebane was a passenger of Terrell Bellamy’s vehicle, […]

May 10, 2023

Insurance – Life – STOLI Policy – Insured’s Options

Even though the insured agreed to buy insurance on his own life simply as a means of making money on the sale of the policy to a stranger, since the insured always had the option of retaining the policy, the policy was not an illegal wagering contract on human life. The life insurance policy issued […]

Mar 13, 2023

Insurance – Life – Labor & Employment – ERISA – Policy Conversion Deadline – Equitable Tolling

Even though plaintiff’s decedent, an ERISA plan participant, was incapacitated by illness during the period when he could have converted his employer-provided life insurance policy to an individual policy, and even though the participant tried to make the conversion 26 days after the conversion period ended, the defendant-plan administrator did not abuse its discretion in […]

Dec 27, 2022

Insurance – Fire – Notice of Cancellation – ‘Giving’ – Mail

Where G.S. § 58-44-16(f)(10) says an insurer may cancel fire insurance policies by “giving” written notice to the insured, all that is required is that the insurer mail notice of cancellation to the insured. No proof of receipt of the notice is required. Even though plaintiffs never received the notice of cancellation, since the defendant-insurer […]

May 23, 2022

Insurance — Auto – UIM – Multiple Tortfeasors & Policies – First Impression

Although a passenger who was killed in a motor vehicle accident was entitled to $100,000 in underinsured motorist coverage under two separate policies, since the negligence of two tortfeasors – each with liability coverage of $100,000 – caused the passenger’s death, the amount of UIM coverage payable to the passenger’s estate is $0. We affirm […]

May 6, 2022

Insurance — Personal Liability Coverage – Intentional Acts Exclusion – Gunshots

Defendant’s personal liability insurance policy excludes coverage for intentional acts. During an altercation with defendant, Baron Thomas Cass removed himself and walked away. Defendant produced a handgun and fired multiple shots in the direction of Cass, some of which struck and killed him. When considering the intentional action of firing a pistol multiple times in […]

May 6, 2022

Insurance — Commercial – Civil Practice – Discovery – Reserve Information – Relevance

The defendant-insureds suffered an equipment breakdown and related losses, and their insurers seek a declaratory judgment as to coverage. Since this case does not involve fraud, the insurers’ reserves are not relevant and therefore are not discoverable. The court denies defendants’ motion to discover the insurers’ reserves. There is no real disagreement among the state […]

Mar 18, 2022

Insurance — Auto – Breach of Contract Claim – Damage Cause – Unfair Trade Practices Claim

A divided panel of the Court of Appeals affirmed in part, reversed in part and remanded the trial court’s summary judgment order. We affirm the majority decision (Where the plaintiff-insured claims an unidentified vehicle backed into hers and drove away, but where the defendant-insurer claims the injury to plaintiff’s vehicle was caused by her own […]

Mar 16, 2022

Insurance – COVID-related business losses are not ‘physical loss’

Where a West Virginia business closed two of its art studio locations because of the governor’s COVID-19 executive order, its claim for lost business income and other expenses was denied because there was no material destruction or harm to its covered premises. Background In March 2020, Uncork and Create LLC operated a “creative events” business […]

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