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Oct 2, 2023

Insurance appeal dismissed after intervening settlement 

By Nick Hurston  A commercial insurance carrier’s appeal of an order requiring it to defend a lawsuit was dismissed after the 4th U.S. Circuit Court of Appeals found that it lacked jurisdiction because the underlying action was resolved by an intervening settlement.  The insurer argued that the District Court’s order to defend was effectively an […]

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 20, 2023

Commercial insurance: An annual review of coverages can prevent future disaster

ROCHESTER, NY –With spring (finally!) approaching, companies should consider adding an annual insurance checkup to their “spring cleaning” to-do list. Many businesses have, at some point, encountered this nightmare scenario: despite paying substantial insurance premiums year after year, a significant claim arises and the company learns that it is not fully covered. The claim might [&hell[...]

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 […]

Nov 17, 2021

Excess insurer can enforce anti-assignment clause 

Excess insurers may enforce insurance policy provisions prohibiting or restricting post-loss assignments with the clauses construed based on the actual language in the insurance policy, a North Carolina Business Court judge has ruled, resulting in a split decision for the eight excess insurers disputing payment for damage to a chicken processing facility.  On Dec. 14, […]

Dec 18, 2020

Bicyclist injured in hit-and-run settles insurance claim for $250K

  A cyclist who says he was seriously injured when he was knocked off his bicycle by a motorist who then fled the scene has settled a claim with his insurance carrier for $250,000, his attorney reports. Ann Groninger of Johnson & Groninger in Charlotte reports that her client, David Scott Campbell, was riding his […]

Oct 21, 2020

Restaurant owners score win in battle with insurer over COVID

An insurance company must honor its business interruption coverage for 16 North Carolina restaurants that closed on the orders of the state due to COVID-19 because the restaurants suffered actual “physical loss,” a Durham County Superior Court judge has ruled. Judge Orlando Hudson’s ruling is an “historic and powerful win,” said Gagan Gupta, an attorney […]

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