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Insurance

Dec 28, 2012

Jury rules that owner of historic NC inn set fire

ASHEVILLE (AP) — The company that owned a historic inn in Asheville that burned down four years ago won’t be able to collect on a $6 million insurance policy after a federal jury ruled it intentionally set the fire.

Dec 27, 2012

Tort/Negligence – Insurance – Vacant Property – Theft & Vandalism Exclusion – Contract

Rayfield Properties, LLC v. Business Insurers of the Carolinas, Inc. The plaintiff-property owner failed to show that the defendant-insurance agency had a duty to procure insurance that covered theft and vandalism for plaintiff’s vacant property or to specifically inform plaintiff about the theft and vandalism exclusion in plaintiff’s policy.

Nov 2, 2012

Plaintiff and defense work makes for an uneasy practice

The question often arises concerning whether lawyers can effectively and ethically represent opposite types of clients — for example, insurance carriers and insurance coverage plaintiffs.

Oct 30, 2012

Insurance – Life – Application – False Answer – Materiality – Tort/Negligence – Breach of Fiduciary Duty

Johnson v. Household Life Insurance Co. State court records show that plaintiff’s decedent gave a false answer on his life insurance application when he said he had not had his driver’s license suspended during the two previous years.

Oct 18, 2012

Insurance – Disability – ERISA – Medicare – Equity

Strickland v. AT&T Umbrella Benefit Plan No. 1 Where the disabled plaintiff alleges that he relied on defendant’s misleading statements in deciding to have necessary but non-emergency surgery without first obtaining Medicare Part B, plaintiff may be entitled to equitable relief under ERISA.

Oct 11, 2012

Insurance – Disability – Breach of Contract – Civil Practice – Statute of Limitations – Constructive Fraud

Lawley v. Liberty Mutual Group, Inc. If defendants breached their disability insurance contract with plaintiff, they did so when they denied her claim on March 28, 2003, not every time a monthly disability payment was due. Plaintiff’s June 27, 2011 complaint was not timely filed.

Oct 11, 2012

Tort/Negligence – Sovereign Immunity – Insurance – Exclusion – Animal Control

Ruiz v. Franklin County Animal Control Even though defendants are covered by the county’s liability insurance, since the policy excludes any claim that would otherwise be subject to governmental immunity, the policy does not waive governmental immunity.

Oct 2, 2012

Tort/Negligence – Sovereign Immunity – Municipal Park – Revenue – Insurance

Horne v. Town of Blowing Rock Although our statutes and case law generally favor the application of governmental immunity in the operation and maintenance of public parks – particularly when the municipality derives no income from operating and maintaining the park – there remain issues of fact as to what revenue, if any, the defendant-town derives from its operation of the park in wh[...]

Sep 24, 2012

Insurance – CGL – Duty to Defend or Indemnify – Intentional Conduct – Advertising Injury

Pennsylvania National Mutual Casualty Insurance Co. v. Sharpe Images, Inc. Where the business insurance policy at issue includes only defendant Sharpe Images, Inc. on the declarations page that lists the insured parties, and where the policy denies coverage to any “limited liability company … not shown as a Named Insured in the Declarations,” defendant Nextplans, LLC – a wholly ow[...]

Sep 21, 2012

Civil Practice – Federal & State Actions – Abstention – Insurance – Real Property

Beaufort Dedicated No. 5 Ltd. ex rel. Syndicate1318 at Lloyd’s v. Bradley In this declaratory judgment/rescission action, the plaintiff-insurers allege that the defendant-insured provided false information on his insurance application. The insured has failed to show that his insurance agent or the co-owners of the insured property are necessary parties.

Sep 21, 2012

Insurance – Fire – Tort/Negligence – Bad Faith Refusal to Settle Claim – Unfair Trade Practices – Breach of Contract

Kielbania v. Indian Harbor Insurance Co. Based on a drawn-out appraisal process that ignored some losses and changed the value of others without explanation, plaintiffs have presented a jury question as to their claims of unfair insurance settlement practices and bad faith refusal to settle a claim.

Sep 17, 2012

Insurance – Health – ERISA Plan – Reimbursement Provision – Personal Injury Settlement

Smithey v. Tyson Foods, Inc. Plaintiff remains in actual or constructive possession of funds that she received in settlement of a personal injury claim. Pursuant to the parties’ healthcare plan, defendants seek reimbursement of medical expenses that defendants advanced because of plaintiff’s personal injury.

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