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New York Appellate Court Permits Use of Extrinsic Facts to “Clarify Ambiguous Pleadings” and Establish the Applicability of a Policy’s Auto Exclusion

On October 23, 2018, our Global Insurance Services group hosted an interactive webinar discussing states’ varying interpretations of what is considered “loading and unloading” in the context of a liability policy’s “Aircraft, Auto or Watercraft” exclusion. During that presentation, we identified inconsistencies in the courts’ application of this provision when assessing an insurer’s duty to defend, particularly in New York. Ironically, that same day, a New York Appellate Court analyzing the application of a the “Aircraft, Auto or Watercraft” exclusion

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Third Circuit Revives Consumer Fraud Act Class Action against Insurer Based on Adjuster’s Alleged Deceptive Conduct

The Third Circuit’s recent decision in Alpizar-Fallas v. Favero, __ F.3d __, 2018 WL 5987140 (3d Cir. Nov. 15, 2018), is a stark reminder that the process of adjusting an insurance claim is not exempt from the New Jersey Consumer Fraud Act, N.J.S.A. 56:8-1 et seq. (CFA). In Favero, Progressive Garden State Insurance Company (Progressive) insured, under two separate policies, the drivers of two vehicles involved in an accident. After the accident, a Progressive adjuster allegedly visited Ana Lidia Alpizar-Fallas

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We Need Your Vote!

Attention Blog readers! We are proud to announce that our Insurance and Reinsurance Report blog have made it to the voting round in The Expert Institute’s 2018 Best Legal Blog Contest! Over the past month, this contest received thousands of nominations, which were then narrowed to the “most exciting, entertaining, and informative legal blogs online today.” The polls are now open – if you like our blog, please consider voting. How it works: You can submit one vote per blog.

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No Second Chances: New Jersey Appellate Division Prohibits Alleged Insurance Fraudster From Re-Litigating Issue Of Whether There Was An Underlying Auto Accident

The New Jersey Appellate Division held that an individual alleged to have submitted a fraudulent insurance claim as a result of an auto accident was collaterally estopped from litigating for a second time the issue of whether there was in fact an auto accident. In Badolato v. McMillan, No. A-5474-16, 2018 WL 5091799 (App. Div. Oct. 19, 2018) an individual, Charyse McMillan, filed a claim with New Jersey Manufacturers Insurance Company (NJM) for personal injury protection (PIP) benefits as a

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Florida’s Statutory Sovereign Immunity Language Inserted Into Any Government Liability Policy Takes Precedence Over the Policy’s Definition of “Occurrence”

In Florida, as in most jurisdictions, government agencies may be subject to liability for tortious acts, with the recovery limit capped by law. A recent decision, State of Florida v. Barnett, explores the recent conflict regarding the limit of recovery against a state agency for an “occurrence” involving multiple claimants. Section 768.28(5), Florida Statutes (2010), states in relevant part as follows: Neither the state nor its agencies or subdivisions shall be liable to pay a claim or a judgment by

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Years Later, Hurricane Sandy Claims Still Present Unique Coverage Questions

The Second Circuit’s recent reversal of summary judgment involving a coverage dispute over a $50M Hurricane Sandy storm surge claim is an important reminder to always closely read the policy. At first blush, the policy in question was a seemingly standard all-risk commercial property policy that featured a flood exclusion and a separate windstorm or hail deductible endorsement. The coverage analysis in this case should have been straightforward – storm surge falls within the scope of the flood exclusion vitiating

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What on Earth? Court Finds Ambiguous Property Appraisal Award for Earthquake Damage

The U.S. District Court for the Southern District of Illinois recently held that outstanding coverage issues and an ambiguous notation in an appraisal award precluded a finding that an insurer satisfied its coverage obligations. Windsor Oaks, LLC v. Cincinnati Ins. Co., No. 17-CV-689-SMY-SCW, 2018 WL 4303141 (S.D. Ill. Sept. 10, 2018). The insured, a hotel owner, submitted to its insurer a property claim for earthquake damage. The insurer retained an engineering expert, who determined the hotel did not sustain earthquake damage.

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