Articles Posted in Insurance Law

by
The Ninth Circuit certified the following questions of state law to the California Supreme Court: 1. Are the lenders identified in Article XV of the California Constitution, see Cal. Const. art. XV, 1, as being exempt from the restrictions otherwise imposed by that article, nevertheless subject to the requirement in section 1916-2 of the California Civil Code that a lender may not compound interest "unless an agreement to that effect is clearly expressed in writing and signed by the party to be charged therewith"? 2. Does an agreement meet the requirement of section 1916-2 if it is comprised of: (1) an application for insurance signed by the borrower, and (2) a policy of insurance containing an agreement for compound interest that is subsequently attached to the application, thus constituting the entire contract between the parties pursuant to section 10113 of the California Insurance Code? View "Wishnev v. Northwestern Mutual Life Insurance Co." on Justia Law

Posted in: Insurance Law

by
The Ninth Circuit certified the following question of law to the Nevada Supreme Court: Under Nevada law, if a plaintiff has filed suit against an insurer seeking damages based on a separate judgment against its insured, does the insurer's liability expire when the statute of limitations on the judgment runs, notwithstanding that the suit was filed within the six-year life of the judgment? View "Nalder v. United Automobile Insurance Co." on Justia Law

Posted in: Insurance Law

by
The panel certified the following questions of state law to the Oregon Supreme Court: 1. If the Director of the Department of Consumer and Business Services approves a contractual limitations provision in an insurance policy under Oregon Revised Statutes 742.021, does the language of the policy always control or do the standard provisions of the Oregon Insurance Code apply if the standard provisions are more favorable than the approved insurance policy provision? 2. If the Oregon standard provisions do apply, when does "the period for which the insurer was liable" under Oregon Revised Statutes section 743.429 end? View "Raynor v. United of Omaha Life Insurance" on Justia Law

Posted in: Insurance Law

by
The Ninth Circuit certified the following questions of state law to the Arizona Supreme Court: 1. Whether Arizona equitable indemnity law incorporates Section 78 of the Restatement (First) of Restitution; and if so, 2. Whether equitable indemnity under Section 78 requires that the indemnity plaintiff's liability to the underlying plaintiff have been coextensive with the indemnity defendant's liability to the underlying plaintiff. View "KnightBrook Insurance v. Payless Car Rental System" on Justia Law

Posted in: Insurance Law

by
The Ninth Circuit reversed the dismissal of plaintiff's putative class action filed under California's Unfair Competition Law (UCL), Cal. Bus. & Prof. Code 17200–17210, and common law, alleging that AARP, through its arrangement with Medigap, transacts insurance without a license in violation of the California Insurance Code. The Ninth Circuit held that plaintiff stated a plausible claim at the motion to dismiss stage that AARP "solicits" insurance without a license, and consequently committed an unlawful act in violation of the UCL. Plaintiff also adequately alleged that AARP violated the UCL's "fraudulent" and "unfair" prongs where plaintiff plausibly alleged that members of the public are likely to be deceived into paying AARP's additional 4.95% fee because AARP collects and labels the the fee as a "royalty" rather than a "commission." View "Friedman v. AARP" on Justia Law

Posted in: Insurance Law

by
LMA filed suit against its excess insurance carrier, National Union, based on National Union's refusal to either contribute $3.75 million toward the settlement of claims brought by a third party or take over the defense. At issue was whether the district court erred in applying the rule in Diamond Heights Homeowners Association v. National American Insurance Co., instructing the jury, denying National Union's motion for judgment as a matter of law (JMOL), and awarding fees and costs. In Diamond Heights, a California appellate court ruled that an excess liability insurer has three options when presented with a proposed settlement of a covered claim that has met the approval of the insured and the primary insurer. The excess insurer must (1) approve the proposed settlement, (2) reject it and take over the defense, or (3) reject it, decline to take over the defense, and face a potential lawsuit by the insured seeking contribution toward the settlement. The court held that the district court did not err in applying the rule in Diamond Heights where National Union has not presented convincing evidence that the California Supreme Court would not follow Diamond Heights, and Diamond Heights is not distinguishable on its facts. The court also concluded that the district court did not commit prejudicial error in defining the standard of proof applicable to LMA's breach of contract claim; National Union's challenge to the bad faith claim failed because a jury could rationally conclude based on these facts that National Union acted unreasonably by refusing to take over the defense or approve the reasonable settlement, knowing full well of its obligations under California law; and the court affirmed the district court's award of fees and costs. Accordingly, the court affirmed the judgment and denied National Union's motion for certification. View "Teleflex Medical Inc. v. National Union Fire Insurance Co." on Justia Law

Posted in: Insurance Law

by
Plaintiffs, elderly Oregonians or their successors who purchased long-term healthcare insurance policies sold by Bankers, filed suit alleging that Bankers developed onerous procedures to delay and deny insurance claims. The court certified the following question to the Oregon Supreme Court, pursuant to Oregon Revised Statues 28.200: Does a plaintiff state a claim under Oregon Revised Statutes 124.110(1)(b) for wrongful withholding of money or property where it is alleged that an insurance company has in bad faith delayed the processing of claims and refused to pay benefits owed under an insurance contract? View "Bates v. Bankers Life & Casualty" on Justia Law

Posted in: Insurance Law

by
The court certified the following questions of state law to the California Supreme Court: 1. Is California’s common law notice-prejudice rule a fundamental public policy for the purpose of choice-of-law analysis? May common law rules other than unconscionability not enshrined in statute, regulation, or the constitution, be fundamental public policies for the purpose of choice-of-law analysis? 2. If the notice-prejudice rule is a fundamental public policy for the purpose of choice-of-law analysis, can a consent provision in a first-party claim insurance policy be interpreted as a notice provision such that the notice-prejudice rule applies? View "Pitzer College v. Indian Harbor Insurance Co." on Justia Law

Posted in: Insurance Law

by
Plaintiffs filed suit against Lincoln seeking to recover damages for the injuries they incurred from the insured. The court certified the following question to the Supreme Court of California: When determining whether an injury arises out of the “use” of a vehicle for purposes of determining coverage under an automobile insurance policy and an insurance company’s duty to defend, is the appropriate test whether the vehicle was a “predominating cause/substantial factor” or whether there was a “minimal causal connection” between the vehicle and the injury? View "Gradillas v. Lincoln General Ins." on Justia Law

Posted in: Insurance Law

by
Kaady, a mason, filed suit against Mid-Continent after Mid-Continent denied Kaady's claim for indemnification under its commercial liability insurance policy. The district court granted summary judgment to Mid-Continent based on the ground that Kaady's claim was barred by the policy's known-loss provision. The court concluded that MidContinent has offered no reason to treat the insured’s work and the work of others as different property in every provision of the policy except the known-loss provision. Thus, the known-loss provision also distinguishes between them. The insured’s knowledge of damage to his own work doesn’t automatically constitute knowledge of damage to the components of the structure furnished by others. Further, an insured’s knowledge of one type of damage to property doesn’t automatically constitute knowledge of any and all damage to the property; the claimed damage must be related to the known damage. In this case, Kaady’s knowledge of the cracks in the masonry before he bought the policy doesn’t constitute knowledge of the claimed “property damage” to the structural components. The court concluded that the correct inquiry is whether the claimed damage to the structural components was a “continuation, change or resumption” of the cracks. If it was, Kaady’s knowledge of the cracks would bar coverage of the claimed damage; if not, his knowledge of the cracks wouldn’t bar coverage. In this case, without any record evidence connecting the cracks in the masonry that Kaady observed before he bought the policy to the damage to the wooden components for which Kaady claims coverage, summary judgment was inappropriate. Accordingly, the court reversed and remanded. View "Kaady v. Mid-Continent Cas. Co." on Justia Law

Posted in: Insurance Law