Articles Posted in Insurance Law

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The Court of Appeals answered a question certified to it by the United States Court of Appeals in the negative, answering that under New York law generally, and particularly in light of the New York Court of Appeals’ decision in Excess Insurance Co. Ltd. v. Factor Mutual Insurance Co., 3 NY3d 577 (N.Y. 2004), there is neither a rule of construction nor a presumption that a per occurrence liability limitation in a reinsurance contract caps all obligations of the reinsurer, such as payments made to reimburse the reinsured’s defense costs. The court held definitively that Excess did not supersede the “standard rules of contract interpretation” otherwise applicable to facultative reinsurance contracts. Therefore, New York law does not impose either a rule or a presumption that a limitation on liability clause necessarily caps all obligations owed by a reinsurer, such as defense costs, without regard for the specific language employed therein. View "Global Reinsurance Corp. of America v. Century Indemnity Co." on Justia Law

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Michael Carlson, individually and in his capacity as administrator of his deceased wife Claudia Carlson’s estate and as assignee of William Porter, brought this action pursuant to N.Y. Ins. Law 3420(a)(2) to collect on certain insurance policies. The policies were issued to DHL Worldwide Express, Inc. (DHL) by National Union Fire Insurance Co. (National Union) and American Alternative Insurance Co. (AAIC), and Plaintiff had previously obtained a judgment against MVP Delivery and Logistics, Inc. (MVP) and William Porter. At issue on appeal was whether Michael sufficiently pleaded that MVP was an “insured” under DHL’s policies and whether the policies fell within the purview of N.Y. Ins. Law 3420 as policies “issued or delivered” in New York. The Court of Appeals held (1) dismissal of Plaintiff’s first cause of action pursuant to N.Y. Ins. Law 3420(a)(2) and (b) to collect on certain insurance policies was improper as to National Union and AAIC; (2) whether MVP was an “insured” under DHL’s policies presents a question of fact to be resolved by the trier of fact; and (3) section 3420 encompasses situations where both insureds and risks are located in the state of New York. View "Carlson v. American International Group, Inc." on Justia Law

Posted in: Insurance Law

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Assuming that the legislature’s 2013 amendment to N.Y. Workers’ Comp. Law 25-a has a retroactive impact by imposing unfunded costs upon Plaintiffs for policies finalized before the amendment’s effective date, that retroactive impact is constitutionally permissible. Plaintiffs - approximately twenty insurance companies that wrote workers’ compensation insurance policies in New York - commenced this declaratory judgment action in 2013, alleging that the legislature’s amendment to section 25-a operated retroactively to the extent that it imposed unfunded liability upon Plaintiffs and that this retroactive impact was unconstitutional. Supreme Court granted Defendant’s motion to dismiss, concluding that the amendment operated prospectively. The Appellate Division reversed and entered a judgment declaring section 25-a(1-a) unconstitutional as retroactively applied to policies issued before October 1, 2013. The Court of Appeals reversed, holding that, even assuming that the amendment has retroactive impact, this impact is constitutional. View "American Economy Insurance Co. v. State" on Justia Law

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Excess Line Association of New York (ELANY), a legislatively created advisory association under the supervision of the Department of Financial Services (DFS), does not have capacity to sue its members to recover fees that it is statutorily authorized to receive and does not have capacity to sue to compel an accounting to determine amounts allegedly owed. ELANY commenced this action against Defendants - a third-generation, family-owned and operated insurance brokerage firm and consortium - seeking, inter alia, to recover stamping fees for excess line policies allegedly procured from 1989 through 2011 and to enforce its purported right to conduct an examination and accounting pursuant to the Insurance Law. Supreme Court dismissed the action, determining that ELANY lacked capacity to sue. The Appellate Division affirmed. The Court of Appeals affirmed, holding that the courts below correctly concluded that ELANY does not have capacity to sue for the relief sought. View "Excess Line Ass’n of New York v. Waldorf & Associates" on Justia Law

Posted in: Insurance Law

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An entity engaged in the bail bond business may not retain the premium paid on a criminal defendant’s behalf when bail is denied and the defendant is never released from custody. Arthur Bogoraz was indicted on state law fraud charges. Plaintiffs, Bogoraz’s wife and family friends, entered into an indemnity agreement with Ira Judelson, a licensed bail bond agent affiliated with the International Fidelity Insurance Agency, to secure Bogoraz’s release from custody in exchange for a premium of $120,560. The district court denied the bail bond after a hearing, however, and Bogoraz was never released from custody. Judelson refused to return the $120,560 to Plaintiffs. The district court found that the indemnity agreement permitted Judelson to retain the premium. On appeal, the United States Court of Appeals for the Second Circuit certified a question of law regarding the issue to the Court of Appeals. The Court of Appeals held that, under the Insurance Law, an entity engaged in the bail bond business does not earn a premium for a bail bond if a court refuses to accept the bond following a bail source hearing and the principal is not released on bail. View "Gevorkyan v. Judelson" on Justia Law

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Where an insurance policy is restricted to liability for any bodily injury “caused, in whole or in part” by the “acts of omissions” of the named insured, the coverage applies to injury proximately caused by the named insured. The Appellate Division denied summary judgment in favor of the insurance company on the issue of coverage after interpreting this policy language as extending coverage broadly to any injury causally linked to the named insured. The court also concluded that an additional insured may collect for an injury caused solely by its own negligence even where the named insured bears no legal fault for the underlying harm. The Court of Appeals reversed, holding that the language “caused, in whole or in part” requires the insured to be the proximate cause of the injury giving rise to liability, not merely the “but for” cause. View "Burlington Insurance Co. v. New York City Transit Authority" on Justia Law

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Plaintiffs commenced this action seeking a declaration of coverage under a program of builder’s risk insurance furnished by Defendants for weather-related damage to a tower crane. The Appellate Division granted summary judgment declaring that Defendants had no obligation to provide coverage for the subject loss under the policy. At issue in this case was (1) whether the crane was covered in the first instance under the insurance provided for temporary works and, if so, whether the contractor’s tools exclusion defeated that initial grant of coverage; and (2) whether the contractor’s tools exclusion was ineffective because it would render the coverage granted in the first instance for temporary works illusory. The Court of Appeals affirmed, holding (1) assuming that the policy contains coverage for the crane in the first instance, the contractor’s tools exclusion would defeat that coverage; and (2) the contractor’s tools exclusion does not render the coverage afforded under the temporary works provision of the policy illusory. View "Lend Lease (US) Construction LMB Inc. v. Zurich American Insurance Co." on Justia Law

Posted in: Insurance Law

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Luz Herrera was injured in an accident while operating a vehicle insured by Hanover Insurance Company, a no-fault insurer. Herrera also had private health insurance through Aetna Health Plan. Herrera received medical treatment for her injuries, and the medical providers submitted some of their bills directly to Aetna, who paid the bills. Aetna subsequently sought reimbursement from Hanover, but Hanover did not respond. Meanwhile, Aetna filed a lien against Herrera for reimbursement. Herrera then resubmitted all of the medical bills to Hanover and assigned her rights against Hanover to Aetna. Aetna then commenced this action against Hanover seeking reimbursement for the medical bills it paid on Herrera’s behalf. Supreme Court dismissed the complaint, concluding (1) because Aetna was not a “health care provider” under the no-fault statute, it was not entitled to direct payment of no-fault benefits; (2) Aetna was neither in privity of contract with Hanover nor an intended third-party beneficiary of Hanover’s contract with Herrera; and (3) Aetna could not maintain a subrogation claim against Hanover. The Appellate Division affirmed. The Court of Appeals affirmed, holding that New York’s Comprehensive Motor Vehicle Reparations Act statutory law and regulatory scheme does not contemplate reimbursement to a health insurer, as opposed to a health care provider. View "Aetna Health Plans v. Hanover Ins. Co." on Justia Law

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The Glidden Company - now known as Akzo Nobel Paints LLC (ANP) - made, marketed, and sold lead paint. Based on a 1986 purchase agreement, Millennium Holdings LLC, which Appellant insurance companies insured, and its predecessors were required to indemnify ANP and its predecessors from 1986 to 1994. In turn, ANP and its predecessors were required to indemnify Millennium and its predecessors from 1994 onward. Beginning in 1987, a number of lead paint related lawsuits were filed against the predecessors of Millennium and ANP (the lead cases). Appellants satisfied Millennium’s obligations pursuant to monetary settlements reached in the cases. Appellants subsequently commenced this action against ANP seeking to be subrogated to the right of Millennium to indemnification against ANP. Supreme Court determined that the antisubrogation rule prohibited Appellants' right of subrogation. The Appellate Division affirmed. The Court of Appeals reversed, holding that there was no reason to apply to antisubrogation rule under the facts of this case, and therefore, the courts below erred in granting summary judgment for ANP on that basis. View "Millennium Holdings LLC v. Glidden Co." on Justia Law

Posted in: Insurance Law

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At issue in this case was whether two companies (the Insureds) were entitled to coverage under additional excess policies issued to their predecessor by the Excess Insurers and, if so, how indemnity should be allocated across the triggered policy periods. The Delaware Court of Chancery granted summary judgment for the Insureds with respect to the availability of coverage and the allocation of liability under the excess policies, concluding that New York law applied to the dispute, that the Insureds were each entitled to coverage under the excess policies, and that the proper method of allocation was the all sums approach, as compared with the pro rata allocation method propounded by the Excess Insurers. After a trial, the Delaware Superior Court entered judgment largely in the Insureds’ favor. On appeal, the Delaware Supreme Court concluded that resolution of the parties’ disputes over allocation and exhaustion depended on unsettled questions of New York law. The Court of Appeals answered (1) under New York law, the contract language of the applicable insurance policies controlled the questions certified to the Court; (2) all sums allocation was appropriate based on the language of the policies at issue here; and (3) vertical, rather than horizontal, exhaustion was required before the excess policies attached. View "In re Viking Pump, Inc." on Justia Law

Posted in: Insurance Law