Justia New York Court of Appeals Opinion Summaries

Plaintiffs acquired a homeowners' insurance policy from Defendant effective as of the closing date of the home they had entered into a contract to purchase. The closing date was scheduled to take place on March 31 but was delayed until May 20. On May 15, a fire completely destroyed the house. Defendant disclaimed coverage on the pertinent grounds that the dwelling was unoccupied at the time of the loss, and therefore, it did not qualify as a "residence premises" under the policy. Supreme court granted Defendant's motion for summary judgment and dismissed the complaint. The appellate division modified the order, concluding that the "residence premises" requirement in the policy failed to define what qualifies as "resides" for the purpose of attaching coverage and that the policy was ambiguous in the circumstances of this case, and otherwise denied summary judgment. The Court of Appeals affirmed, holding (1) there were issues of fact as to whether Plaintiffs' daily presence in the house, coupled with their intent to eventually move in, was sufficient to satisfy the policy's requirements; and (2) the term "residence premises" in the contract was ambiguous. View "Dean v. Tower Ins. Co. of N.Y." on Justia Law

Travelers Indemnity Company issued to Plaintiff an insurance policy covering direct physical loss of or damage to a building. The policy contained an exclusion for loss or damage caused by earth movement, which included earth sinking whether "naturally occurring or due to made made or other artificial causes." The building suffered cracks as a result of an excavation being conducted on the lot next door to it. Travelers rejected Plaintiff's claim, relying on the earth movement exclusion. Plaintiff sued for breach of the policy. Supreme court denied Travelers' motion for summary judgment, and the appellate division affirmed. At issue on appeal was whether Pioneer Tower Owners Ass'n v. State Farm, in which the Court held that an "earth movement" exclusion in an insurance policy did not unambiguously apply to excavation, applied in this case. The Court of Appeals reversed, holding that because the policy in the instant case had added language expressly making the earth movement exclusion applicable to "man made" movement of earth, the exclusion was unambiguous and the loss caused by excavation was excluded from the policy. View "Bentoria Holdings, Inc. v. Travelers Indem. Co." on Justia Law

The New York City Off-Track Betting Corporation (NYC OTB) was a public benefit corporation charged with operating an off-track pari-mutuel betting system within the City. Later, NYC OTB filed for bankruptcy and shut down. The City's Corporation Counsel then announced that NYC OTB retirees would lose coverage under the City's health insurance and welfare benefit plans because the Corporation was no longer able to reimburse the City. A union representing NYC OTB employees and retirees and others (collectively, Plaintiffs) brought suit against the State and City, seeking a judgment declaring that the failure of the State and City to fund, and the termination of retiree health insurance and supplemental benefits, violated the City Administrative Code and other express and implied obligations. Supreme Court rejected the four theories advanced by Plaintiffs to support State or City liability for NYC OTB retiree health benefits. The appellate division affirmed. The Court of Appeals affirmed, holding (1) Plaintiffs did not demonstrate a likelihood of success on the merits of their claim against the City; and (2) because NYC OTB had a legal identity separate from the State, Plaintiffs stated no viable theory under which the State could be held liable in this case. View "Roberts v. Paterson" on Justia Law

This case arose when a tower crane operated by Joy collapsed during construction of a high-rise condominium, killing seven people and injuring dozens, damaging several buildings and destroying one. At issue was the dispute in coverage under the excess policy for "additional insureds" within the meaning of the comprehensive general liability (CGL) policy. The court concluded that there were material issues of fact in this case as to whether the high-rise building under construction was residential or mixed-use; Admiral's other claims related to Joy's alleged misrepresentations in its underwriting submission were properly interposed against Reliance and the owners/developers as well as Joy; the LLC exclusion did not foreclose coverage of those owners/developers that were limited liability companies; and defendants' remaining arguments were without merit. Accordingly, the court held that the order of the Supreme Court, as modified by the Appellate Division, was not properly made. View "Admiral Ins. Co. v Joy Contrs., Inc." on Justia Law

This case arose from a contract between the school district and DJH to perform heating, ventilation, and air condition work. The contract required DJH to obtain a performance bond which DJH secured from Nova, a compensated surety. At issue was whether Nova was discharged from it surety obligation to the school district on the bases that the school district allegedly violated New York's Lien Law 70[1] by improperly diverting construction contract payments constituting trust fund assets to a non-beneficiary and breached the terms of the parties' performance bond. The court held that under the facts, Nova had not demonstrated that discharge of its surety obligation was warranted. The court also considered whether the school district was entitled to attorneys' fees expended in the prosecution of the litigation and concluded that the request for attorneys' fees was properly denied. View "Mount Vernon City School Dist. v Nova Cas. Co." on Justia Law

Plaintiff, an auto parts distributor with operations in multiple states, secured general liability, automotive liability, and workers' compensation policies from defendants for annual coverage periods between September 1992 and September 2003. At issue was whether the six-year statue of limitations applicable to the insurers' breach of contract counterclaims began to run when they possessed the legal right to demand payment from the insured or years later after they issued invoices. Under the terms of the insurance contracts in this case, the court concluded that the counterclaims accrued when the insurers had the right to demand payment. View "Hahn Automotive Warehouse, Inc. v American Zurich Ins. Co." on Justia Law

Plaintiff represented psychiatrists who treated patients eligible for both Medicare and Medicaid and defendants were responsible for administering Medicaid in New York and for implementing and enforcing medicaid reimbursement rates. At issue was whether the 2006 amendment to the Social Services law found in a budget bill implementing a coinsurance enhancement for the benefit of psychiatrists who treat patients eligible for both Medicare and Medicaid was intended to be permanent or whether the amendment was intended only to provide a limited one-year enhancement. The court concluded that the Legislature only intended to provide for a one-time coinsurance enhancement, limited to the 2006-2007 fiscal year. View "New York State Psychiatric Assn., Inc. v New York State Dept. of Health" on Justia Law

This action arose from practices employed in connection with the handling of claims made under retrocessional reinsurance treaties providing what was known as "non-life" coverage. At issue was the sufficiency and extra-territorial reach of plaintiff's claim under New York State's antitrust statute (Donnelly Act), General Business Law 340 et seq. Plaintiff, a New York branch of a German reinsurance corporation, sued defendants, English based entities engaged in the business of providing retrocessionary reinsurance. The Appellate Division found that the complaint adequately pled a worldwide market. And, while acknowledging that the crucial allegations contained in paragraph 36 of the amended pleading did not separately allege market power, the allegations read together and liberally construed were adequate to that purpose. The Appellate Division granted plaintiff leave to appeal, certifying to the court the question of whether its order reversing the order of Supreme Court was properly made. The court answered in the negative and reversed. Even if the pleading deficiency at issue could be cured and the court perceived no reason to suppose that the formidable hurdle of alleging market power could be surmounted by plaintiff there would remain as an immovable obstacle to the action's maintenance, the circumstance that the Donnelly Act could not be understood to extend to the foreign conspiracy plaintiff purported to described. View "Global Reins. Corp.-U.S. Branch v Equitas Ltd." on Justia Law

Insurer commenced the instant suit against insureds, alleging eight causes of action and requesting a declaration that the insurer's policy provided no coverage or duty to indemnify any amount paid or payable by insured and the plan in an underlying class action suit. At issue was whether the disputed language in an insurance policy extended coverage to alleged violations of the Employee Retirement Income Security Act of 1974 (ERISA), 29 U.S.C. 1001 et seq., by insureds. The court reaffirmed fundamental principles of insurance contract interpretation and held that the plain language of the policy did not cover such acts and, therefore, the Appellate Division correctly held that insurer was entitled to summary judgment and a declaration that was not required to indemnify insured in the manner requested. View "Federal Ins. Co. v Int'l Bus. Machs. Corp." on Justia Law

Exum, an employer of Elrac, served a notice of intention to arbitrate on Elrac, seeking uninsured motorist benefits. Elrace petitioned to stay the arbitration. Supreme Court granted the petition, but the Appellate Division reversed, permitting the arbitration to proceed. The court affirmed and held that a self-insured employer whose employee was involved in an automobile accident could not be liable to that employee for uninsured motorist benefits, notwithstanding the exclusivity provision of the Workers' Compensation Law. View "Matter of Elrac, Inc. v Exum" on Justia Law