Where an insurance policy required a homeowner to replace his damaged property within two years from the date of the fire, but the homeowner waited more than two years before purchasing a replacement house and did not tell the carrier ...

Tagged with: Insurance Judge James P. Jones U.S. District Court - Western District

Where a hospital failed to allege that the presence of SARS-CoV-2 droplets in the air and on surfaces in its facilities constituted physical alteration to its property, it wasn’t entitled to coverage under a business interruption policy. Background This matter ...

Tagged with: Insurance Judge Michael F. Urbanski U.S. District Court - Western District

Although hospitals lost revenue during the COVID-19 crisis because the Virginia governor banned certain elective and/or non-emergent procedures at their facilities, the “Interruption by Communicable Disease,” or ICD, endorsement provision provided no coverage. The ICD endorsement requires that the government ...

Tagged with: Insurance Judge Thomas T. Cullen U.S. District Court - Western District

Although a driver involved in a motor-vehicle accident was simultaneously covered by insurance policies issued by separate carriers, because one policy provided primary liability coverage and the other policy provided excess coverage, the carriers did not have an equal pro ...

Tagged with: Insurance Judge Thomas T. Cullen U.S. District Court - Western District

Where a North Carolina statute requires a life insurer to mail a letter to the insured’s last known post-office address “in this State,” but the insured here had informed the carrier that she had moved out-of-state and the carrier’s letter ...

Tagged with: 4th U.S. Circuit Court of Appeals Insurance Judge James A. Wynn Jr.

Where a homeowners policy required a man to give notice “as soon as is practical” after an “occurrence,” but he waited 238 days after he was involved in a bar fight to give notice to his carrier, and only gave ...

Tagged with: Insurance Judge Arenda L. Wright Allen U.S. District Court - Eastern District

Where an application for admiralty insurance sought coverage for work in and around South Florida and the carrier insured that work based upon the representations in the insurance applications, it had no duty to cover a boat loss that occurred ...

Tagged with: Insurance Judge Joel Hoppe U.S. District Court - Western District

A property insurer that refused to make advance payments after a devastating fire at a seafood processing plant and allegedly coerced the claimant into cooperating with an investigation into third parties can be sued for fraud. In Sustainable Sea Products ...

Tagged with: Insurance Judge John A. Gibney Jr. U.S. District Court - Eastern District

Where the only actual medical evidence in the administrative record concerning plaintiff’s condition are the opinions of his primary care physician and his orthopedic surgeon, both of whom opined that plaintiff was totally disabled, and the plan provided that totally ...

Tagged with: Insurance Judge Anthony J. Trenga U.S. District Court - Eastern District

Where policyholders withdrew their tender after their carriers filed a declaratory judgment action, the suit was not ripe for resolution and was dismissed. Because the court was unpersuaded that the carriers acted in bad faith, wantonly or for other oppressive ...

Tagged with: Insurance Judge Rossie D. Alston Jr. U.S. District Court - Eastern District