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Appeals, Insurance Law

Punitive Damages Award Not Recoverable in Subsequent “Bad Faith Failure to Settle” Case Against Insurer

A judgment which included punitive damages was assessed against an insured.  The insured sued the insurance company for a bad-faith failure to settle the libel and slander claims within policy limits.  The First Department determined the insurance company was entitled to summary judgment because public policy precludes the insured from recovering the punitive damages portion of any judgment resulting from the insurer’s bad faith.  The Court also noted that the public policy argument could be raised for the first time on appeal because no new facts were alleged and only purely legal arguments were made.  Seldon v Allstate Ins. Co., 2013 NY Slip Op 01628, 9542, 116217/08, 1st Dept. 3-14-13

 

March 14, 2013
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Civil Procedure, Evidence, Insurance Law

Herniated Disc not “Serious Injury”—Insufficient Proof of Physical Limitations.

The Second Department reversed the trial court’s denial of a motion pursuant to CPLR 4404 to set aside the jury verdict.  The issue was whether the plaintiff had proven he sustained “serious injury” within the meaning of Insurance Law 5102(d).  The plaintiff had a bulging or herniated disk but did not provide objective proof of the extent or degree of the alleged physical limitations caused by the disc injury. In describing the criteria for analysis, the Court wrote:  “ ‘A motion pursuant to CPLR 4404(a) to set aside a jury verdict and for judgment as a matter of law will be granted where there is no valid line of reasoning and permissible inferences which could possibly lead rational persons to the conclusions reached by the jury on the basis of the evidence presented at trial…’ “.  Bacon v Bostany, 2011-08654, 2012-07634, Index No 997/08, Second Dept. 3-6-13

 

March 6, 2013
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Contract Law, Insurance Law

Record-Keeping Was a Condition Precedent to Insurance Coverage

The record-keeping requirement in an insurance policy was a condition precedent. “Here, the defendant established its prima facie entitlement to judgment as a matter of law by submitting evidence that the plaintiff failed to comply with the record-keeping requirement set forth in the subject insurance policy, which was a clear condition precedent to coverage … “ Stars Jewelry…v Hanover Insurance Group, Inc., 2011-09098, Index No 5221/10, 2nd Dept. 3-6-13

 

March 6, 2013
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Insurance Law

Settlement Without Insurer’s Consent.

When an insured settles with a tortfeasor in violation of a condition requiring his or her insurer’s written consent to settle, and fails to preserve the insurer’s subrogation rights, the insurer is prejudiced, and the insured is prohibited from asserting a claim for underinsured motorist benefits …”. Matter of Travelers Home and Marine Insurance Company vs Kanner, 2012-02625, Index No. 16172/11 Second Dept. 2-13-13

 

February 13, 2013
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Insurance Law

a follow the settlement clause in a reinsurance treaty requires deference to the allocation of reinsurance proceeds by the insured, but does not render the allocation immune from scrutiny for reasonableness.

The Court of Appeals, in a full-fledged opinion by Judge Smith, determined there were questions of fact whether the insured’s, USF&G’s, allocation of reinsurance proceeds in this billion dollar asbestos case was reasonable in that, inter alia, it ignored “bad faith” claims not covered by the the reinsurance:

We conclude … that there is an issue of fact as to whether  USF&G [the insurance company, called a cedent in this context], in allocating the settlement amount, reasonably attributed nothing to the so called “bad faith” claims made against it. We also find a factual issue as to whether certain claims were given unreasonable values for settlement purposes. * * *

Having settled the coverage case, USF&G turned to its reinsurers, defendants in this case, with whom it had entered into a “treaty” of reinsurance applicable to the years 1956 through 1962. The reinsurance was of the type known as “excess of loss”: the reinsurers agreed to pay to USF&G the amount over $100,000 of any loss occurring during the period covered by the treaty. Since USF&G’s loss in the asbestos litigation could not, under its policies, exceed $200,000 per claimant, the reinsurers’ liability was in effect capped at $100,000 per loss. But the reinsurance treaty, like the underlying policies, had no aggregate limit—the reinsurers could be liable for any number of losses, up to $100,000 each. * * *

… [W]e find it impossible to conclude, as a matter of law, that parties bargaining at arm’s length, in a situation where reinsurance was absent, could reasonably have given no value to the bad faith claims. This issue must be decided at trial. …

Whether the values assigned to lung cancer, asbestosis, pleural thickening and other cancer claims could reasonably have been agreed on in arm’s length bargaining in the absence of reinsurance presents an issue of fact. United States Fid. & Guar. Co. v American Re-Ins. Co., 2013 NY Slip Op 00784 [20 NY3d 407], CtApp 2-7-13

 

 

February 7, 2013
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Insurance Law, Landlord-Tenant, Negligence, Toxic Torts

Single Policy Limit Held to Apply to Successive Tenants in Lead-Paint-Tainted Apartment.

In a full-fledged opinion by Justice Smith, the Fourth Department discussed the liability-limits of an insurance carrier for injuries caused to children by lead paint in the insured apartment.  The policy, which had a $500,000 limit, included the following sentence:  “All bodily injury and property damage resulting from one accidental loss or from continuous or repeated exposure to the same general conditions is considered the result of one accidental loss.”  Children in one family who lived in the apartment suffered injury from lead paint and the carrier paid out $350,000.  Subsequently children in another family who moved into the same apartment suffered injury from lead paint.  The question before the Court was whether the liability to the second family was capped at $150,000 because the total liability of the carrier could not exceed $500,000, or whether the injury to the second family triggered another $500,000 in policy coverage.  The Fourth Department determined the carrier was liable for a total of $500,000 for the injuries to both families and the second family could recover no more than $150,000.   Nesmith, et al v Allstate Insurance Company, 1252, CA 12-00182 Fourth Dept. 2-1-13

 

February 1, 2013
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Contract Law, Insurance Law, Unfair Competition

Duty to Defend Broader than Duty to Indemnify.

The Second Department applied the rule that an insurer’s duty to defend under a policy is broader than its duty to indemnify.  Because the language of the policy was broad enough to cover the cause of action for unfair competition, the insurer was obligated to defend, in spite of the fact that the related breach of contract cause of action was excluded from coverage under the terms of the policy.  Natural Organics, Inc v OneBeacon America Insurance Co., 2011-03268, 2011-05298, Index No. 12763/10 Second Dept. 1-16-13

 

January 16, 2013
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