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Insurance Claims Appeals

Carlton Fields

Florida Appeals Court Decisions Week of July 21 - 25, 2025

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U.S. Eleventh Circuit Court of Appeals - Am Sec Ass’n v. SEC - APA, rule challenge - Weinstein v. 440 Corp - Rule 41(a), dismissal ...more

Carlton Fields

Seventh Circuit Affirms Judgment Dismissing Bad Faith Claim Without Viable Breach of Contract Claim

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In Wolf v. Riverport Insurance Co., the Seventh Circuit Court of Appeals affirmed the dismissal of an insured’s bad faith settlement delay claim against her insurer after she attempted to recover under section 155 of the...more

Cozen O'Connor

Texas Supreme Court Reaffirms Procedure for Litigating Bad Faith Claims in UM/UIM Cases

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In In Re State Farm Automobile Insurance Co. and Lindsey Nicole Dessart, 712 S.W.3d 53 (Tex. 2025), the Texas Supreme Court clarified the proper procedure for litigating bad faith claims related to uninsured/underinsured...more

Lowenstein Sandler LLP

Bad Faith No More: New York Courts Shift the Insurance Paradigm

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In this episode of Don't Take No For An Answer, Lynda A. Bennett and Eric Jesse discuss two New York cases that mark a turning point in allowing policyholders to pursue bad faith claims against their insurers. The cases shift...more

Carlton Fields

Seventh Circuit Affirms Broad Reading of CGL Policy’s “Radioactive Matter Exclusion” to Include EMF Radiation

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On July 9, 2025, in Hammond Power Solutions Inc. v. National Union Fire Insurance Co., the Seventh Circuit Court of Appeals affirmed the district court’s decision granting summary judgment to the insurer and finding, under...more

Saul Ewing LLP

The Friday Five: Five ERISA Litigation Highlights - July 2025

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This month’s Friday Five explores recent ERISA disability benefit decisions involving key issues such as when attorney’s fees should be decided and factors used in determining venue transfer. It also explores retroactive...more

Zelle  LLP

N.M. Cyber Ruling Will Spur Litigation As Coverage Remedy

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A June 16 appellate decision involving the construction of a cyberinsurance policy demonstrates a concerning lack of judicial understanding about the nature and scope of cyber liability coverage and implicitly incentivizes...more

Wiley Rein LLP

Louisiana Appellate Court Enforces Bodily Injury Exclusion in an Errors and Omissions Policy

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The Court of Appeal of Louisiana, Third Circuit, has held that a bodily injury exclusion in a carrier’s errors and omissions policies barred coverage for a third-party claim by another carrier and a third-party demand by an...more

Wiley Rein LLP

For the Record: Cyber Coverage “For” a Security Breach is Ambiguous under New Mexico Law

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The New Mexico Court of Appeals has held that cyber policy language affording coverage “for” a security breach was ambiguous and must be construed broadly to provide coverage for a breach of contract claim “because of,”...more

Cozen O'Connor

Fourth DCA Reverses Jury Verdict Due to Improper Admission of Claims Handling and Bad Faith Evidence

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In Universal Property & Casualty Insurance Co. v. Naze, No. 4D2024-0098 (Fla. 4th DCA June 4, 2025), the Fourth District Court of Appeal reversed a jury verdict in favor of the insured, holding that the trial court improperly...more

Cozen O'Connor

Claims Notes: July 2025

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Jones owned an eight-acre property with a half-acre pond in front of his house. Hatcher, a broker, offered to secure cheaper insurance, asking Jones to sign a single-page application without questions. Hatcher inspected and...more

Tyson & Mendes LLP

Calculating Past Medicals in California

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The Third District Court of Appeal in California recently addressed the standard in proving the reasonableness of charges for past medical services within the context of the Hospital Lien Act’s definition of emergency and...more

Marshall Dennehey

A Costly Mistake

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Key Points: A workers’ compensation judge is not required to correct a mistakenly-issued Notice of Compensation Payable, but they may correct a mistakenly-issued Notice of Compensation Payable....more

Rivkin Radler LLP

June 2025 New York Insurance Coverage Law Update

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A worker was injured when he fell from a ladder while working for a subcontractor at a construction project. The injured worker sued the owner of the project, seeking damages for his injuries. The owner was defended by its...more

Carlton Fields

Sixth Circuit Finds No E&O Coverage for GL Carrier Under E&O Policy for Underlying Motel Claim

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In Columbia Casualty Co. v. State Auto Mutual Insurance Co., the Sixth Circuit Court of Appeals concluded, under Ohio law, that a demand letter to a general liability insurance carrier’s insured containing allegations of bad...more

Wiley Rein LLP

Colorado Court of Appeals Permits COVID-19 Coverage Suit to Proceed Based on Health Care Endorsement Coverage

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The Colorado Court of Appeals (Division VI), applying Colorado law, partially affirmed a trial court decision dismissing an action seeking insurance coverage for COVID‑19 related losses. Spectrum Retirement Communities, LLC...more

Davis Wright Tremaine LLP

Two California Appellate Decisions Highlight Liability Risks Arising From Hospital "Conditions of Admission" Forms and Billing...

In the ever-evolving world of healthcare billing, two recent reported California appellate court decisions, Naranjo v. Doctors Medical Center of Modesto and Dameron Hospital Association v. Progressive Casualty Insurance...more

Rivkin Radler LLP

June 2025 Insurance Update

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We’ve selected five recent insurance decisions for this month’s update. Foreign insurers will be pleased with the Second Circuit’s revamped view of the New York Convention. In finding that the international treaty is...more

Troutman Pepper Locke

Fifth Circuit Clarifies Enforcement of IDR Awards Under the No Surprises Act

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On June 12, the U.S. Court of Appeals for the Fifth Circuit issued a significant opinion in the case involving Guardian Flight, LLC and Med-Trans Corporation, two air ambulance providers, against the defendant insurance...more

Marshall Dennehey

Pennsylvania Superior Court Finds Appellants’ Position Unreasonable

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In Hespen v. Erie Insurance Company, Levy Insurance Company, LLC and Thomas Levy, 332 A.3d 1229 (Pa. Super. 2024), the Pennsylvania Superior Court rejected the appellants’ assertion of the applicability of the doctrine of...more

Spilman Thomas & Battle, PLLC

NC Court of Appeals Clarifies How Insurers’ Duties to Defend and Indemnity Are Triggered in Atypical Employment Relationships

The Court of Appeals’ opinion in N.C. Farm Bureau Mut. Ins. Co. v. Young, (No. COA24-594) addresses how a court is likely to assess the duty to defend and the duty to indemnify under an insurance contract, and the interplay...more

King & Spalding

Appeals Court Revives Company’s Suit against Blue Cross for Breach of ERISA Fiduciary Duty

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On May 21, 2025, the Sixth Circuit revived a company’s lawsuit against Blue Cross Blue Shield of Michigan (BCBSM) for breaching its fiduciary duties under ERISA as a third-party administrator (TPA). The plaintiff company,...more

Foley & Lardner LLP

Eighth Circuit Affirms Summary Judgment to Insurer in Dispute with Construction Project Owner Over Lost Rental Income

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On Monday, June 9, 2025, the Eighth Circuit Court of Appeals ruled that a Missouri real estate developer could not recover insurance proceeds for lost rental income arising out of a retaining wall failure that caused delays...more

Wiley Rein LLP

New York Court Deems Subsequent Sexual Harassment Lawsuit “Related” to Prior Suits

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A New York intermediate appellate court, applying New York law, has held that an insurer had no coverage obligation for a third lawsuit filed against its insured that was deemed related to two earlier lawsuits that were filed...more

Cozen O'Connor

Insurer’s Use of Conflicting Reports Not Bad Faith, Says Court

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In El Dueno, LLC v. Mid-Century Insurance Company (2025 WL 1540329) (10th Cir. 2025)), the Tenth Circuit Court of Appeals affirmed summary judgement on behalf of the insurer on the basis that the insurer did not act in bad...more

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