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Insurance Industry › Fraud › Insurance Litigation

Zelle LLP

Court Grants Insurer’s Motion for Summary Judgment on Nearly All of Insureds’ Causes of Action

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Schnatzmeyer v. State Farm Ins. Co., No. 3:23-CV-02820-K, 2025 WL 1697505, at *1 (N.D. Tex. June 17, 2025). In a case involving two overlapping freeze claims—and a substantial array of legal issues affecting insurers in...more

JUSTICENTER

How Long Is an Insurance Check Good For?

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If you’ve received a settlement check from an insurance company after a car accident, property damage claim, or injury settlement, you might be wondering: how long is an insurance check good for? While holding onto it for a...more

Zelle LLP

Invoking ‘Our Option’ and Preferred Contractor Network Endorsements

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Increasing abuses in the claims process have caused insurance companies to rethink the traditional model of sending out cash to pay claims. Far too often, that cash is used for purposes other than fixing damage, with a...more

Goldberg Segalla

Fraud Doesn’t Pay in New York – February 2025 Update

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As a part of our Quarterly Practice Group Update, we are pleased to produce another installment with examples of our continued success in the area of fraud litigation. The New York State Workers’ Compensation Board has...more

Goodwin

Aetna’s “Fraud Scheme” Lawsuit Against Radiology Group Highlights Health Plans’ Resistance to Private-Equity-Backed Providers

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On December 23, 2024, various Aetna affiliates (referred to hereafter as Aetna) filed suit against Radiology Partners, Inc., a national, private-equity-backed radiology group, alleging that Radiology Partners defrauded the...more

Miller Nash LLP

The Northwest Policyholder | When the Application is the Risk: Application-Based Insurance Policy Rescission

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Surprised insurers are unhappy insurers. And unhappy insurers are more likely to resist paying claims. As are insurers who fail to heed their good faith and other obligations to their policyholders. So if you seek coverage...more

Wiley Rein LLP

New Jersey Appellate Court Affirms Rescission of Policies Based on Law Firm’s Misrepresentation in Applications

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In a win for Wiley’s client, a New Jersey appellate court, applying New Jersey law, affirmed a trial court’s decision rescinding four lawyer’s professional liability policies because of material misrepresentations made in the...more

Wiley Rein LLP

Lending Exclusion in Bankers Professional Liability Policy Bars Coverage For Claim Alleging Financing a Ponzi Scheme

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The United States District Court for the Central District of California, applying California law, has held that a lending exclusion in a bankers professional liability policy barred coverage for underlying lawsuits alleging...more

Marshall Dennehey

Appellate Court Affirms Ruling a Sworn Proof of Loss and Estimate Related to Later Claim Was Inadmissible as Hearsay and...

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Universal Property & Casualty Insurance Company v. Luis Nacimiento, Fla. 3rd DCA, 3D23-0301, Apr. 3, 2024 - The insured reported a claim to Universal Casualty & Property Insurance Company in February 2016 for water damage...more

Faegre Drinker Biddle & Reath LLP

Court Sides with Long-Term Care Insurer Over Claim Denial and Potential Fraud

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A judge from the District of Colorado recently issued an opinion that might leave the door open for long-term care insurers to void policies after the contestability period expires if an insured commits fraud. See Meyer v....more

Wiley Rein LLP

Dishonesty Exclusion Bars Coverage For Claim Based On Actions Of Contractor Authorized To Conduct Operations On Behalf Of Insured

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Applying California law, a California state appeals court has held that a policy exclusion barring coverage for “any [c]laim . . . [b]ased upon or arising out of any . . . act or omission . . . which is . . . dishonest,...more

Wiley Rein LLP

Fraud Exclusion, California Insurance Code Section 533 Preclude Coverage for Arbitration Award

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A California federal court, applying California law, has held that an employment liability policy does not provide coverage for a judgment against the insured following an arbitrator’s finding of fraud....more

Bennett Jones LLP

Court of Appeal Endorses Draconian Deterrent to Insurance Fraud

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In Abbas v Esurance Insurance Company of Canada, 2023 ABCA 36 [Abbas], the Alberta Court of Appeal endorsed what it described as draconian consequences for insurance fraud as consistent with the Insurance Act, RSA 2000 c I-3...more

Carlton Fields

Expect Focus - Volume I, January 2023

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More than 25 years have elapsed since the SEC adopted Exchange Act Rule 17a-4(f) governing electronic recordkeeping by broker-dealers. In an effort to update the rule to reflect “technology neutral” concepts, the SEC adopted...more

Rivkin Radler LLP

The Title Reporter — Winter 2023

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Here is what we cover in this issue of The Title Reporter: A Legal Update for the Title Insurance Industry •A federal district court in New York granted summary judgment in favor of a title insurance company and its...more

Wiley Rein LLP

Lawsuit Deemed Related to Notice of Circumstances Submitted During Prior Claims-Made Policy Period Under Florida’s “Sufficient...

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The United States District Court for the Western District of Louisiana, applying Florida law, has held that an investor’s lawsuit against an attorney related back to a notice of a potential claim submitted during the earlier...more

Carlton Fields

Federal Court Rejects Computer Fraud Coverage for Social Engineering Loss

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In SJ Computers LLC v. Travelers Casualty and Surety Company of America, the U.S. District Court for the District of Minnesota recently addressed the scope of insurance available for a phishing scheme under the terms of a...more

White and Williams LLP

To Be or To Be On Behalf Of: That Is the Question

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On August 10, 2022, the U.S. District Court for the Middle District of Florida held, on a motion to dismiss, that losses allegedly caused by fraudulent payment requests by persons purporting to be the insured qualified for...more

Wiley Rein LLP

No Coverage for Loss in Consequence of Social Engineering Fraud

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Applying North Carolina law, a federal district court has held that an E&O insurance policy does not provide coverage for loss arising from social engineering fraud despite the fact that the insured’s negligence also...more

Wiley Rein LLP

Insured Cannot Bring Bad Faith Allegation When Coverage “Fairly Debatable”

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The United States District Court for Minnesota, applying Minnesota law, has affirmed a magistrate judge’s decision denying an insured’s motion to amend its complaint to add a claim for bad faith....more

Carlton Fields

Annuity Litigation Roundup

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Court Emphasizes Disclosure Substance Over Form - A recent decision in Nofsinger v. Jackson National Life Insurance Co. shut down a putative class action in which the plaintiff alleged she surrendered her annuity contract...more

Carlton Fields

Recent Trends and Defense Strategies in Agent Sales Practice Suits

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Allegations of misconduct by agents and brokers are a consistent feature of lawsuits aimed at insurance companies. Several recent court decisions illustrate the types of claims insurers have faced and which defense strategies...more

Carlton Fields

Texas Federal Court Finds No Coverage Under Crime Policy for Phishing Scheme Because Insured Did Not “Hold” Diverted Funds and...

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RealPage was the victim of a phishing scheme that resulted in the diversion of its client funds from the bank account of a third-party payment processer, Stripe Inc. In the ensuing insurance coverage litigation styled...more

Cozen O'Connor

Texas Supreme Court Crafts “Undisputed Evidence of Collusive Fraud” Exception to Eight-Corners Rule

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In Texas, and as a general rule, only the four corners of the policy and the four corners of the petition against the insured are relevant in deciding whether the duty to defend applies. Richards v. State Farm Lloyds,...more

K&L Gates LLP

Two Federal Appellate Courts Rule That Policyholders Are Entitled to Insurance Coverage for Losses Arising from Social Engineering...

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In recent years, courts across the country have considered policyholder’s claims for insurance coverage for so-called social engineering losses, e.g., losses that result from a criminal tricking a policyholder into wiring...more

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