Michael S. Saltzman, Author at The Insurance & Reinsurance Report

November 19, 2013 Policy Conditions, Considerations, Construction, and Formation

Employee Exclusion Applies to “Statutory Employees” Even if Not Technically Employed by Additional Insured

The Eleventh Circuit recently held that a standard employee exclusion in a liability policy bars coverage to an additional insured where the injured claimant is a “statutory employee” of the additional insured for purposes of workers’ compensation law, even if the injured claimant is not technically employed by the additional insured.

The estate of an employee of a third-tier subcontractor on a construction project sued the project’s general contractor after the employee fell at the construction site and died as a result. The general contractor …

October 30, 2013 Policy Conditions, Considerations, Construction, and Formation

District Ct. Finds Co-Primary Coverage For Settlement of Underlying Accident

This declaratory judgment action derives from an underlying boat accident where a pontoon boat driven by Matt Higgins, collided with Jeremy Wood’s boat, seriously injuring Wood. The owner of the boat was insured by Owners Insurance Company (OIC). The driver of the boat was insured, through his homeowners’ carrier, State Auto Property and Casualty Company (State Auto). The resulting civil suit settled for $300,000. OIC paid $259,000, while the rest of the co-defendants contributed $41,000 collectively. OIC now seeks reimbursement from State Auto for one-half …

May 14, 2013 Policy Conditions, Considerations, Construction, and Formation

New York First Department’s Message to Insureds: An Equitable Defense Concerning A Policy Exclusion Cannot Be Decided By Motion Practice

206-208 Main St. Assocs. d/b/a/ Sutphin Blvd., LLC v. Arch Ins. Co.
(N.Y. App. Ct., 1^st Dept. May 2, 2013)
A New York appellate court recently held that the issue of whether an insurer was equitably estopped from raising an earth movement exclusion as a defense to coverage two years after it had assumed the purported additional insured’s defense was an issue for the trier of fact.

The plaintiff, 206-208 Main Street Associates, Inc. d/b/a 8930 Sutphin Blvd., LLC hired defendant H & H …

May 9, 2013 Environmental

Court Rules Policyholder Arguments Do Not Hold Water

Grinnell Mut. Reinsurance Co. v. Hubbs
(Appellate Court ofIllinois, Third District, April 24, 2013)

This water resource/environmental coverage action arises from an underlying dispute involving the interference and damages from the divergence or obstruction of streams or surface water between landowners. Specifically, plaintiff insurer brought a declaratory judgment action against landowners who alleged damages to crop land caused by the policyholder’s alleged alteration of the flow and level of surface and groundwater following the policyholder’s construction of a holding pond on the property.

The insurer …

March 11, 2013 Policy Conditions, Considerations, Construction, and Formation

Attorney’s Fees Count Toward Amount-in-Controversy Calculation Under Federal Removal Statute

Francis v. Allstate Ins. Co. (4th Cir. (Md.) Mar. 7, 2013)

The Fourth Circuit recently held that the amount of attorney’s fees sought by an insured in a declaratory judgment action should be included in the calculation to determine whether an insurance coverage case satisfies the amount-in-controversy requirement under the federal removal statute.

In 2008, the insured, a California resident, and her minor son were sued in the Maryland state court. The claimant worked as a resident aide at the Maryland School for the Deaf …

February 21, 2013 Policy Conditions, Considerations, Construction, and Formation

Claim for Improperly Sterilized Medical Equipment Limited to Policy Limits for One Occurrence

Mitsui Sumitomo Ins. Co. ofAmericav. Duke University Health Sys. No. 11-2057, United States Court of Appeals for the Fourth Circuit. February 11, 2013
The Fourth Circuit held that Duke University Health System was limited to policy limits for one occurrence when a mishap occurred where surgical instruments were sterilized with elevator hydraulic fluid. The facts of the case involve elevator workers placing hydraulic fluid into buckets distributed to them by Duke University, which had originally stored surgical detergents. Duke employees then used the hydraulic fluid …