Cases Cited in Goldberg Segalla’s Case Watch

Click here for the full decision to the cases cited in this edition's Case Watch:

Download Admiral_Ins__v__G4S_Youth_Services__pdf

Download Ashmore_v__Ceridian_Corp__et_al___pdf

Download Auto-Owners_Ins__v__Hickory_Springs__et_al___pdf

Download Dairy_American_v__NY_Marine_and_General_Ins___pdf

Download Myron_Corp__v__Atlantic_Mutual_Ins__Corp___pdf

Download XL_Speciality_Ins__v__Financial_Industries_Corp__pdf

For more information on Case Watch, please contact Sarah Delaney at [email protected]

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New York Court Determines that Insurer Did Not Have A Duty to Defend Contractor’s Affirmative Defense

P.J.P. Mechanical Corp., v. Commerce and Industry Ins. Co., 2009 NY Slip Op 04984 (App. Div. June 18, 2009)

The policyholder purchased a commercial general liability policy from the insured which covered work it was performing for the third-party general contractor.  A pipe burst in one of the houses that the policyholder worked on and the general contractor alleged it was due to the negligence of the policyholder.  No suit was instituted but the general contractor withheld the remaining contract balance owed to

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Cases Cited in Goldberg Segalla’s Reinsurance Review – July 2009 Edition

Supreme Court Decision – Download Stolt-Nelsen.v.AnimalFeed

Fifth Circuit Decision – Download Saipem.v.Wellington

Northern District of Illinois Decision - Download In.re.arbitration.in.London

Southern District of New York Decision - Download TIG.v.Century.Indemnity.Order

State of California, Fourth Appellate District Decision – Download Ceradyne.v.Argonaut.Insurance.Co

United Kingdom Decision – Download Flexsys America.v.XL Insurance

United Kingdom Decision – Download Youell.v.La Reunion

Download Nonadmitted and Reinsurance Reform Act of 2009

For more information, please contact Jeffrey Kingsley at [email protected]

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District Court Determines that Administrator’s Decision to Deny Benefits was Reasonable

Ramsteck v. Aetna Life Ins. Co.

S.D.N.Y., June 24, 2009

 

Concluding the plaintiff had a full and fair review of her medical claim, the district court held the plan administrator’s decision to deny benefits was reasonable and, therefore, not arbitrary and capricious.   Documentation in the administrative record was sufficient to demonstrate the procedure was “experimental and investigational” and not covered under her medical plan.  Additionally, the court determined that plaintiff did not demonstrate “good cause” to support a review of testimony outside

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Court finds that Insured Must Pay Self-Insured Retention for Each Work Related Injury

Supervalu Inc. v. Wexford Underwriting Managers, Inc.

(Cal.Ct.App. June 22, 2009)

The court affirmed summary judgment in favor of the insurers, upholding the insurers' interpretation of “occurrence” related to excess workers' compensation policies.  Plaintiff was required to pay a self-insured retention every time a worker sustained injury due to an accident or occupational disease, which is the occurrence triggering coverage.  The court held that “occurrence” refers to the cause of employee damage, rather than loss to the insured. 

 

For a copy of

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Welcome to the Confusing World of Kidnap, Ransom and Extortion Insurance: An Overview

In light of recent world events, it comes as no surprise that the kidnap, ransom and extortion insurance policies are being discussed as a way to provide comfort to international businesspersons who travel in areas where kidnappings are common.  By way of background, kidnap, ransom and extortion provide compensation for ransom payments, loss of income, medical care and, possibly, interest derived from any bank loans needed for one’s release.

 

In considering the practical realities involved in these types of transactions, however, kidnap, ransom and

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UK Court Declares That Master Insurance Policy Does Not Drop Down Leaving Insured with A Multi-Million Dollar Gap in Coverage

Flexsys America L.P. and XL Insurance Company Ltd. (2009 EWHC 1115)

 

Flexsys America is an Ohio Corporation and subsidiary of a global company based in Belgium. Flexsys purchased a Public and Products Liability Policy from XL Capital Group, termed “Master Policy,” by the Court, and provided US$25 Million in coverage.  Flexsys was also insured under a XL Capital Group Commercial General Liability policy issued in Ohioand providing US$1 Million in coverage.

The plaintiff “KKPC” filed suit against Flexsys alleging that Flexsys engaged in

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Fourth Circuit Dismisses Title Insurance Overcharge Class Action

Arthur v. Ticor Title Insurance Co. of Florida

(4th Cir. [MD] June 18, 2009)

A class action was brought against Ticor Title Insurance Co. under the federal Real Estate Settlement Procedures Act for charging excessive rates for title insurance policies and sharing the money with agents during home refinancings. The action sought treble damages for the overcharges in addition to compensatory and punitive damages for violations of the federal law, as well as negligent misrepresentation and civil conspiracy under Maryland law.

Affirming the dismissal

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Excess Insurer Seeks Declaration that Certain Sprint D&O “Claims” Are Unrelated

Old Republic Insurance Company has made a counterclaim against Sprint Nextel Corp. seeking a declaration that no coverage is owed under a 1999-2000 claims made policy for a 2003 securities lawsuit.

According to the counterclaim, in 1999, Sprint announced a proposed merger between it and MCI WorldCom, Inc. Shortly thereafter, it was sued in eight separate class action suits, alleging that Sprint gave preferential treatment to WorldCom, failed to seriously negotiate with other potential merger partners, and failed to use open auction procedures to ensure

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