Yearly Archives: 2016

Subrogation recovery did not violate the made-whole-rule and was not in bad faith per Wisconsin Sup. Ct.

It is highly unusual to find an insurance bad faith case which stems from an insurance company’s subrogation recovery. On July 6th, Wisconsin’s highest court had such a case, reversing the appellate court and holding that Dairyland Insurance Company’s subrogation recovery did not support a breach of contract action and its conduct was not in bad faith. Dairyland paid its insured Dennis Dufour his uninsured bodily injury policy limit of $100,000 and $15,598 for 100% of his property loss after he was injured in a motorcycle accident caused by an insured of American Standard. Dairyland then pursued American Standard for subrogation in connection with its $15,598.86 property damage payment. As a result of the subrogation action, American Standard paid $100,000

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Genuine Dispute Defeats Both Bad Faith and Elder Abuse

The Paslays sued State Farm for failing to pay a portion of the damage caused to their Pacific Palisades house by a heavy rainstorm and for forcing them to move back into the house while it was still under construction. The complaint asserted claims for breach of insurance contract, bad faith, punitive damages and financial elder abuse under California’s Welfare and Institutions Code. State Farm brought a motion for summary judgment, arguing that it paid all of the benefits due under the policy, and even if it did not, there was a genuine dispute regarding the benefits owed, and therefore State Farm’s conduct was reasonable. The trial court agreed and granted summary judgment, dismissing the case. On appeal, the court

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The Advantages of Removal: Twombly and Iqbal Applied to Bad Faith Claims

This month, the Eastern District of Pennsylvania issued an opinion that reminds insurance carriers and their counsel that it is often beneficial to remove certain cases to federal court. While federal court offers many advantages in insurance litigation, the recent opinion in Camp v. N.J. Mfrs. Ins. Co., No. 16-1087, 2016 U.S. Dist. LEXIS 74496 (E.D. Pa. June 8, 2016) highlights one important benefit: the federal court’s role in protecting carriers from frivolous and groundless claims at an early point in the litigation. In Camp, the court considered whether to grant the insurer’s motion to dismiss when it was faced with a complaint alleging bad faith for denying the insured’s underinsured motorist (“UIM”) claim. The insurer had denied the claim

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The Duty to Follow-up Part II: When The Underlying Litigation Changes

In many states, an insurer not only has a duty to timely communicate with its insured and respond to demands for settlement by a claimant asserting a claim regarding the adjustment of a loss, that duty may also include the duty to follow-up on those communications.  Recent case law further emphasizes the importance of follow-up in the context of an offer to settle made by a tort claimant, as well as when the insurer is apprised of changes to the status of claims and defenses in the underlying tort case.  Neglecting the duty to follow-up can cost an insurer – converting a $25,000 claim to a $7 million loss.  As a recent case decided by the United States District Court

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Should You Withdraw The Reservation of Rights To Avoid Entry of a Consent Judgment?

An insurer that defends its insured against a third party’s lawsuit, while reserving rights to deny coverage to its insured for any judgment, may face a decision point when underlying settlement discussions become ripe to resolve the case.  In some states, the insurer must decide whether to stand on its coverage defenses, or whether to withdraw its reservation of rights with the understanding that it will pay for the settlement within its policy limits and waive those defenses while it gains control over the settlement negotiations.  These decisions are among the greatest challenges, and are often the most time-sensitive issues, that third-party liability insurers may face when invited to participate in underlying mediations. One of the key factors influencing whether

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Posted in Reservation of Rights

The Duty to Follow-up: How A $25,000 Offer To Settle Turns Into A $7 Million Loss

In many states, an insurer not only has a duty to timely communicate with its insured and respond to demands for settlement by a claimant asserting a claim regarding the adjustment of a loss, that duty may also include the duty to follow-up on those communications.  As a recent case decided by the United States District Court for the Northern District of Illinois shows, the costs of not doing so, even on a relatively small claim under a low limit policy, can be catastrophic. Horace Mann Insurance Company provided automotive insurance limits of $25,000.  Less than 45 days after a motor vehicle accident involving its insured near Tampa, Florida in which the insured’s SUV collided with a motorcycle, Horace Mann

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Will Discovery Unlock Your Claim File? Federal or State Court Jurisdiction Could Make The Difference

Differences between federal court and state court procedure can be important for insurers that find themselves involved in “bad faith” litigation.  If a lawsuit alleging extracontractual claims is filed in federal court, or if it is removable to the federal court’s jurisdiction, the parties’ discovery approach and procedural strategies could significantly change from those of a similar case that is litigated in state court. For example, discovery into the contents of an insurer’s claim file in bad faith litigation may be more restricted in federal court than in state court.  As a general suggestion to all insurers, the editors of “Avoiding Bad Faith” believe that claims representatives can improve the substance of their claim files by always assuming that everything

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When is Rescission Based Upon Material Misrepresentations The Proper Course of Action?

Carriers rely on application representations regarding the existence of potential claims.  Sometimes, the carrier learns after the fact that an applicant may not have reported all known potential claims.  What can/should the carrier do?  A recent example is found in Continental Casualty v. Gargoyles, a case involving allegations of securities fraud.  Continental extended a defense under a reservation of rights, which it later sought to withdraw when the president of Gargoyles confessed to criminal wrong-doing as part of a plea agreement.  In this case, the facts confessed in the plea agreement contradicted the reported claims in the insured’s policy application.  Once the plea agreement was confirmed, Continental moved to rescind the policy and recoup its defense costs.  The court held

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Avoid Inconsistent Communications By “Revolving Door” Adjusters

In CE and CLE courses, we hear all the time that the most often cited reason for a grievance or complaint is lack of communication.  This truism provides a useful rule of thumb to avoid bad faith claims.  Remember, for most claimants, the event giving rise to an insurance claim often is the most significant event which will happen to the claimant this year.  Events such as a car wreck, an injury claim, a home fire, a product disruption can wreak havoc on the insured.   And, many insureds have little idea as to how to cope with these disruptions.  At these times, when tension runs high and patience runs low, the carrier which responds promptly to communications from the claimant

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Florida Regulators Approve Policy Language Aimed at Limiting “Assignments of Benefits” Claim Practice

Insurance companies that write property risks in Florida are getting in line to request approval from the Office of Insurance Regulation (OIR) for two key policy revisions intended to control losses from a water damage property claim practice called “assignment of benefits.” Many insurers have attributed the rising costs of water claims in Florida to an increase in the use of assignments of benefits (AOBs).  This practice occurs primarily in the residential homeowners’ context and involves a situation where, following a water damage event, the insured assigns its rights and benefits under its insurance policy to a third-party contractor or water mitigation company.  The water remediation contractor then bills the insurance company directly with rates that often substantially exceed the

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Avoiding Insurance Bad Faith
Cozen O’Connor represents insurance clients in jurisdictions throughout the U.S. against statutory and common law first- and third-party extracontractual claims for actual and consequential damages, penalties, punitive and exemplary damages, attorneys’ fees and costs, and coverage payments. Whether bad faith claims are addenda to a broader coverage matter or are central to the complaint, Cozen O’Connor attorneys know how to efficiently respond to extracontractual causes of action. More
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