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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 13 Civ. 1580; 12 Civ. 6811
Regular Panel Decision
Jun 17, 2015

U.S. Bank National Ass'n v. PHL Variable Life Insurance

This decision and order by District Judge McMahon addresses numerous motions in limine filed by both U.S. Bank National Association (applicant) and PHL Variable Life Insurance Company (Phoenix, defendant). The court evaluates the admissibility of expert testimony, evidence relating to actuarial justifications for cost of insurance (COI) rate increases, and Phoenix's financial condition. Key rulings concern claims of breach of the covenant of good faith and fair dealing, the relevance of life settlement investments, and the application of hearsay and prejudice rules. The decision provides detailed findings on specific exhibits and types of testimony, balancing probative value against potential unfair prejudice.

Insurance LawContract LawCovenant of Good Faith and Fair DealingCost of Insurance RatesActuarial AnalysisExpert Witness AdmissibilityMotions in LimineHearsay EvidenceRule 403 Balancing TestLife Settlement Industry
References
48
Case No. MISSING
Regular Panel Decision

National Union Fire Insurance Co. of Pittsburgh v. American Re-Insurance Co.

The case revolves around a dispute between National Union Fire Insurance Company and American Re-Insurance Company regarding a pollution exclusion clause in a reinsurance policy. National Union sought reimbursement from American Re after settling claims where employees were exposed to metalworking fluids. American Re denied coverage, arguing its pollution exclusion applied. The court, applying Ohio law, found American Re's pollution exclusion ambiguous due to its broad language and its intended purpose of covering environmental contamination. Consequently, American Re's motion for summary judgment was denied, and National Union's motion to strike American Re's defense was granted, requiring American Re to "follow the fortunes" of National Union.

ReinsurancePollution Exclusion ClauseContract InterpretationFollow the Fortunes DoctrineSummary JudgmentInsurance CoverageAmbiguity in ContractsOhio State LawDiversity JurisdictionIndustrial Contamination
References
31
Case No. MISSING
Regular Panel Decision

Metropolitan Life Insurance v. Durkin

The plaintiff, Metropolitan Life Insurance Company, initiated an action seeking a declaration that sections 213 and 213-a of the New York State Insurance Law prohibited the retroactive payment of a wage increase. This increase of $2.85 per week was awarded by the National War Labor Board to its insurance agents, dating back to the start of arbitration proceedings. The plaintiff argued these statutes, designed to prevent excessive post-facto compensation, made such retroactive payments unlawful. However, the trial court and Appellate Division, whose decision was affirmed, concluded that the statutes were not intended to interfere with the common practice of collective bargaining and arbitration, which frequently involves retroactive wage adjustments. The court emphasized that the legislative intent behind the insurance laws was to curb abuses like bonuses and gratuities, not to hinder ordinary and orderly wage-fixing mechanisms, thereby affirming the legality of the retroactive wage increase.

Insurance RegulationRetroactive CompensationCollective Bargaining DisputesWage Arbitration AwardNew York Insurance LawLabor Relations BoardStatutory InterpretationAppellate Court RulingEmployee Benefits LitigationContractual Agreements
References
5
Case No. MISSING
Regular Panel Decision
Jan 13, 1995

National Union Fire Insurance Co. of Pittsburgh, PA v. State Insurance Fund

Plaintiff National Union Fire Insurance Company of Pittsburgh, PA (National Union) initiated a declaratory judgment action against The State Insurance Fund (SIF) to recover defense and settlement costs. These costs were expended on behalf of Regional Scaffolding and Hoisting Co., Inc., a mutually insured party in an underlying personal injury action. The Supreme Court initially denied National Union's motion for summary judgment and ruled in favor of SIF. However, the appellate court reversed this decision, concluding that the antisubrogation rule did not apply in this context. Consequently, it determined that National Union and SIF were co-insurers for Regional Scaffolding's common-law liability. The court granted National Union's motion for summary judgment in part, declaring SIF's duty to reimburse National Union for one-half of the reasonable settlement and defense costs, and remanded for a trial to ascertain these amounts.

Antisubrogation RuleDeclaratory JudgmentSummary JudgmentInsurance Coverage DisputeCo-Insurer LiabilityDefense Costs ReimbursementSettlement CostsEmployer's LiabilityComprehensive General LiabilityThird-Party Action
References
8
Case No. MISSING
Regular Panel Decision

National Casualty Co. v. Allcity Insurance

This case concerns an appeal from an order of the Supreme Court, Bronx County, which initially denied Allcity Insurance Company's motion for summary judgment and granted National Casualty Company's cross-motion for reimbursement. The underlying dispute involved National's request for one half of settlement and defense costs from Allcity, stemming from a personal injury action where the owner and general contractor were additional insureds on a subcontractor's general liability policy. The appellate court unanimously reversed the lower court's decision, granting Allcity's motion and denying National's cross-motion. The reversal was based on the antisubrogation rule, which precluded National from seeking recovery from Allcity, the subcontractor's workers' compensation carrier, as Allcity would not have been obligated to contribute to the settlement. Consequently, the complaint against Allcity was dismissed.

Summary JudgmentAntisubrogation RuleAdditional InsuredReimbursementDefense CostsGeneral Liability PolicyWorkers' Compensation CarrierAppellate DivisionInsurance LawPersonal Injury Action
References
2
Case No. MISSING
Regular Panel Decision
Feb 28, 1991

North River Insurance v. United National Insurance

This appellate decision addresses the apportionment of liability between North River Insurance Co. and United National Insurance Company arising from a settlement for an injured employee. The court clarified that North River, as the workers' compensation carrier, is solely responsible for its waived lien, reversing a lower court's finding. It further determined that both insurers' "other insurance" clauses called for pro rata contribution, not equal shares, for the $588,245 settlement payment and defense costs. The court calculated specific shares for each insurer and ruled that North River is entitled to interest from the original payment date in 1982. The Supreme Court's order was thus modified to reflect these findings.

Insurance disputePro rata contributionEquitable apportionmentWorkers' compensation lienDefense costsOther insurance clausesSettlement apportionmentInterest calculationAppellate decisionInsurer liability
References
10
Case No. MISSING
Regular Panel Decision

Spear, Leeds & Kellogg v. Central Life Assurance Co.

Plaintiff Spear, Leeds & Kellogg (SLK), a registered futures commission merchant and a member of the New York Stock Exchange, sought a preliminary injunction against three life insurance companies (Defendants) to prevent compulsory arbitration. Defendants had filed an arbitration demand with the NYSE, seeking recovery of monies they paid out on life insurance policies of a customer named Marvin Goodman. Defendants alleged that SLK either falsified account documents or knew of their falsification by Goodman, leading to their losses. SLK argued it had no transactional nexus with Defendants and thus no obligation to arbitrate under NYSE Constitution and Rules. The court found no valid arbitration agreement between the parties and granted SLK's motion for a preliminary injunction, enjoining Defendants from compelling arbitration. The court emphasized that arbitration is a creature of contract, and no such contract existed between SLK and the Defendant insurance companies.

ArbitrationPreliminary InjunctionNYSE RulesContract LawSecuritiesInsuranceDispute ResolutionNon-Member ArbitrationFinancial FraudFalsified Documents
References
9
Case No. 2015 NY Slip Op 07554 [132 AD3d 500]
Regular Panel Decision
Oct 15, 2015

Bridge Street Contracting Inc. v. Everest National Insurance

This case addresses an insurer's disclaimer of coverage due to late notice of claims. The Appellate Division, First Department, modified a lower court order, declaring that Everest National Insurance Company has no duty to defend or indemnify Bridge Street Contracting Inc. in the underlying action. The court ruled that Everest properly disclaimed coverage without needing to demonstrate prejudice, as it was not participating in the defense when Bridge Street was served with the claims. Arguments regarding waiver of the late notice defense and antisubrogation were rejected. CastlePoint Insurance Company's motion to intervene was also denied as academic.

Insurance CoverageLate NoticeDisclaimer of CoverageSummary JudgmentDuty to DefendDuty to IndemnifyAntisubrogationInterventionAppellate DivisionContract Law
References
4
Case No. MISSING
Regular Panel Decision
Jun 30, 1992

National General Insurance v. Hartford Accident & Indemnity Co.

This case concerns a declaratory judgment action regarding insurance coverage following a fatal airplane crash. Warren Geddes, president of American Investor Services, Inc. (AIS), was piloting a plane carrying Gary Conway, an AIS employee, when it crashed, killing both. National General Insurance Company, insurer of the plane owner, sought for Hartford Accident and Indemnity Company, AIS's workers' compensation insurer, to defend and indemnify AIS and Geddes' Estate in a wrongful death action. Hartford denied coverage for Geddes' Estate, arguing he was not a named or additional insured under their policy. The court modified the initial judgment, declaring that Hartford has no duty to defend or indemnify the Estate of Geddes, while otherwise affirming the judgment.

Insurance CoverageDeclaratory JudgmentWrongful DeathDuty to DefendDuty to IndemnifyNamed InsuredAdditional InsuredWorkers' Compensation PolicyAirplane CrashEstate Liability
References
5
Case No. MISSING
Regular Panel Decision
Nov 16, 2004

Bovis Lend Lease LMB, Inc. v. Royal Surplus Lines Insurance

This case involves an insurance coverage dispute between National Union Fire Insurance Company of Pittsburgh, PA (National Union), The Trustees of Columbia University in the City of New York (Columbia), and Bovis Lend Lease LMB, Inc. (Bovis) against Royal Surplus Lines Insurance Company (Royal). The core issue is whether Royal's disclaimer of liability under Insurance Law § 3420 (d) was timely. The court found that Royal's disclaimer to Bovis and Columbia was untimely as a matter of law because its internal staffing issues were not a reasonable excuse for the delay. However, the court also ruled that § 3420 (d) does not apply to disclaimers between co-insurers, thus Royal's disclaimer was timely as to National Union. Furthermore, the court determined that Royal's "New Residential Work or Products Exclusion" did not apply to Millennium's work on a mixed-use building, thus obligating Royal to defend and indemnify Bovis and Columbia, and Royal was ordered to reimburse National Union for defense costs incurred from March 3, 2003.

Insurance CoverageDisclaimer of LiabilityDenial of CoverageInsurance Law § 3420 (d)Timeliness of DisclaimerInternal Staffing IssuesCo-Insurer LiabilityAdditional InsuredPolicy ExclusionNew Residential Work Exclusion
References
22
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