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Insurance Law

INSURANCE LAW NOTES

Pennsylvania Insurance Coverage Law, Cases, and Comments
By Richard Victoria

Post Frequency: 0.1/day

Last Entry: March 20, 2012 at 11:52:00

Bad Faith Claims Not Assignable

Posted on March 20, 2012
Contrary to earlier rulings by the Pennsylvania Superior Court in Brown v. Candelora, 708 A.2d 104, 110 (Pa. Super. 1998), Scopel v. Donegal Mut. Ins. Co., 698 A.2d 602 (Pa. Super. 1997), and Stidham v. Millvale Sportsmen's Club, 618 A.2d 945 (Pa. Super...

Exception to Exclusion Enabled by Extrinsic Evidence

Posted on May 05, 2011
Generally speaking, an insurer is not permitted to rely upon extrinsic evidence when to make its duty to defend determination. Instead, the insurer is required to rely solely upon the allegations of the complaint against its insured and must defend whenever a claim potentially falls withing the policy's coverage...

To Merge or Not To Merge?

Posted on January 22, 2009
At least for now, two of PA's big health insurers, Pittsburgh's Highmark Inc. and Philadephia's Independence Blue Cross, have decided to call off their planned merger due to their dissatisfaction with proposed restrictions from state regulators. Apparently due to anti-trust concerns, they would have been required to give up their "Blue Cross" and "Blue Shield" trademarks as a condition of the merger, something neither was willing to do.

10 Worst Insurance Companies in America?

Posted on October 17, 2008
Earlier this year, the American Association for Justice issued its report naming the "10 Worst Insurance Companies in America." The authors of the report describe the process undertaken to compile this list as follows:To identify the worst insurance companies for consumers, researchers at the American Association for Justice (AAJ) undertook a comprehensive investigation of thousands of court documents, SEC and FBI records, state insurance department investigations and complaints, news accounts from across the country, and the testimony and depositions of former insurance agents and adjusters...

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Great Source of Information for Policyholders

Posted on September 23, 2008
If you have an insurance claim or are interested in insurance law, call me ... or ignore that shameless plug and take a look at the United Policyholders website, which is loaded with helpful information. As explained on their site, their mission is to educate the public on insurance issues and consumer rights.

Declaratory Judgment Action Stayed; Claim Potentially Covered

Posted on September 08, 2008
When a liability policyholder is sued and tenders the lawsuit to its insurer demanding that the insurer provide a defense in an underlying suit, if there is any doubt about whether the claims set forth in the suit are covered under the policy, an insurer may provide a defense to the policyholder under a reservation of rights and simultaneously seek a declaratory judgment that the insurer is not required to defend...

Checks Are Not "Tangible Property"

Posted on July 01, 2008
In R&L Zook v. Pacific Indem., No. 07-03774 (May 1, 2008), the U.S. District Court for the Eastern District of PA determined that checks that were allegedly improperly cashed by an insured check cashing company did not trigger coverage under that company's liability policy and did not require an insurer to defend the check cashing company in an underlying lawsuit in which the company was being sued for its alleged improper check cashing...

PA Superior Court Denies Insurer Reimbursement of Defense Costs

Posted on May 22, 2008
The PA Superior Court has held that, in cases where the insurance policy at issue does not provide for reimbursement of defense costs paid by the insurer, an insurer is not entitled to such reimbursement despite the insurer's reservation of rights letter specifically addressing the issue and a later finding of no coverage under the policy...

Third Circuit Discusses Reasonable Expectations Doctrine

Posted on February 21, 2008
In West v. Lincoln Benefit Life Company, the U.S. Court of Appeals for the Third Circuit reviewed and summarized PA's reasonable expectations doctrine in ruling that a former policyholder did not have a reasonable expectation that a life insurance policy would be reinstated...

Surety Bonds Not Subject to Bad Faith Statute

Posted on February 20, 2008
A recent case from the U.S. District Court for the Middle District of PA provides further support for those arguing that surety bonds are not insurance policies for purposes of PA's bad faith statute, 42 Pa.C.S.A. � 8371. In reaching this conclusion, the court in Intercon Construction, Inc...

Supreme Court Clarifies Sackett and Stacking

Posted on January 08, 2008
Bringing to a close, at least for now, the Sackett saga discussed in my prior notes here and here, the PA Supreme Court issued two decisions (Sackett v. Nationwide Mutual Insurance Co., No. 8 WAP 2006 (Pa. Dec. 27, 2007) (Justice Castille's opinion for the dissent) and Everhart v...

Baumhammers Decided

Posted on January 04, 2008
Following up on my post from a few months ago, the PA Supreme Court has issued its opinion(s) in the Baumhammers case addressing the number of occurrences issue. You can read the majority opinion here and the two concurring and dissenting opinions here and here...

Liability Coverage Applies to Criminal "Claim"

Posted on January 03, 2008
Though the term "claim" is regularly used in liability policies, it is also a term that is commonly not defined in such policies. Mindful of this fact, the PA Superior Court recently determined that an award of restitution in a criminal action constitutes a "claim" for purposes of liability coverage...

Bad Motive Not Required to Prove Bad Faith

Posted on January 02, 2008
PA courts have routinely advised that, to prove bad faith under 42 Pa.C.S. � 8371, an insured must prove by clear and convincing evidence that its insurer: (1) did not have a reasonable basis for denying benefits under a policy; and (2) knew or recklessly disregarded its lack of a reasonable basis in denying the claim...

Insurance Law Notes a "Top Blog"

Posted on December 04, 2007
The good people at LEXIS-NEXIS have deemed Insurance Law Notes worthy of designation as a "Top Blog" on their Insurance Law Center site. As much as I enjoy patting myself on the back, the important thing to take from this is that you should really visit thieir excellent site, which is a great source of insurance news, commentary, and information generally for lawyers and industry types alike.

Auto Insurance Discount Available With Training Course

Posted on December 04, 2007
I am reasonably sure that there is bigger news in the PA insurance world, but I just wanted to post this photo.In any event, the Pennsylvania Department of Transportation has approved a 4-hour Mature Driver Improvement Refresher Course to allow drivers age 55 and older the opportunity to continue to qualify for discounted vehicle insurance...

PA Supreme Court Sacking Sackett's Stacking Backing?

Posted on November 20, 2007
No, Not This StackingBack in April of this year, in Sackett v. Nationwide Mutual Insurance Co., the PA Supreme Court ruled that insurance companies must have their policyholders reject or waive stacked UIM coverage every time a vehicle is added to an existing policy...

If It Looks Like a Tort and Acts Like a Tort...

Posted on November 10, 2007
Resolving an issue that has been disputed in just about every courtroom in PA, the PA Supreme Court has determined, once and for all, that the two-year statute of limitations applies to bad faith claims brought under 42 Pa.C.S.A � 8371. You can read all about it in Ash v...

The Good News and the Bad News on Bad Faith

Posted on October 11, 2007
I have been less than prolific these last few months, but it was summer and, more recently, the Steelers have been playing and winning and diverting my attention from insurance law. That being said, today it is cold, summer is over, and it is time once again to focus on the Law...

Fiduciary Duties of Insurance Agents

Posted on October 01, 2007
Frequently, after a claim is denied, policyholders turn to their agents and say, "I didn't know anything about insurance. That's why I gave you all of my information and told you, 'Get me what I need."' Sometimes, these allegations lead to breach of contract and/or negligence claims against an agent for failure to procure insurance or to claims against an insurer for failing to provide what has been promised in the policies...

"Failure to Warn" is Not a Products Claim

Posted on August 30, 2007
According to the PA Superior Court's recent decision in Bombar, Intervenor, Upright Materials Handling, Inc. v. The West American Insurance Co. and First Insurance Center, Inc., Superior Court of Pennsylvania, No. 224 MDA 2006 (Pa. Super. July 26, 2007), claims alleging negligent "failure to warn" fall outside of the products hazard of certain liability policies...

The Ambiguity Ambiguity

Posted on July 18, 2007
Anyone who deals with insurance coverage in PA (particularly asbestos or latent disease coverage) really should read the recently published case of Asten Johnson v. Columbia Casualty Co., Civil Action No. 03-1552 E.D. Pa., March 30, 2007), which was decided by Judge Stengel of the Eastern District of PA...

"Get a Hybrid; Be Good People Now"

Posted on June 11, 2007
What do Larry David, Gerald Broflovski, and the PA Insurance Department have in common?They each encourage you to purchase a hybrid vehicle, of course.According to the Insurance Department's June 11, 2007 Press Release:Pennsylvania motorists who own a hybrid vehicle may be eligible for a discount on their auto insurance premiums, according to the Pennsylvania Insurance Department...

Power to the People

Posted on June 06, 2007
The Pennsylvania Senate is considering a Bill that would put bad faith claims under 42 Pa.C.S. 8371 into the hands of juries.Currently, PA law generally requires that the issues of insurer bad faith and the damages that flow from bad faith conduct are to be resolved by a judge...

The Electric Light and Insurance

Posted on June 01, 2007
I know this is a bit off topic, but I found this interesting and amusing: "Insurance is one of the greatest modern inventions of humankind."Have a wonderful weekend.

Horseshoes, Hand Grenades, and Bad Faith Claims

Posted on May 30, 2007
The Philadelphia County Court of Common Pleas has awarded an insured consequential damages, even though it also denied the same insured's bad faith claim.In Prime Medica Associates v. Valley Forge Insurance Company, a jury awarded the insured, Prime Medica, $4,000,000 on its claim again Valley Forge...

Public Policy Defense Fails

Posted on May 28, 2007
In a recent case in the Eastern District of PA involving a claim under a claims made Directors, Officers and Corporate Liability Insurance Policy for coverage of an underlying breach of contract and UCC claim, the Eastern District Court has refused to rely upon public policy to preclude insurance coverage for contractual claims asserted against an insured...

Friends in High Places

Posted on May 23, 2007
In getting this site off the ground, I scoured the web for other sites and blogs of interest, several of which are linked on this page. In so doing, I discovered the Insurance Coverage Law Blog, a rather inspiring site run by Portland, Oregon lawyer David Rossmiller...

Contra Proferentem Not Always the Answer

Posted on May 16, 2007
I have always liked the doctrine of contra proferentem, not only because it is a rule that often benefits policyholders, but because it sounds like a made-up or misused latin term that could have been used on Johnny Dangerously's "death walk." Apparently, not everyone likes contra proferentem as much as I do...

Late Notice Defense Still Requires Actual Prejudice

Posted on May 09, 2007
The requirement that, to avoid coverage, an insurer must demonstrate that it was actually prejudiced as a result of an insured's late notice of a claim has been reaffirmed by the PA Superior Court.The case of American States Ins. Co. v. Estate of Braheem arises from the death of Mr...

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