Legal Issues

Showing 25 to 48 of 143 items.
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WTC Captive Insurance Co. Seeks to Dismiss Misuse of Public Funds Lawsuit

The World Trade Center Captive Insurance Co. (WTCC) is seeking to dismiss a lawsuit filed last month that accuses the captive of misusing a $1 billion grant from the Federal Emergency Management Association (FEMA).

Earth Movement Exclusion Applies, Even if Caused by Covered Peril

Defendant insurer denied coverage to plaintiff homeowner after her house collapsed. The homeowner brought this declaratory judgment action. The insurer moved for summary judgment, which was denied by Supreme Court, Nassau County. The Appellate Division reversed.

Carriers Late Disclaimer Ruled Invalid

Plaintiff Granite Avenue Utility Corporation commenced this suit to recover damages and attorneys fees against defendants for the alleged failure to procure insurance coverage, and negligence.

NYLB Sues OneBeacon Over Reinsurance Proceeds

ALBANY, N.Y., August 16 – The New York Liquidation Bureau has filed a lawsuit against OneBeacon Insurance Company, seeking to recover $2.2 million in reinsurance proceeds due to Midland Insurance Company in liquidation.

N.Y. Appellate Court Denies Chase Manhattan Bank Request for Summary Judgment in Alpha Trust Transaction Case

ALBANY, N.Y., August 15 – The Appellate Division Third Department unanimouslyupheld a lower court decision granting the superintendent of insurances requestfor all communication pertaining to United Community Insurance Companys (UCIC) involvement in the Lawrence Group insurance transactions and denying a summary judgment to Chase Manhattan Bank and other investors.

N.Y. AG Files Lawsuit, Restraining Order Against Homeward Bound

ALBANY, N.Y., August 14 – A lawsuit and restraining order have been issued to Homeward Bound Services of North America by Attorney General Andrew Cuomo. The Pennsylvania-based company and its owners, Marc Orth and Thomas Muldoon, have been accused of promising services to help keep seniors out of nursing homes and in home-based care settings and then not delivering the services they guaranteed to provide in the agreements.

Even if Defendant Defaults, Auto Accident Victim Must Meet Threshold

In this case, wrote the Appellate Division, we address the issue of whether or not a plaintiff who has been granted a default judgment on the issue of liability in a case seeking compensation for personal injuries arising from a motor vehicle accident is required to demonstrate the element of serious injury at the inquest on damages. For the reasons that follow, we conclude that, unless the issue of serious injury has been previously determined, the plaintiff must demonstrate at the damages inquest proof of a serious injury before there can be any recovery for pain and suffering arising from a motor vehicle accident.

Guilty Plea in N.J. for Producing Phony Insurance Cards

TRENTON, N.J., August 7 – A husband and wife were sentenced to state prison for three years and three and a half years respectively after they pleaded guilty to charges of producing and selling phony car insurance cards.

Chipped Tooth is Not Fracture, N.J. Court Says

TRENTON, N.J., August 5 – The New Jersey State Supreme Court unanimously ruled that a chipped tooth is not a fracture under New Jerseys no-fault auto insurance law.

Appeals Court: Insurers Not Liable for Katrina Flood Claims

NU ONLINE NEWS SERVICE, August 2 – A federal appeals court ruled insurers are not liable to pay claims resulting from flooding when the levees broke in New Orleans in the aftermath of Hurricane Katrina.

Insurer Gets Stay of Order to Defend Insured While DJ Action is Appealed

Defendant Federal Insurance Company (Federal) moved to stay this courts opinion and judgment which held that Federal was obligated to pay the defense costs of certain claims brought against Tower Automotive, Inc. (Tower) under the Employee Retirement Income Security Act of 1974 (ERISA). The motion was granted.

Record Settlement Resolves Outstanding WTC Issues

When the Twin Towers shook the ground in Lower Manhattan, no one knew that it would take nearly six years to untangle the financial knot created by the confusion over the sites insurance carriers liabilities for the devastation.

Medical Providers Prior Fraud Conviction Does Not Apply to Current Case

In this no-fault benefits suit, defendant insurer moved to renew and reargue a prior order granting summary judgment to plaintiffs. In granting plaintiffs summary judgment, the court had held that they had established, prima facie, that their office manager had personally mailed the pertinent no-fault claim forms to defendant and that defendant had failed to deny plaintiffs claims timely. Defendant raised no objection to plaintiffs prima facie case.

Carriers Still Exposed to Asbestos Liabilities Worth Millions

Two insurance carriers may have to pay additional asbestos-related claims on behalf of their policyholder, despite arguments that coverage limits were exhausted more than a decade ago, according to a May 8 court decision.

Prior Failure to Appear Means Insurer Waives Defense to Coverage and Policy Limits

American Transit Insurance Company failed to make an appearance in two prior petitions by another insurer to stay UM arbitration. Apparently (it is inferred but not specifically stated in this decision), because American Transit defaulted in those petitions, the court there made a ruling that American Transit owed coverage to its insured. The plaintiff here apparently then sued Americans insured and obtained a judgment on default. Plaintiff then brought this proceeding to enforce the judgment against American Transit.

Landowner Not Obligated to Warn Against Dangers on Adjacent Property

This appeal arose out of the collision of an automobile driven by plaintiff Craig Clementoni and a train operated by the Consolidated Rail Corporation (Conrail). The accident occurred at around 6:00 P.M. on September 27, 1994, as plaintiff was driving across a set of railroad tracks at an unmarked grade crossing intersecting a private gravel road owned by defendantsRaymond and Gertrude Skowron in northeast Erie County.

Standard Relaxed for Insurers to Establish Founded Belief

In the first decision of its kind, so far as I have seen, the Appellate Term has relaxed the standard by which no-fault insurers establish their founded belief that a claim is fraudulent.

Brookdale Files RICO Complaint Against HIP

Health Insurance Plan of Greater New York has allegedly defrauded Brookdale University Hospital and Medical Center out of millions of dollars since 2001, according to a lawsuit filed by the hospital April 9.

Claim Excluded Because Homeowner Not Residing at Premises

Tower brought this DJ action seeking a judgment holding that it has no duty to defend or indemnify the insured in an underlying personal injury action which arose out of a trip and fall at 35-36 9th Street, Long Island City.

No-Fault Denials Based on Peer Reviews Need Not Cite Medical Rationale to Be Valid

In a set of three new decisions, the Appellate Division, Second Department, has changed a major factor in no-fault litigation by holding, for the first time, that an insurers denial of benefits (form NF-10) that is based on the findings of a peer review report, need not cite the medical rationale of the peer review in the denial. These three decisions overrule the prevailing case law, which has held that denials are not valid if they do not recite the medical rationale stated by the peer reviewer.

Adjusters Can Sue for Benefits Termination Under RICO

Insureds have the right to bring charges of illegal benefits refusals against carriers under the Racketeer Influenced and Corrupt Organizations Act (RICO) in the State of New Jersey, according to a ruling by the United States District Court for New Jersey.

Earth Movement Exclusion Does Not Apply to Building Cracks Caused by Excavation

Plaintiff moved for summary judgment for an order declaring that the damage sustained to plaintiffs premises was within the scope of coverage of the policy issued by State Farm. State Farm cross-moved for summary judgment.

Lack of Notice Not Sufficient to Vacate Arbitration Award

Clarendon brought this petition to vacate an arbitration award made by Arbitration Forums Inc. Clarendon alleged that its first notice of the arbitration proceeding was a second notice seeking to collect on the award. Further, it alleged that it did not have coverage on the vehicle in which the claimant, Catherine Pedersen, was an occupant at the time of her work-related accident. Instead, alleged Clarendon, a DMV abstract showed that Liberty Mutual insured the subject vehicle on the date of loss.

Court Rules Time Limit for Filing UM Claim Had Not Expired

On May 31, 1998, a vehicle owned and operated by the respondent Melissa M. Rand was involved in a collision with a vehicle owned by Tracy Augustyne. Crystal Laureano was a passenger in Rands vehicle. In two separate letters dated June 10, 1998, the respondents attorney provided notice to Preferred Mutual Insurance Company of their uninsured/underinsured claim under Rands policy. In a letter dated July 7, 1998, Preferred Mutual informed the respondents attorney to forward copies of any legal papers and also instructed the respondents to complete and return Notice of Intention to Make Claim forms. It is undisputed that the respondents never completed and returned these forms, nor did they forward copies of any legal papers.

Showing 25 to 48 of 143 items.
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