Insured Can’t Claim Damages in Proof of Loss Were “Puffed” Up to Avoid Federal Jurisdiction: Federal Court Deems Damages Demand in Sworn Proof of Loss Submitted to Insurer More Credible than Complaint’s Unsworn Estimate

On October 10, 2018, a Florida federal court ruled that an insured’s precise damages estimate, set out in an exhibit to his complaint against his insurer, of $73,963.19, was less credible than his pre-suit demand in his proof of loss form of $100,709.34. The insured, Roger Ulloa, sued his insurer, Integon National Insurance Company, alleging it failed to fully pay his property damage claim in the wake of Hurricane Irma. Integon removed the case to federal court on the basis
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The ALI’s Recently Adopted “Restatement of the Law of Liability Insurance” Receives Mixed Reviews from Courts and Legislatures

The much-anticipated Restatement of the Law of Liability Insurance (RLLI) was recently approved by the American Law Institute (ALI) during its Annual Meeting in May 2018. Since its adoption, the RLLI has been met with mixed reviews from courts as well as at least one state legislatures. As discussed in previous blogposts, the RLLI is the ALI’s first publication in the field of insurance law and touches upon nearly every legal issue frequently faced by insurance professionals. Prior to its adoption,
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Compliance Deadline Approaching for NY Cybersecurity Regulation

A key compliance date for the NY Cybersecurity Regulation is quickly approaching. September 4, 2018 will serve as the third key implementation date for individuals and companies (Covered Entities) governed by New York’s Cybersecurity Requirements for Financial Services Companies (23 NYCRR Part 500). Unless the Covered Entity qualifies for one of the exemptions under 23 NYCRR 500.19, by September 4, all Covered Entities must have completed the following*: create and maintain systems that can reconstruct material financial transactions to support and maintain
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Sixth Circuit Uses Every Tool in the Box To Build Case for Coverage for Defrauded Policyholder

July 12, 2018, we reported on the Medidata decision handed down by the Second Circuit in which the court found coverage for a claim resulting from social engineering fraud. We suggested the ruling in Medidata lacks persuasive power due to its unusual factual circumstances and atypical policy language. The Sixth Circuit’s decision in American Tooling Center, Inc. v. Travelers Casualty & Surety Co. of America, No. 17-2014, 2018 WL 3404708 (6th Cir. July 13, 2018), will have more persuasive power,
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Second Circuit’s Decision Upholding Social Engineering Fraud Coverage Likely a Paper Tiger

In a case closely monitored by the insurance industry, the Second Circuit upheld in a non-precedential summary order a New York federal district court’s summary judgment finding coverage under the computer fraud coverage of a commercial crime policy. Medidata Solutions, Inc. v. Fed. Ins. Co., No. 17-2492, 2018 WL 3339245 (2d Cir. 2018). Although the policyholders are apt to tout the decision as a seismic victory, the atypical policy language and factual circumstances should greatly limit its persuasive value. As
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The ALI Votes to Approve the “Restatement of the Law of Liability Insurance”

After nearly a decade of debate and controversy, the American Law Institute (ALI) voted to approve the much anticipated Restatement of the Law of Liability Insurance (RLLI) at its annual meeting on Tuesday, May 22, 2018.  The project that ultimately resulted in the RLLI was launched in 2010, under the direction of Reporter Tom Baker of the University of Pennsylvania School of Law and Associate Reporter Kyle D. Logue of Michigan Law School, and produced nearly 30 drafts through the lifecycle of the project, before
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Exceptionally Navigating Abstention: Northern District of Illinois Applies the Colorado River Doctrine to Stay Arbitration

An insurer and a policyholder entered into an agreement, or didn’t they? Either way, the Northern District of Illinois doesn’t have to decide because “exceptional circumstances” triggered the Colorado River abstention doctrine, allowing the court to stay the case asking it to determine whether the agreement existed. A policyholder and one of its insurers began having disputes about who had to provide coverage for certain claims. As a result of those disputes, the policyholder and the insurer allegedly entered into
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Pennsylvania Federal Court Sets Standards for Burden of Proof in Rescission Matter

The ongoing coverage litigation between H.J. Heinz Company and Starr Surplus Lines Insurance Company in the U.S. District Court for the Western District of Pennsylvania has yielded another important decision that is instructive in rescission matters.  As a follow up to our previous report on October 22, 2015 on the court’s order that Starr must produce information from its underwriting files involving other policyholders, the court has now set guidelines for the burden of proof and jury instructions in the
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Pennsylvania Federal Judge Orders an Insurer to Produce Information from Underwriting Files Involving Other Policyholders in a Rescission Dispute

Discovery disputes in insurance coverage litigation frequently concern whether an insurer must produce information about policies issued to other policyholders or other claims against the insurer involving similar policies or circumstances. Policyholders often seek such discovery to compare the insurer’s position in the disputed claim with positions it may have taken in other claims or under other policies. Insurers typically resist such discovery as being irrelevant to issues involving the particular policy or claim at issue in the litigation. A
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NAIC and CSIS Host Cyber Risk Conference

This post first appeared on Goldberg Segalla’s Data Privacy & Security blog. On September 10, 2015, the National Association of Insurance Commissioners (NAIC) and the Center for Strategic and International Studies (CSIS) hosted a conference entitled “Managing Cyber Risk and the Role of Insurance.” Over three hundred individuals attended, including more than 30 insurance regulators, senior representatives from the U.S. Departments of Treasury and Homeland Security, and representatives from the private sector. The primary focus of the conference was to explore
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