Conflict of Interest Insufficient to Warrant De Novo Review, Denial of Benefits Upheld

Hobson v. Metropolitan Life Ins. Co.

(2nd Cir., July 29, 2009)

 

The Second Circuit rejected plaintiff’s argument that a de novo review was warranted given the administrator’s structural conflict of interest.  In the wake of MetLife v. Glenn, the court acknowledge that a conflict is created by an administrator’s ability to both determine eligibility and pay benefits, but found there was no evidence suggesting the administrator’s decision was influenced by the conflict and, therefore, afforded it no weight. 

 

Under

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Deception and Estoppel Preclude Insurer’s Claim for Deductible Reimbursement After Class Action Settlement

American National Fire Insurance Company v. York County (1st Circuit (Me) August 5, 2009)

The insured, York County, was sued in a class action for its strip search policy. ANFIC covered a period during which these claims arose. The ANFIC policy had a $5,000 per occurence deductible, which ANFIC maintained applied to each claim. ANFIC previously reserved its rights on this issue. ANFIC after protracted negotiations agreed to participate in a class settlement where it contributed $750,000. The record indicates that under any calculation (with the deductible

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Eight Circuit Allows General Contractor’s First-Party Property and Bad Faith Claims to Proceed Against Hyatt’s Insurers

Weitz Company, LLC v. Lloyd’s of London

(8th Cir. (Iowa) Aug. 4, 2009)

Hyatt retained the plaintiff firm to act as general contractor to build a luxury retirement community in Florida. Severe rains caused extensive water damage to the work site in June 2002. The contractor immediately took steps to repair the damage and, in November 2002, notified Hyatt representatives that it wished to submit a claim to their commercial property insurers, which covered all of Hyatt’s real and personal property. Hyatt notified its

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SECOND CIRCUIT HOLDS THAT WORLD TRADE CENTER COVERAGE DISPUTE IS RIPE

SR International Business Insurance v. Port Authority el al

(2nd Circuit, July 28, 2009)

 

In the ongoing coverage litigation relating to the World Trade Center tragedy, SR International Business Insurance Co., Ltd. v. Allianz Insurance Company,   the Second Circuit, applying New York law, held that a dispute between the insurer and the insured regarding priority of recovery for World Trade Center losses was ripe for adjudication.  The insured claimed that the matter was un-ripe because, among other things, it was

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UK High Court Rejects “Joint and Several Liability” Doctrine in the Reinsurance Context

LEXINGTON INSURANCE CO. V. AGF INSURANCE LIMITED ET AL  [2009] UKHL 40 (July 30, 2009)

 

The central issue before the United Kingdom’s High Court in this action is whether a reinsurer is responsible for the full amount of the cedent’s costs associated with a court ordered environmental clean-up under the theory of “joint and several liability.”  The pollution cited to in the underlying action occurred over several decades, but the reinsurance contract covered only a portion of that timeframe.    

In

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Court Of Appeals Affirmed Dismissal Of Policyholders’ Class Action Breach Of Contract Claims Against Insurer

Harden and Chambers v. State Farm Mutual Automobile Ins. Co.

(United States Court of Appeals, Eleventh Circuit, July 22, 2009)

 

Policyholders appealed from the dismissal of their class action breach of contract suit against insurer and for certification of a question of law to the Georgia Supreme Court to determine whether Georgia law prohibits the insurer from asserting set-offs in the payment of uninsured motorist personal injury claims.  Specifically, the policyholders argued that their failure to meet the condition precedent imposed by Ga.

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Cases Cited in Goldberg Segalla’s Reinsurance Review – August 2009 Edition

Eighth Circuit Decision - Download Donaldson.v.Burroughs 

Third Circuit Decision - Download Nationwide.v.George.V.Hamilton

Eastern District of Pennsylvania Decision- Download United.National.Ins.Co.v.Aon

Southern District of New York Decisions - Download AIU.v.TIG; Download In.the.Matter.of.the.Petition.of Insurance Company.of.North.America

Middle District of Georgia Decisions - Download International.Fidelity.v.BMC

United Kingdom Decisions –Download Lexington v agf lexington; Download Doronch.v.Westminster

Recent Filing of Interest – Download McGrath.v.American Re-Insurance

For more information, please contact Jeffrey Kingsley at [email protected]

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Port Authority Ordered to Reimburse Con Ed and Insurers $17.6M for September 11th Damage

In re September 11 Litigation Consolidated Edison Co. of N.Y., Inc. v. Port Auth. of N.Y. & N.J. (S.D.N.Y. July 27, 2009)

 A federal judge has ordered the Port Authority of New York and New Jersey to pay $17.6 million to Consolidated Edison and its insurers for property damage sustained during the September 11th attacks on the World Trade Center. In 1968, Con Ed and the Port Authority entered into a lease and electrical supply agreement wherein the Port Authority granted Con Ed

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