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  • UPMC Benefit Mgmt. Serv., Inc. v. United Pharmacy Serv.

    Publication Date: 2023-01-02
    Practice Area: Insurance Law
    Industry: Health Care | Insurance
    Court: Commonwealth Court
    Judge: Judge Cannon
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 558 C.D. 2021

    Hearing officer properly found pharmacy's fee review applications were not premature because petitioner was obligated to dispute liability for claimant's treatment through the utilization process in order to render pharmacy's fee applications premature. Affirmed.

  • Chubb Indem. Ins. Co. v. Rosenberg

    Publication Date: 2023-01-02
    Practice Area: Insurance Law
    Industry: Insurance
    Court: U.S. District Court for Pennsylvania - Western
    Judge: District Judge Horan
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 2:22-CV-00633-MJH

    Court granted insurers declaratory judgment absolving them from defense and indemnification obligations under umbrella liability policy where insureds failed to contest action. Plaintiffs' motions for default judgment and judgment on the pleadings granted.

  • Loughery v. Mid-Century Ins. Co.

    Publication Date: 2023-01-02
    Practice Area: Insurance Law
    Industry: Insurance
    Court: U.S. District Court for Pennsylvania - Western
    Judge: District Judge Hardy
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 19-383

    Both parties moved for summary judgment on plaintiff's claim for statutory bad faith alleging defendant insurer requested an independent medical examination without obtaining a court order and without good cause and court found plaintiff did not show defendant acted unreasonably and in bad faith in failing to pay because there was a split of opinion in the courts as to the validity of the IME clause and defendant's interpretation was in accordance with the interpretation of law expressed by some of those courts. Plaintiff's motion den

  • Snider v. State Farm Fire & Cas. Co.

    Publication Date: 2022-12-26
    Practice Area: Insurance Law
    Industry: Insurance
    Court: U.S. District Court for Pennsylvania - Eastern
    Judge: District Judge Goldberg
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 21-4224

    Defendant moved to dismiss plaintiff's bad faith denial of insurance coverage action after a water supply line broke and damaged house and court found plaintiff's allegation that defendant relied on an unreasonable interpretation of the policy and a blatant misrepresentation of facts to deny coverage could provide a factfinder with a sufficient basis to infer defendant lacked a reasonable basis for denying benefits. Motion denied.

  • Ungarean v. CNA & Valley Forge Ins. Co.

    Publication Date: 2022-12-19
    Practice Area: Insurance Law
    Industry: Health Care | Insurance
    Court: Superior Court
    Judge: Judge Panella
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 490 WDA 2021

    Trial court properly granted summary judgment to plaintiff in action for insurance coverage for loss of business income due to COVID-19 under policy's business income and extra expense provisions and court agreed with trial court's interpretation of "direct physical loss of or damage to" to include the act of being deprived of the physical use of one's property. Affirmed.

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    District of Columbia Legal Malpractice Law 2024

    Authors: Shari L. Klevens, Alanna G. Clair

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  • MacMiles, LLC v. Erie Ins. Exch.

    Publication Date: 2022-12-19
    Practice Area: Insurance Law
    Industry: Hospitality and Lodging | Insurance
    Court: Superior Court
    Judge: Judge Stabile
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 1100 WDA 2021

    Trial court erred in finding plaintiff established a valid claim for COVID-19 related income loss under the business income provisions of the policy because trial court's reading of "direct physical loss of or damage to Covered Property" to cover purely economic losses was strained and unconvincing and trial court erred in finding a triable issue of fact under the civil authority provision of the policy. Reversed.

  • Nat'l Fire & Marine Ins. Co. v. Genesis Healthcare, Inc.

    Publication Date: 2022-12-12
    Practice Area: Insurance Law
    Industry: Health Care | Insurance
    Court: U.S. District Court for Pennsylvania - Eastern
    Judge: District Judge Kearney
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 221410

    Various lawsuits arising from COVID-19 infections in nursing homes constituted separate healthcare events under corporate liability insurance policy, where each suit concerned the actions or inaction of the operating subsidiary company and alleged different circumstances leading to the resident's infection. Plaintiff's motion for judgment as a matter of law granted, defendant's motion for judgment as a matter of law denied.

  • Atain Ins. Co. v. V2 Properties, LLC

    Publication Date: 2022-12-05
    Practice Area: Insurance Law
    Industry: Construction | Insurance | Real Estate
    Court: U.S. District Court for Pennsylvania - Eastern
    Judge: District Judge Padova
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 22-288

    While defendant's policy excluded coverage for injuries suffered by workers on plaintiff's job site, the scant record raised a genuine issue regarding whether the policy should be reformed to reflect the insured's reasonable expectation that it would be covered for bodily injuries to workers who were not direct employees. The court denied plaintiff's motion for judgment on the pleadings.

  • Woloszyn v. Nationwide Prop. & Cas. Ins. Co.

    Publication Date: 2022-11-21
    Practice Area: Insurance Law
    Industry: Insurance
    Court: Courts of Common Pleas, Lawrence County
    Judge: Judge Hodge
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 10246 of 2022, C.A.

    Court denied defendant insurance company's motion to dismiss plaintiff's bad faith insurance claim. Defendant argued that they were not obligated to provide coverage because plaintiff's previous policy contained a provision reducing coverage which had transferred to her new policy. The court disagreed, holding that 75 Pa.C.S.A. §1731 requires that insurance companies receive a signed resignation of underinsured/uninsured motor vehicle coverage and defendant's argument that the old coverage limits transferred must fail.

  • Deal v. Nationwide Prop. & Cas. Ins. Co.

    Publication Date: 2022-11-14
    Practice Area: Insurance Law
    Industry: Insurance
    Court: U.S. District Court for Pennsylvania - Western
    Judge: District Judge Horan
    Attorneys: For plaintiff:
    for defendant:
    Case Number: 2:22-CV-01269-MJH

    Section 1716 of the Motor Vehicle Financial Responsibility Law did not apply to UM benefits, as there were no "hybrid" benefits since the MVFRL was organized into subchapters, each of which dealt with a specific type of auto insurance benefits, and §1716 was not in the subchapter addressing UM benefits. Defendant's partial motion to dismiss granted in part and denied in part.