October 2010 Case Law Update
Here is a brief summary of some recent insurance-related decisions from October 2010:
Here is a brief summary of some recent insurance-related decisions from October 2010:
When a fire engine plowed through his yard this past August, a homeowner in Spring Hill, Fla. figured he’d hear from the fire rescue district’s insurance company. What surprised him was how rude and arrogant the adjusters were; what he absolutely didn’t expect was that the insurance company would deny the claim, saying the district was under no legal obligation to pay because the damage was not the result of the driver’s negligence.
Florida’s state insurance company is the target of a class action suit filed last week. The suit, filed on behalf of 1.2 million Citizens Property Insurance Company policyholders, alleges that the insurer awarded 33 no-bid contracts improperly over the past six years. Citizens was founded to provide insurance to property owners, both private and commercial, who could not find insurance elsewhere.
Both the federal government and the State of Michigan filed suit this week against Blue Cross & Blue Shield of Michigan, alleging that the insurer’s “most favored nation” clauses with hospitals violate the Sherman Antitrust Act and the Michigan Antitrust Reform Act. The Justice Department did not indicate if there are plans either to investigate or to take legal action against health plans in other states; the outcome of the suit, however, will likely affect how the Blues and other health insurance companies contract with hospitals throughout the nation.
This is the last of a series of three posts about a wealthy woman, her death, her companion, her family, and a $15 million life insurance policy. The policy listed the beneficiary as the woman’s companion, who was the last to see the woman alive. The companion claims the policy was taken out to protect his business, explaining that the woman was his partner in the venture. The insurance company argues that no one is entitled to the proceeds of the policy, because it was purchased fraudulently as a “stranger-originated” policy. The family has also entered the fray.
In our last post, we started to examine the intricacies and mystery surrounding a life insurance dispute. The insured, a woman of considerable wealth, died under unusual circumstances. While the death was ruled accidental, her daughter and the rest of the family were unconvinced. When a $15 million life insurance policy turned up, essentially naming the deceased’s companion and purported business partner as sole beneficiary, both the family and the insurance company became suspicious. Now, the companion, the insurance company and the family are all involved in a legal action to determine who is entitled to the $15 million.
In 2008, the mother-in-law of a well-known business executive was found dead in her bathtub. She was fully clothed, high heels still on her feet. It was just the beginning of a mystery her family is trying to unwind — a mystery that involves a business associate cum social companion and a $15 million life insurance policy.
In our last post, we talked about the law changes affecting insurance discounts for hurricane-proofed homes throughout Florida. Initially, following the devastating 2005 hurricane season, the Legislature required double discounts for hurricane mitigation efforts in order to minimize both the damage to homes and the claims cost to insurance companies. The rationale for many of this year’s laws was to protect customers and their insurers from financial harm as well as to protect the health and safety of customers. Critics and homeowners are wondering if in practice the emphasis was more on insurers than on customers.
In the wake of Hurricane Wilma, Florida lawmakers required homeowners insurance companies to double the discounts allowed for hurricane-safe structures for the next plan year. The primary goal was to encourage homeowners to make improvements to their property in order to minimize damage from future storms. Insurers figured the discounts granted would cost less than paying billions of dollars in hurricane claims.
Florida residents affected by Hurricane Wilma have until October 24 to file claims related to the storm. Hurricane Wilma was the fourth Category 5 hurricane of the 2005 season. What Katrina started that year, Wilma finished off. In Florida, more than 1 million insurance claims resulted in insurance payouts of over $9 billion. Total damage from Wilma was estimated at $29.1 billion.