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Property Coverage - Consumer Fraud Act
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No Consumer Fraud Act Claim against Insurer for Failure to Pay
Insurance Proceeds
v. Franklin Mut. Ins. Co., 2014 N.J.
Super. . LEXIS 910 (App. . Apr. 23, 2014)
In this consolidated appeal, the New Jersey Appellate Division
affirmed a trial court's dismissal of the policyholders' claims against
their insurers under the Consumer Fraud Act for failure to pay a
first-party property claim. The policyholders claimed their well was
damaged by lightning and needed to be replaced. The insurer retained
an expert who opined that the damage to the was caused by
pressure exerted by ground and surface water rather than by lightning and,
as a result, declined to pay costs incurred in repairing and replacing the . In the
ensuing coverage action, the Appellate Division found the insurer could not
be held liable under the Consumer Fraud Act for simply refusing to pay
benefits it did not believe were warranted.
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Standard Flood Insurance Policy Applied
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Non-Owned Debris Removal Not Covered under Standard
Flood Insurance Policy Unless Debris Located In or On Insured Dwelling
Torre v. Liberty Mut. Fire Ins. Co., 2014 U.S. Dist.
LEXIS 57133 (D.N.J. Apr. 24, 2014)
Policyholders sought coverage under their standard flood
insurance policy for the removal of debris that had collected outside their
shore home after Hurricane Sandy. The District Court applied the policy to
find that the policy did not cover costs associated with removing non-owned
debris because that debris was not in or on the insured dwelling itself.
Policyholders owned a home at the New Jersey shore that was
damaged by Hurricane Sandy. They filed a claim under their standard flood
insurance policy in relation to damage to the covered dwelling. The
policyholders later pursued a supplemental claim for indemnification for
the cost associated with removing debris that had collected outside the
exterior perimeter walls of their dwelling.
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Auto Coverage - Statutory Minimum
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Insurer Disclaimed under Applicable Rider Yet Still Required
to Cover Up to Statutory Minimum
v. Am. Millennium Ins. Co., 2014 N.J.
Super. . LEXIS 1131 (App. . . 2014)
A passenger in an ambulance was injured when she fell out of
her wheelchair during the ride. The passenger sued the ambulance owner, who
sought coverage from two insurers. One insurer disclaimed because the
ambulance driver had not been "listed" in accordance with a
policy rider. The Appellate Division panel acknowledged the , but
nevertheless found for equitable reasons that the insurer owed coverage up
to the statutory coverage minimum for ambulances.
Both of the ambulance owner's insurers sought to avoid
providing coverage in relation to the accident. The first insisted that no
coverage was available pursuant to an auto exclusion clause. The second
admitted it owed coverage under a $35,000 vehicle-related insurance policy;
but it disclaimed in relation to a second vehicle-related policy that
covered the difference between the $35,000 policy and the $500,000
statutory minimum for ambulances.
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Occurrence / Construction Defects
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Policy Amendment of the Definition of
"Occurrence" Did Not Expand the Definition to Include Faulty
Workmanship
National Union Fire Ins. Co. Pittsburgh, PA v Turner Constr. Co.,
2014 N.Y. App. . LEXIS 3546 (N.Y. App. . 1st
15, 2014)
applying New Jersey law finds that a
policy's definition of "occurrence" that includes "accident,
event or happening" does not provide coverage for of faulty
workmanship against the insured.
The insurer sought a declaration that
it was not obligated to defend and indemnify its insured in a lawsuit in
New Jersey arising out of allegations of defects in the design and
installation of a pipe rail system in a commercial building. The
insured was the general contractor who subcontracted the design and
building of an exterior wall, which included a pipe rail system.
After the installation, a segment of the pipe rail system fell to the
street from the eighth floor of the building. An outside consultant hired
by the building's owner determined that the installation did not conform to
the building plans.
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Priority of Coverage - Professional Liability
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Court Finds General Liability Policy
is Excess to Professional Liability Policy Based on Other Insurance
Provision
WCHCC (Berm.) Ltd. v. Granite State
Ins. Co., 2014 U.S. App. LEXIS 8383 (2d Cir. N.Y. May 5, 2014)
finds professional liability policy
does not explicitly provide its position in a priority of coverage analysis
with respect to other excess policies.
An insurer
who issued a professional liability policy to a nurse brought a declaratory
judgment action against the general liability insurer of a medical center
seeking a declaration that the general liability insurer was the primary
carrier and solely responsible for a settlement entered into by the
insured. First, the court recognized the policies at issue reflect
two types of excess policies under
Mut. Cas. Co. v. Allstate Ins. Co.: (1) those that purport to be
excess over other sources of insurance; and (2) those that purport to be
excess and delineate the interplay with other excess policies.
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