Insurer Requirement of Evidence of Functional Limitations Reasonable in Determining Applicability of Self-Reported Symptoms Limitation The United States Court of Appeals for the First Circuit, applying federal law, affirmed the district court’s grant of summary judgment to the insurer Unum Life Insurance Company of America (“Unum”), finding that its application of a plan’s self-reported symptoms (“SRS”) benefit limitation when faced... Read More

Negligence Claims Remain in State Court Despite Nursing Homes’ Defense Based on Federal PREP Act The United States Court of Appeals for the Third Circuit, applying federal law, affirmed the district court’s dismissal of negligence and wrongful-death claims for lack of subject-matter jurisdiction, remanding the cases back to state court. The negligence and wrongful death complaints stemmed from the deaths... Read More

SOL Tolled Until Discovery Due to Broker Misrepresentations The Illinois Appellate Court for the First District, in an opinion written by Justice Walker, applying Illinois law, reversed the trial court’s dismissal of an insured’s, 2837-55 Irving Park, LLC (“Irving Park”), complaint as untimely, holding instead that Irving Park’s complaint adequately stated facts bringing it within the time allowed by the... Read More

Settlement Payments for Allegations of Fraud Insurable under Excess Policy The United States District Court for the Northern District of Illinois, in an opinion written by Judge Valderrama, applying Illinois law, granted the insureds’, Astellas US Holding, Inc. and Astellas US Pharma, Inc. (collectively “Astellas”), motion for summary judgment against their excess insurer, Federal Insurance Company (“Federal”), holding that Federal... Read More

The United States District Court for the Eastern District of Wisconsin, applying Wisconsin law, dismissed the insured Eaton Corporation’s (“Eaton”) claim for declaratory judgment against three high-level excess insurers for lack of jurisdiction, holding that Eaton’s claims were not ripe, and thus, did not present a justiciable controversy. The three insurers—Independent Specialty Insurance Company, Fireman’s Fund Insurance Company, and Travelers... Read More

Recording and Distribution of Material or Information Exclusion Applies to IL BIPA Violations The United States District Court for the Middle District of North Carolina, applying North Carolina law, granted the insurers’ motion for judgment on the pleadings, holding that the insurers had no duty to defend the insured against alleged violations of the Illinois Biometric Information Privacy Act (BIPA)... Read More

State Employee Health Plan Waived Sovereign Immunity The United States Court of Appeals for the Fourth Circuit, applying federal law, denied a motion to dismiss from the defendant North Carolina State Health Plan for Teachers and State Employees (NCSHP), holding instead that NCSHP waived its state sovereign immunity by accepting federal financial assistance. As a result, the plaintiffs, who are... Read More

Internal Coverage Evaluations Not Protected Work-Product The United States District Court for the Southern District of Illinois, applying both Illinois and federal law, granted the insured’s motion to compel, which sought the production of documents, including internal coverage evaluations, found on the insurer’s privilege log and the inclusion of more detailed descriptions for other entries on the privilege log. The... Read More

Defense Duty Triggered by Allegations of Potential Vicarious Liability The United States Court of Appeals for the Seventh Circuit, in an opinion written by Judge Hamilton and joined by Judge Scudder, applying Illinois law, affirmed the district court’s grant of summary judgment for the additional insured Prate Roofing & Installations, LLC (“Prate”), holding that insurer United Fire & Casualty Company... Read More

Sexual Misconduct Exclusion Applies to School District Settlement The United States Court of Appeals for the Seventh Circuit, in an opinion by Judge Easterbrook, applying Illinois law, held that a policy exclusion for sexual misconduct barred coverage of liability against a school district, thus reversing a ruling by the district court. The district court had found that the exclusion was... Read More