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TODAY'S TOP DEVELOPMENTS Monday, July 14, 2014

Industry news, expert analysis, and daily updates on the most significant insurance coverage legal developments—from the insurance and legal experts of The National Underwriter Company.

Commercial General Liability
When "And" Means "Or": Fifth Circuit Interprets "Claim Expense" in Coverage Litigation Stemming from Mold Suit
The U.S. Court of Appeals for the Fifth Circuit has ruled that the word "and" in an insurance policy's definition of the term "claim expense" had to be interpreted in the disjunctive under applicable Texas law, affirming a district court's decision in favor of an insurance carrier on this issue. Read More

Automobile Insurance
No-Fault Arbitration Award Can Include Value of Insured's Household Care and Maintenance Services Even Where They Had Not Been Replaced, Minnesota Appeals Court Rules
An appellate court in Minnesota, affirming a trial court's decision, has ruled that an arbitrator in a no-fault case did not exceed his authority when he awarded no-fault benefits for the reasonable value of the insured's household care and maintenance services even where they had not been replaced. Read More

Health Insurance
Montana Supreme: No Policy Provision Prevented Insured from Receiving Duplicate Payment for Medical Expenses under Separately Purchased, Uncoordinated Insurance Policies
The Montana Supreme Court, reversing a trial court's decision, has ruled that an automobile insurance policy did not prohibit an insured from receiving payment for medical expenses that already had been paid by the insured's separate health insurance policy. Read More

Commercial Property
Insured's Action against Insurer Filed More than Two Years after Tornado Damaged Insured's Properties Is Dismissed as Untimely
A federal district court in Minnesota has ruled that a lawsuit by a property owner against his insurance company that was brought more than two years after his properties had been damaged by a tornado was untimely and had to be dismissed. Read More

View All Case Law Developments

Health Insurance
Health Insurer Settles Charges It Denied Mental Health and Substance Abuse Treatment for Thousands of New Yorkers
New York City-based health insurer EmblemHealth, Inc., has reached a settlement with New York Attorney General Eric T. Schneiderman requiring the health insurer to reform its behavioral health claims review process, cover residential treatment, and charge the lower, primary care co-payment for outpatient visits to mental health and substance abuse treatment providers. Read More

Insurance Fraud
Pennsylvania Insurance Fraud Prevention Authority Appoints New Executive Director
The board of directors of the Pennsylvania Insurance Fraud Prevention Authority ("IFPA") has appointed Thomas A. Donahue III as its next executive director. Read More

View All Legislative/Regulatory Developments
Mark Hamelburg of Epstein Becker Green Named Senior Vice President of Federal Programs at America's Health Insurance Plans Read More

Litigator Tarron Gartner-Ilai Joins Insurance Coverage Boutique Firm Amy Stewart Law Read More

Arch Capital Group Announces Reinsurance Group Promotions Read More

Helvetia and Nationale Suisse to Form a New Swiss Insurance Group Read More

Constance Bayne Appointed President of Liberty Mutual's Mid-Atlantic Business Insurance Operations Read More

View All Industry News
Q & A
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60px_newMeyerowitz Steven A. Meyerowitz, ESQ.
Director, FC&S Legal
[email protected]
60px_newSpears Victoria Prussen Spears, ESQ.
Associate Director, FC&S Legal
[email protected]
FC&S Legal Editorial Advisory Board
Mitchell J. Auslander, Willkie Farr & Gallagher LLP
Carrie Cope, Schuyler, Roche & Crisham, P.C.
Anjali C. Das, Wilson Elser
John F. Finnegan, Chadbourne & Parke LLP
Michele L. Jacobson, Stroock & Stroock & Lavan LLP
Timothy P. Law, Reed Smith LLP
Donald S. Malecki, Malecki, Deimling, Nielander &
Associates, LLC
Cort T. Malone, Anderson Kill & Olick, P.C.
D. Milone, Kelley Drye & Warren LLP
Joseph P. Monteleone, Rivkin Radler LLP
Anne M. Murray, Rivkin Radler LLP
Jerold Oshinsky, Kasowitz, Benson, Torres &
Friedman LLP
Seth B. Schafler, Proskauer Rose LLP
David D. Thamann, The National Underwriter Company

FC&S Daily Legal Report ($1,295 annual subscription) is included as part of your subscription to FC&S Legal: The Insurance Information Center. FC&S Daily Legal Report and The Insurance Coverage Law Report are publications of The National Underwriter Company. For more information, visit To subscribe to FC&S Legal, please contact customer service at 1-800-543-0874 or [email protected].
FC&S Legal: The Insurance Coverage Law Information Center
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